When casually asked as to what must lie behind such a compulsion to wash hands, he replied, "People touch door knobs, gas pumps, grocery carts, and the thought that I must have touched the same objects after them makes me feel so dirty. I have never liked feeling dirty. That I may be taking my hand that has touched these dirty things, loaded with germs, to my face and mouth, makes me feel so yucky.
"I bite my nails, so it is important that I don't bring those germs inside my mouth."
The last statement made me pay special attention to what he was saying. For we know behind germ phobia lies fear of contamination which is basically a fear of sexual contact. Ultimately the phobia of touching is dread of sexual contact.
And I wondered whether in this young man's case the fear of germs coming in to contact with his mouth and face was not fear of inadvertently submitting himself to passive oral homosexual submission which his ego revolts at and demands that such a repugnant thought must be undone by washing his hands over and over again.