President-elect Donald Trump, during a news conference in New York City on Wednesday, vehemently denied the salacious and unverified allegations put forth in a 35-page dossier published by BuzzFeed News. Behind a podium in the lobby of Trump Tower, the president-elect professed an awareness that the hotel rooms he visits overseas may be bugged with tiny cameras. And responding to a personal section of the unsubstantiated report, Trump added, "I'm also very much of a germaphobe, by the way, believe me." (The audience, according to the transcript of the news conference, laughed.)
Trump is keen to avoid microbes, particularly those transmitted via touch. He is not alone in the world of celebrities and politicians, some of whom have been labelled germaphobes of varying degrees. Toward the end of his life, billionaire Howard Hughes holed himself in dark hotel rooms to dodge perceived germ threats. Television host Howie Mandel, who has spoken about struggling with germ fears, handles his anxiety with a far less extreme method: Mandel rarely shakes hands, preferring the fist bump.
But legion are the palms a president must grip. In June, Barack Obama half-joked that George W. Bush's most sage advice was to always use hand sanitiser. The New Yorker once estimated that a president pumps about 65,000 hands over the course of a year. Trump, for his part, has called shaking hands a "barbaric" practice, fearing the flu and "all sorts of things."
Accusations of barbarism aside, it is true that handshakes spread bacteria. A 2014 report in the American Journal of Infection Control recommended the fist bump as an alternative to the handshake. The high five, a team of British biologists found, transferred half the microorganisms of a shake. A bump or dap greeting will pass on even smaller amounts of bacteria.
But where, exactly, does a healthy fear of sickness become presidential-level germaphobia?
"It's a very interesting question," said psychology professor Michael Kyrios, when asked to describe the line between germaphobia and appropriately zealous hygiene. Kyrios, an expert on obsessive-compulsive disorder at the Australian National University in Canberra and a past president of the Australian Psychological Society, told The Washington Post by phone early Thursday morning that true germaphobia is "most commonly associated with OCD," particularly when behaviours to avoid contamination "interfere with someone's work, social life or studies."
Broadly speaking - Kyrios made it clear that the way any one person presents a psychological disorder was unique - germaphobes have two reactions to microbes. First, they may be obsessed with biological threats and have intrusive thoughts of contamination. These can go beyond physical sickness, the psychologist said, to the point a person worries about moral deficiencies as a reaction to a taint.
Second, several germaphobes develop what Kyrios called neutralising responses. He offered examples by way of celebrity habits he has observed: "Quite often you will see people in the spotlight put their hands behind their backs, or in their pocket. Or refuse to shake hands altogether."
Neurologist William A. Hammond first described what he called mysophobia on April 7, 1879. In a speech to the New York Neurological Society, he said the phobia was "characterised by a morbid, overpowering fear of defilement or contamination."
The physician based the concept upon his observations of 10 subjects, several of whom were "constantly washing the hands in order to remove taints" after coming in contact with certain objects. One woman, upon reading a newspaper account of a man who contracted smallpox after handling bank notes, proceeded to clean her own hands. Then she washed out the drawer where she stored her money, the dress she was wearing at the time and her hands again. She began to fear shaking hands with other people. "Nothing would persuade me to do so, unless I had gloves on at the time," she told Hammond.
Germaphobia is particularly prevalent among people who have had a specific issue with germs in the past, Kyrios told The Post. Common triggers include shaking hands, touching doorknobs or handling money. He has seen patients go to great lengths to avoid contamination. One of his clients had her house to be built with three interior sections: Upon returning home from the supermarket, she would wash her food in the entrance. In the next-innermost section, she would wash her food again. Only after washing her food in a third time, in the innermost sanctum, would she eat.
As for Trump's self-avowed germaphobia, he reportedly will not press a ground-floor elevator button on the principle it is the most frequently touched. And in his third book, 1997's "Art of the Comeback," Trump elaborated on handshakes: "One of the curses of American society is the simple act of shaking hands, and the more successful and famous one becomes the worse this terrible custom seems to get," he wrote. "I happen to be a clean hands freak. I feel much better after I thoroughly wash my hands, which I do as much as possible."
(His reluctance to shake hands briefly became a target of opportunity for Jeb Bush during the GOP primary campaign, as The Washington Post reported in September 2015, with the Bush team mocking the "candidate who is a germaphobe when it comes to shaking hands.")
There are perfectly rational arguments to be made for washing hands, such as after using the bathroom or before eating. But problems arise, Kyrios said, when a person takes sanitation too far. There can be an "obsession with germaphobia," he said, that leads to damaging consequences. "We see asthma and allergies and a whole range of other effects on children," the psychologist pointed out, referring to concepts sometimes called the hygiene or "old friends" hypotheses. Humans living in too-clean environments (or having fallen out of touch with old friends, meaning microbes), so the theories go, may end up with an underdeveloped immune system - in turn leading to severe allergic reactions or immune disorders later in life.
Kyrios told The Post that cognitive behavioural therapy, including exposure to a trigger, can benefit people with OCD who have germophobic symptoms. A recent area of Kyrios's research suggests that online therapy can be more effective than medication. The goal is to promote alternative, rational beliefs, Kyrios said. "Ultimately, we like to help people become their own psychologists."
Trump, after all, does not shy away from every form of touch, even with strangers. "I'd kiss babies, well, kissing babies isn't so bad," Trump told Dateline NBC reporter Stone Phillips in 1999 about a then-hypothetical presidential run. "I'd much rather do that than shake hands."
With apologies to the future germaphobe in chief, kissing is far from bug-free. Ten-second smooches exchange millions of bacteria, as saliva-swappers may be aware, but even avuncular pecks transfer bacteria by the thousands.