Ruth Langely was 30 years old when she sought help from a therapist after experiencing long-standing fears of contamination. She stated that she became intensely uncomfortable with any dirt on herself or in her immediate environment. After noticing any dirt, she felt compelled to carry out elaborate and time-consuming cleaning procedures. This usually involved thoroughly washing her hands and arms. Moreover, if she found dirt in her apartment, she was compelled to scrub her apartment methodically, in addition to showering in a very regimented manner. Her cleaning rituals have severely restricted her life. She now washes her hands at least four or five times an hour, showers six or seven times a day, and thoroughly cleans her apartment at least twice a day.