What is the ruling on one afflicted with severe obsessive-compulsive disorder (OCD) regarding purification (istinja') and prayer, who also suffers from urinary incontinence and the emission of prostatic fluid (madhy)? How does he purify himself if he intentionally looks at his private parts and feels pleasure, and is he exempted from accountability?

You must repent to Allah for the blasphemy you have committed. You should fend off these whispers (waswas) and not give in to them. When you relieve yourself, suffice by pouring water over the place of impurity until you are reasonably certain it has been removed. Do not repeat istinja (definition)' unless you are absolutely certain that urine has exited. If you suffer from سلس ( سلس البول: incontinence), perform ablution for prayer after its time has begun, and pray as much as you wish with that ablution until the time expires. If you are greatly distressed, there is no harm in acting upon the view of the Malikis, which states that it is not obligatory to remove impurities that exit involuntarily if they exit at least once every day. A person suffering from whispers (waswas) may adopt the easiest of scholarly opinions.