i think these compulsions are a little like addictions... they hold back true spiritual progress.... patterns of unwanted repetitive behaviour, having a seemingly crucial internal link (much on the idea of religious / God pleasing) and a tormenting feeling or anxiety only being relieved by the driven behaviour which itself is ultimately unsatisfying. i have heard of people being caught between two opposite viewpoints and being tormented by the contrariness the pair present... i.e. not good enough/holier than thou, drunk or sinner/saint, free/bound, perfectionist/spontaneous, rejection/rebellion or as you mentioned dirty/clean... the perceptual data received under anxiety seems slanted to support the reality of these views but often will not stand up under interrogation. One method used is to identify the authority of the compulsive views and to challenge its basis from the perspective of Biblical truth. More common in a humanist society.... it seems to gain strength by the denial of absolute life values i.e. the view that there are not absolutes of right & wrong and that we make our own reality becomes a torment if (a) there is no God to help and (b)God (believed to be the self) is unsure of what to do next. The link makes interesting reading. Hypnotherapy would definitely complicate the sufferers issues. My perspective, for what it's worth (a lot, I believe) is that the truth will set you free!... but not all truth is God's truth... Bible Study has helped a lot of people with this problem. Thanks for posting.