Field of Science

Olfactory Reference Syndrome: My attempt at self diagnosis

When one is in their first relationship, mistakes are made. There are certain unspoken rules that a novice can accidentally break. Forgetting to hold the door open, laughing at the wrong moment, or believing them when they say "I don't want a Valentines day gift". I had watched many colleagues fall foul of these errors, and vowed to not make these errors with my first girlfriend. I was young, naive and almost certainly scared.
You see, my first girlfriend had several burly, older brothers, which as you may imagine, raised the stakes somewhat.
So the situation is thus. After a day at her place, her mother kindly decided to drop me off at the station so that I could go home. Of course my girlfriend decided to ride along, because it was the decent thing to do. 
 A perfectly innocent situation, the only risk being the necessarily stilted conversation with the mother. Keep to short sentences. The less words said, the less chance of causing offence.
But then the worst thing that could possibly happen in an enclosed space with both my girlfriend and her mother. But soon, there was something else in the room. It announced it's presence in the most subtle of ways. It was barely audible.
The sound of a zipper being pulled very slowly. As it got louder, it's pitch deepened. Soon, we were regaled with the wet baritone creak of a troubled colon. I didn't, and still don't understand how such a small girl could have created such a noise. I may have been able to keep my composure, if I hadn't had to cope with the humid stench that enveloped the car.
"Did you just fart ?!" I exclaimed.
"No" she responded, with an angelic expression.
"I'm pretty sure...." 
" No, I think that was you" With absolute conviction.
At this point , my subconscious began to ring alarm bells. I was about to get into an argument in front of her mother. If I came across as too confrontational, her mother would probably assume that I was a wife beater, and I would have to go to prison, where I would get the stuffing kicked out of me by the aforementioned brothers.*
Just by giving into the juvenile impulse of naming and shaming those who loudly produce gas, I had stumbled into minefield. 
What could I do? I could simply keep telling the truth and call her a liar. I could accuse her mother, who was also another person in the car who didn't fart. Only one other option remained.
"oh, err, my mistake" were the words that I probably mumbled. Perhaps this was another one of those unwritten chivalric rules that are alluded to but never mentioned. Maybe all men take responsibility for whatever untoward smells that emanate from their partners. Unless there's a dog present .Then blame the heck out of it**. Dogs don't care. 
Or maybe I actually did emit the horrible fart. That would make far more sense*. Perhaps in it's eternal plots against me, my rectum finally devised a way to sneak odours past me without my knowledge. Worst of all, it had learned to throw it's voice. This one incident may have triggered a disorder knonw formally as "Olfactory Reference Syndrome".
This disorder has been recognised in psychiatry under a number of different names since the 1890's, and a recent systematic review set out to examine this as a disease in it's own right.
They set out three diagnostic criteria:

1) The belief that one emits a malodourous smell ("it does not have to be delusional")
2) This belief causes clinically significant distress
3) This is not a manifestation of another disorder, and that this was a unique condition in it's own right.

So they scoured the literature, and found 180 reported examples of this disorder between the years of 1890, to 2009. Of these, only 82 cases were suitable for analysis. Of these, the majority of the victims were male, and the median age of onset was 15.
Often, this disorder would be triggered by a precipitating event, such as the one I described above. So perhaps this psychological trait could explain why I spent the rest of my teenage years doused in aftershave.
On the basis of this trawl through the literature, the authors suggest that this should be recognised as it's own disorder. However, It should be noted that a large proportion of the cases excluded from this study were done so because the delusional odour manifested as a part of different psychiatric disease.
But here is the thing. Whilst I may have gotten slightly paranoid over this event, it never got to the point where it caused significant distress. The "significant cause of distress" in my life dumped me soon after this event. Whilst I woried about it, it never spilled over into the kind of pathology seen in real sufferers from this disease. People who genuinely smell odours that are not there, people who end up obseesively trying to manage odours that aren't present. In some cases, it ended up getting to the point where their doctors had to prescribe medical treatments to get them to stop.
My technique of occasionally dousing myself in aftershave before meeting people seems tame by comparison. Like many psychological traits, this syndrome can manifest at many levels of severity, and only a relatively small portion of people express it severely enough to actually qualify as sufferers. My case was easy enough to get over. I now have a huge collection of aftershave that I no longer use. Although people still keep giving them to me at birthdays, Christmas, Easter, Thanksgivng, and Ohmygodgetyourarmpitoutofmypostcode day.

* this was what passed for logical thinking when I was a teenager.
** For a long time I suspected this was the real reason rich girls carry dogs around in handbags.

Begum M, & McKenna PJ (2011). Olfactory reference syndrome: a systematic review of the world literature. Psychological medicine, 41 (3), 453-61 PMID: 20529415

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