What is ORS?
Olfactory reference syndrome (ORS) is characterized by excessive worry that one is emitting a foul or offensive body odor, although this odor is not perceived by others. For example, individuals who suffer from ORS may be preoccupied with “bad breath” or a fear that they smell like sweat, garbage, or rotting fish, but others tell them that they smell fine.
Patients often experience significant distress and anxiety related to ORS, and may feel a sense of responsibility for the perceived odor. In an effort to hide or fix the odor, individuals often engage in time-consuming behaviors, such as repetitive showering, frequent changing of clothing, or excessive use of sprays/perfumes to mask the odor. Persons with ORS often avoid public and social situations due to anxiety about the odor. Though limited, research to date suggests that cognitive behavioral therapy (CBT) may be helpful for individuals suffering with ORS.
Treatment for ORS
CBT for ORS is designed to reduce the obsessive thoughts, negative feelings (e.g., embarrassment, shame, anxiety) and behaviors associated with one’s perceived odor, and to address the, often associated with ORS. CBT for ORS helps patients to learn to step back from and to challenge their negative thoughts and beliefs. Individuals learn to repeatedly approach anxiety-provoking situations (exposure) while refraining from compulsions (response prevention). Exposures are done at a pace that the individual is comfortable with, and a patient is never forced to do anything that they are not willing to do. By confronting anxiety-provoking situations, the patient has a chance to learn that their anxiety and distress will go down, and that feared consequences will not occur, even if they don’t complete rituals. ERP helps patients to significantly reduce time spent performing compulsions (e.g., sniffing, changing clothing, excessive grooming or cleansing, masking one’s odor with other scents) and to re-engage with the people, places, and activities they value. Because little is known about this disorder, we are committed to developing a better understanding of the factors leading to, symptoms of, and treatment for, ORS. We hope to address diagnostic questions and treatment needs, and to eventually improve the quality of care for people who suffer from perceived body odor concerns.
For more general information regarding treatment, please read our Treatment Approaches page on our website.
How our program can help:
Our program specializes in evidence-based treatment for ORS. For more information, please contact our intake coordinator at 617-726-6766.