Imagine you're living inside a bathroom for more than two years. And that the confinement is self-imposed.
Sound implausible? That's the reality of a 27-year-old man who shared his experiences with 48 Hours.
48 Hours provides a rare view into obsessive-compulsive disorder with a profile of David. Once he studied philosophy in college; he dropped out two years ago when his fears overtook him.
A Cell of His Own Choosing: David confines himself to one room, his parents' bathroom. Why? He fears he'll contaminate others. His parents feed him flattened food that can slide under the door. His parents wrestle with how to best help him.
It seems unimaginable but David has been living in his parents' bathroom now for more than two years.
What has taken over David's life is a severe case of obsessive compulsive disorder that causes such anxiety that he is paralyzed by his fears.
"What concerns me is that I will spread contamination," David said.
Correspondent Erin Moriarty has kept a close watch on his life, providing a rare view into the world of obsessive compulsive disorders.
"It's unbelievable how much power this thing has over his mind," said David's mother Jackie.
"I think it's getting harder and harder to get out the longer he's in," Jackie said.
David, who is 27 years old, has been battling OCD since childhood.
"When the first really noticeable symptoms started, he was 8," Jackie recalled. "That was when he first started washing his hands; he'(d) wash for 15 minutes at a time. "
While in college in the fall of 1998, David's fear of contaminating others became so overwhelming that he retreated inside his parents' bathroom. "This is the worst it's ever been," he said then. "I'm sort of in my Howard Hughes phase right now."
48 Hours first met David shortly afterward and gave him a special camera so he could describe his world, one of exhausting rules and rituals, including showers that go on for hours.
He scrubbed the floor, saying, "This is about the seventh time I've done this today."
"I don't have any room in the trash basket so I use the second sink," he said.
And why the 12-hour showers? "I wash myself very very thoroughly," he said.
The cleansing process could last for days, even weeks.
And he had to follow certain rules before he could open the door of the bathroom, he said.
And who set the rules?
"I suppose I do, a part of me does anyway," he said.
David missed appointments and spent two birthdays and three Christmases alone.
But if David was trapped behind that door so were his parents on the other side of it.
"People keep saying, 'I don't know how you do it.' You do what you have to do," said his mother Jackie.
David's mother - a tutor - and his father Paul - a college librarian - had to find creative ways to feed a son who, for months at a time, refused to open his door even a crack.
"It's interesting walking througthe grocery store trying to figure out what kind of food is flat enough to go through a half inch space. You get creative," Jackie said.
"You could have a unique cookbook, the only under-the-door cookbook," Paul said in a light-hearted moment.
But don't let the humor fool you; this life was taking its toll.
"I go out and go to work and leave David behind so I get a feel for being more normal, but I am frustrated by continually having to talk to him through the door, have him not let us touch him," Jackie said.
David found ways to pass the time. "Mostly I read the books I get under the door," he said.
And if the phone, books and everything else were removed from the bathroom?
"He'd still be there, if he felt he had to," Jackie said. "This was an attempt to distract him from the fear."
One distraction was playing chess with his father with a board made out of a Styrofoam plate.
"He is so bright, and has so much talent. And he's not being able to ue it," Paul said. "That's tough; I know it's painful for him."
By all accounts, David had been a brilliant philosophy student who planned to get a doctorate.
"It looks like there's no end to this," Jackie said. "When I think about the whole picture, what he could be doing and should be doing if this weren't affecting him, that's when I want to sit down and cry."
Jackie needs all the strength she can muster because as David watches the seasons change outside his bathroom window, he is sinking in despair.
"You have to change your clothes and take a shower," David insisted in one interchange as his mother said, "I was three rooms away from you; I wasn't even around the corner."
"I don't feel like I have any dignity anymore," David said. "I'm locked in a bathroom. If I die tomorrow, it wouldn't make any difference because I haven't gotten anything done."
"The longer I'm in here...the harder it's getting," David recorded in a video diary he has been keeping for two years. "It's so frustrating...that sometimes you become extraordinarily angry."
"We have not found a health care professional in this town who understands OCD and can do behavior therapy," Paul said.
Unable to find help close to home, David's parents turned to Dr. Michael Jenike, a psychiatrist who four years ago started country's first inpatient OCD facility near Boston. He hoped to treat David there once he left the bathroom.
For the first time in a long time they felt hope. "Dr. Jenike...as far as I'm concerned...has been our lifeline to sanity," said Jackie.
Jenike uses email and the telphone to provide free advice long distance to David's parents.
"People with OCD, it's almost pure suffering. It's one of the most intense, painful experiences the patients describe. Much worse than physical pain," Dr. Jenike said.
He's obviously not a conventional therapist; weekly basketball games with his patients are just part of his approach.
"If doctors d things that are a little weird that they don't expect,...that helps make an alliance with them," Dr. Jenike said.
Dr. Jenike does use traditional counseling sessions and anti-depressant medications.
But what seems to work best for his patients is something called exposure therapy, where they are forced to deal directly with their fears.
"When I touch money, I feel very dirty so I have to wash my hands for at least 15 minutes," said Patricia, who fears she is being contaminated by money. Under the rules of exposure therapy, not only is she not allowed to wash her hands after touching money; she's surrounded by it.
"It's actually torture," Patricia explained. "I feel very anxious at this moment, just looking at the money on my bed."
"These patients are actually courageous," Dr. Jenike explained. "It (is) like us having to stand on the edge of the Empire State Building with our eyes closed and having a doctor say, 'Trust me, this'll make you feel better.'"
What makes treating his patients so challenging, says Dr. Jenike, is that no one in the medical community really knows what causes OCD. Severe cases, such as David's, are often misdiagnosed and misunderstood.
"These are real illnesses that are biologic. Just because we don't understand the illness doesn't mean we should slander the patient," Dr. Jenike said. "To me, all of these disorders, involve the brain."
"I don't think it's a disorder of, you know, toilet training or the way you're raised, or stress, or so forth. I think that those things can really intertwine with it...but I think there's an underlying brain problem of some kind," he noted.
The best research suggests that in people with OCD, there is some kind of "misfiring" in the front part of the brain, the part of the mind that controls planning and judgment and gives healthy people confidence in their decisions. Because of that misfiring, David who's convinced he's contaminated, can't be reassured, no matter ow much you try to reason with him.
Because David isn't a threat to himself or others, Dr. Jenike can't force him to get help, but he says it wouldn't work anyway.
Why can't he just pull him out of the bathroom? "Even though it's logical, I just don't know of any cases where it worked," the doctor explained.
Still, Dr. Jenike believes David will get out of the bathroom for treatment because he has seen progress in an even worse case.
A Giant Step Forward: Sometimes progress is measured in small increments. In David's case, it's a question of whether he'll open the bathroom door.
Jackie actually heard it before she saw it.
"He announced his presence in the hall by playing the doorbell chimes," Jackie said.
Whether it was the medication he had been taking or simply sheer will, David began taking a few steps out of the bathroom. He took a camera with him.
A simple walk down the hallway into the family den was a terrifying trip.
"Here's the big thng which is making me really nervous right now and I'm not very happy about it," he said.
What has been the hardest part for his family?
"Waiting," said his mother Jackie. "And not knowing how long; I figure this is a test of endurance on everybody's part."
What's the incentive for David to leave the bathroom if he's getting food when he wants it, if he has parents that do whatever he wants?
"The incentive (for) David is to get a life. I mean, that's not a very satisfactory life for a fellow who has really, apparently a genius IQ," said Dr. Jenike.
"Even if you have a job that you hate, you still have income from it, and you can still better your life in some way. But there's really no benefit whatsoever to just doing mindless, repetitive, painful cleaning rituals," David said.
"He realizes himself he needs help. He told me the other night, 'I know I can't get better on my own,'" his mother Jackie said.
David's parents believed Dr. Jenike's Boston area institute was just what David needs. But first he would have to leave the bathroom.
In August 1999, almost a year after he first went into the bathroom, David finally agreed to meet the cameras of 48 Hours.
But he had rules.
"Whoever gets to see him has to take a shower and change your clothes afterward," his mother Jackie explained.
David feared that just his opening the door will contaminate others.
He asked people to wait in the bedroom, behind a closed door, while he went out in the hallway to pick up some clothes.
After waiting and negotiating for several hours, David stepped out to meet Correspondent Erin Moriarty and invited her into the bathroom.
"So there you are! How does it feel?" she asked.
"I'm kind of nervous. This is where I live," he said.
"Can I walk in? Do you mind?" she asked.
"No, that's OK," he said.
"So this is actually your home," Moriarty said.
"That's my abode; and also my commode, ha ha," he joked.
"David, it is so great to see you. Honestly, you look wonderful!" Moriarty said.
For a young man who hadn't been outside a room in almost a year, David did look good.
But after Moriarty spent some time with him, it became obvious how small his world had become.
"Sometimes I worry that the air from the bathroom will go out and contaminate the people outside," he said.
Determined to get used to being around other people, David agreed to move into his family's den for a sit-down interview but only after making sure the door was shut.
"I've got this thing about closing a door," he explained. "I'm afraid I didn't close it all the way somehow."
"I'm still not real comfortable being in this room yet," he said.
"I'm nervous! I'm feeling very, very, very anxious," he admitted.
David knows that his fears are groundless but that doesn't reduce the anxiety.
"Initially, I felt like I had to be in the bathroom to be safe,...to keep from contaminatnother things," he said.
"I don't think I'm contaminated," Moriarty replied.
"Well, I define contamination so you don't get to choose," David said. "Contamination is an invention of...a sort of malfunctioning part of my brain. So you don't get to say you're not contaminated."
"When you left me a message on my voice mail saying I'm out in the hallway and I'm nervous, what did that feel like? What were you feeling?" Moriarty asked.
"I felt like I was going throw up," he revealed. "I couldn't stop shaking."
For David, this is a giant leap. "I had this picture of...Neil Armstrong in my head," he said.
"This'll be a big plus for him," said his mother.
But is he ready to go to Boston for more help?
A Doctor Makes A House Call: Miles away in the Boston area, Dr. Michael Jenike runs the country's first in-house treatment facility for obsessive-compulsive disorders. If David can't go outside to come to him, Dr. Jenike opts to visit.
As 48 Hours followed David's struggle with OCD over the past two years, it has seemed that for every step forward he takes there are two steps back. With a camera from 48 Hours, David has been documenting his ups and downs.
Correspondent Erin Moriarty gives an up-close account of his progress.
"I don't think I can open the door right now. I don't think I can open it," David said.
Alone in a tiny 5 foot-by-10 foot room David turned to despair.
"I'm tired of trying," he said. "It hasn't been easy. And what have I gotten out of it? I haven't gotten anything."
"If I died tomorrow, it wouldn't make any difference, 'cause I haven't gotten anything done."
He has been so despondent at times he has cut his own arms.
"I asked him why he did it, and he said he feels he needs to be punished," said his mother Jackie.
"It provides sort of a release in a way," said David.
Jackie was afraid he would take the cutting too far so she spent many sleepless nights outside his door.
"It seems like the time and energy and food and shelter and everything would have been better spent on somebody else," David said.
Trying to boost up his spirits, to keep him from hurting himself, Jackie said she has times when she almost loses it. "One time he just said to me, 'Why don't you just let me go?' And I told him, never!"
"You have got to admit you have stuck to it; you have kept trying," Jackie said.
"I haven't gotten anything done in the last five years," David said. "I'm not getting anywhere."
"I've tried to tell him that everybody's going to have problems in their life. As far as I can tell, he's just having his a lot earlier," Jackie said.
Jackie and her husband Paul have spent years since David's childhood trying to get him the proper help.
"All through elementary school and middle school we were getting poor suggestions from professionals that were...harmful," Paul recalled.
"Like if he misbehaved, put him face down on the flor and sit on him until he calmed down," Jackie said.
"If he had gotten help when he was young, it would never become this severe," Paul said.
It was almost two months since David first stepped out of the bathroom to speak to 48 Hours. And since then he had only managed to venture out a few more times.
When Dr. Jenike travelled 800 miles from his office near Boston to make a house call. There was no guarantee that he would even get to meet David face to face.
"Is David apprehensive about our visit?" Dr. Jenike asked.
"Oh yes, he's all kinds of things. He's got a whole list of things he was worried about this morning," said Jackie.
"Well, this is the famous door, huh? I've only seen it on film," Dr. Jenike greeted his patient.
"Do you want me to try to go into the den, 'cause that's not going to be an instantaneous thing; it'll take some time," David said.
"How long will it take?" the doctor asked.
"I don't know," David said.
"A coupl of years?" asked the doctor.
"Hopefully less than that," said David.
"No, I'm not going to change clothes and take a shower. Why not? Because I think it's up to you to violate one or two of your rules. And since I'm here, maybe I can help you deal with the anxiety that comes up. And maybe we can make this a learning thing that might help you get out of there," Dr. Jenike said.
Dr. Jenike tried everything from tough love ("Does some of this seem a little absurd to you, David?") to humor:
"I will take a shower," said the doctor. "I'll walk out of here with your father and your mother's clothes on."
"If you can be a little light-hearted with them, joke around with them," he said, "that can take some of the pressure off."
After several hours his approach paid off. David met him in the den.
"Well, master David, how are you doing? Dr. Jenike asked.
OK. I thought you were going to be wearing a tie," said David.
"You did, huh! You thought I was a real doctor!" joked Jenike.
"What do you see yourself doing the next few years?" asked Dr. Jenike.
"I'd like to be a philosophy professor," David said.
"To get better, you're going to have to take some chances; does that make sense?" Dr. Jenike asked.
"You don't mean like better with a capital B. You just mean improved, right?" David asked.
"Well, moving toward where you want to go," Dr. Jenike said.
After their session, Moriarty spoke with Dr. Jenike.
"How long could David end up living in that bathroom?" Moriarty asked.
"Without treatment and us intervening, he could live in that bathroom for the rest of his life," said Dr. Jenike.
Can he turn around his life for good?
Now as David begins his third year living in a bathroom, there are signs this could be the last year.
"It's not easy for him to come out but he is working at it, and he seems determined to do it and to stay out as long as he can," Jackie said.
Not only is David spnding more time outside the bathroom. He's actually been outside his house.
"Do you want to go to the video store?" asked David. "It's nice to be able to rent some of the movies that I would have liked to have seen when I wasn't able to go out," he said.
But no matter how hard David tries, he can't shake the fear that he is contaminating others.
Until David is willing to face his fears at a place like Dr. Jenike's OCD Institute, he might not get the help he needs.
"It's sort of like a boxer going into a fight. If you're not ready to go into the fight, you just can't do it. You can't fake it. And he's not quite ready to go into the fight," said Dr. Jenike.
There is no cure yet for OCD but the small victories that some have over this debilitating disorder are what keep hope alive for others.
"I believe that there's a purpose to all this. And I really believe that David has a future," Jackie said. "I know he's going to do something special."
"It doesn't really matter if your life is perfectly normal or not," David observed.
"The dreams and aspirations and things that you really want are something that when you strive for them," David said.
"You don't feel like it's pointless, that you can actually, if you work hard enough, achieve them, perhaps. And that's all anybody really wants, I think, is a chance to accomplish what they want."
Not Clean Enough: Helena is obsessed with her own fear: that others are dirty. That is why she shuns her elderly mother. Can Dr. Jenike's clinic help her?
Forty-two-year-old Helena from Northern California has an obsessive fear of contamination.
She washed her hands about 80 times a day, she said.
"It's a very embarrassing thing. You can't hide it very well," she said.
While Helena has never been trapped inside her home for months at a time, her irrational fears are disruptive, she said. She agreed to get treatment at the OCD Institute 3,000 miles away from her homehusband and daughter because in her case obsessive-compulsive disorder is keeping her from her own mother.
Six weeks after Helena traveled to Dr. Jenike's OCD Institute outside Boston for treatment, Correspondent Erin Moriarity caught up with her.
"I came here because I have a 3-year-old daughter and she needs Mommy to get normal," Helena explained.
"My mom is contaminated. I don't see her that often," said Helena. "She's elderly and she wears diapers. And I just have a real hard time with that."
Helena wasn't able to even see her mother for months.
"That's one of the big reasons why I'm here. Because I want to get well so she can come to my house, and I don't have to worry about it. I don't want my daughter to not know her grandparents," Helena explained.
But getting over her fears meant Helena had to go through some agonizing exposure therapy. Her assignment was to spend the day doing exactly what she feared the most: touching things she believed were contamiated. The first stop: a grocery store.
Right away it was tough. "This is really gross," she remarked.
"Whatever people have handled the most is the scariest," she said.
Harder still was touching but not being allowed to wash her hands.
"To not wash right away is really the worst thing," Helena said. "Because I don't get the relief. I have to sit with it."
"There's a concept called habituation," said Dr. Jenike. "When you first expose someone to something they're afraid of, they're very anxious and terrified. If you stay in that scary situation long enough, that terror and fear decreases and you habituate."
"I'm going to use the restroom, and I won't wash my hands," Helena said.
It turned out to be too tough for Helena. She rinsed her hands quickly, she revealed.
Feeling more and more confident, Helena took on an even bigger challenge: the sticky, grimy, germ-filled subway.
"It's a public place that's very dingy and disgusting down there," Helena said.
She even forced herself to shake the hand of a stranger.
After returning to the institute, Helena had to take her really dirty hands and touch everything she owned. "After a while you touch them a couple of times, they won't be so scary; they're kind of neutralized," she said.
"It's really sticky. Ewww, yuck, yuck yuck....It's all over my hair now," Helena said.
"I can smell the metal of the subway station railing. Oh, it's everywhere now," she added.
After six weeks of therapy like this at the institute, Helena was ready to face the dirty world back home.
"I have my good days and my bad days. I had a great start when I first got here," she said.
"It's a day-to-day thing for us," said her husband Mike. "It's exhausting. It consumes every minute of your day."
Early on there was a minor crisis: Helena was with her husband Mike when young Kylie opened up a box of old toys.
The mother became frozen with anxiety, convinced her daughter was now contaminated.
"She's putting it around her neck and in her hair," said Helena about a toy.
Still the anxiety was less than it used to be: She was finally able to touch her daughter.
Having come this far, Helena wanted to go see her mother but she was still not quite ready.
"She's gotten old. She's not the person she used to be. And that just makes her feel dirty to me," Helena said.
With help from Dr. Paul Munford, her local therapist, she slowly worked on reducing her anxiety: She touched a shirt of her mother's over and over again.
"I just want to keep strong and to apply what I've learned and try to not let it bother me. It shouldn't bother me. She's my mother," Helena said.
It took the fear of losing her ailing mother to finally convince Helena to fight her obsessive-compulsive disorder.
For months her obsession with germs kept her from even seeing her mother; she couldn't bear to touch her.
Finally Helena took a major stp latlast year.
"I haven't seen you in a long time," she told her mother.
"I know. How are you doing?" her mother greeted her.
"Miss me?" her mother asked.
"Always, always miss you," said Helena, who gave her mother a hug.
Though she may not be completely cured, for one moment Helena was able to overcome her fears.
Trapped In A Basement: Another one of Dr. Jenike's patients struggled with a need to confine himself - until he had a breakthrough. Find out how Ed Zine wrestled with his obsession to stay in the cellar.
Overwhelmed by obsessions, Ed Zine spent nearly two years trapped in his basement, compulsively repeating movements over and over.
Dr. Michael Jenike first saw Ed Zine in May 1996. "His suffering was transparent. You could almost feel his suffering," Dr. Jenike recalled.
Here's how Zine described his ritual: "If part of my hands touched, that's a ritual within a ritual within walking," he said.
"And then if I accidentally bumped into the fish tank and touched that, then I'd have to touch that and do the compulsions," Zine continued.
"I'd have to undo that, because everything is reversed, undo that to undo this, to just get back to walking," Zine explained.
To walk from one spot in the room to another took him seven and half to 10 hours, he recalled.
Dr. Jenike described how the counting worked for Zine: "The obsession produces anxiety. And the counting is a way to lessen the anxiety. And to keep a person safe...in a way, it's like mental Valium.
"It's your body creating this, to survive," Zine said.
Dr. Jenike prescribed anti-obsessional drugs for Zine but he stopped taking them.
Then one day out of the blue, Zine left the basement. "I worked and understood my mind; I broke it down," he said.
Today Zine still struggles with OCD but he's married, has a new baby and is trying hard to live a normal life. He's now writing a book about his illness.
"If you look at where he was, with persistent suffering, that was all his life was, to where he is now,...I think that he really is a major success," Dr. Jenike said.
How did Zine get out of the basement?
"He can't tell me. He really can't tell me. If he could tell me, then I could apply that to other patients. And maybe we could short-circuit things with David and other people," said Dr. Jenike.
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