OCD and Excessive Reassurance Seeking

Providing Excessive Reassurance Only Makes the Problem Worse

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One of the things that family and friends of people affected by obsessive-compulsive disorder (OCD) find to be the most stressful in dealing with their loved one is the excessive reassurance seeking that can often accompany OCD

What is Excessive Reassurance Seeking?

Excessive reassurance seeking involves checking in with a family member, friend or even a stranger over and over again to make sure everything is okay with respect to a particular worry or obsession.

Excessive reassurance seeking often goes up when levels of distress are high and/or when the person feels unable to tolerate uncertainty. Let's look at few examples.

Example 1:

Jane experiences obsessions related to hitting someone while driving her car and not realizing it. When driving in her car, she asks her husband to look in the rear view mirror over and over again to make sure that she has not run over someone without realizing it. Although annoyed, her husband does not want her to feel anxious, so he looks in the mirror when asked and tells her everything is okay.

Example 2:

Rahim has sexual obsessions related to raping a stranger. Even though Rahim finds these thoughts distressing and does not want to have them, he is convinced these thoughts mean that he is a molester. He is constantly asking his brother whether he is a molester and whether he has ever seen him molest someone. His brother refuses to discuss the issue which causes Rahim to become very distressed.

Example 3:

Donna is extremely worried that she will contract a sexually transmitted disease from doorknobs in public places. After washing her hands, she will often ask a friend, or even a stranger if her anxiety is high enough, whether her hands look clean or whether she should be worried about contracting an illness.

Even if they tell her that she shouldn't be worried, she asks a number of "but what if" questions until she feels completely confident that her hands are clean. Friends and family now avoid going with her to public places because of her behavior.

Example 4:

Zhang has obsessions related to his spouse dying in an accident. He will often call her many times a day at work to make sure she is alive and will sometimes become angry if he is unable to speak with her. His wife's coworkers have started to become concerned about the number of times he calls her at work and she is worried about the impact of this behavior on her career.

Why is Excessive Reassurance Seeking Harmful?

  • It's a type of compulsion. Excessive reassurance seeking is an act that is carried out over and over again in hopes of reducing the anxiety associated with an obsession.
  • It gives the obsession validation. Every time someone with OCD engages in a compulsion, it serves to reinforce the validity of the worry or obsession. After all, why seek reassurance if there is nothing to worry about?
  • It promotes avoidance. It also reinforces the idea that the person cannot cope with the uncertainty or distress associated with an obsession and that avoidance is the only way to deal with it. Avoidance is particularly harmful in the case of OCD as it keeps the person from discovering that their fears may be unfounded. In this way, although excessive reassurance makes the person feel better in the short-term, in the long-term it only serves to perpetuate the symptoms of OCD.
  • It's harmful to relationships. In addition, friends and family members, who are often vital sources of social support, become annoyed and withdraw from the affected person, which only serves to raise their stress levels. Of course, stress is a major trigger of OCD symptoms and needs to be managed effectively.

What is the Best Way to Deal with Excessive Reassurance Seeking?

  • Understand that it's basically a compulsion that needs to be reduced or eliminated. This can often be done very effectively in family meetings that are facilitated by a mental health care provider or OCD therapist.
  • Agree to stop. In the context of OCD treatment, patients, family and friends alike must agree that the asking for/providing of excessive reassurance needs to stop. This can be difficult as family members often want nothing more than for their loved one to feel less anxious, so they will often provide the requested reassurance. However, once family members realize that excessive reassurance seeking is a form of compulsion, many are able to stop.
  • Target the main issues. It is often helpful for patients and family members to identify a number of issues where the person excessively seeks reassurance and to then write down the reassurance response, such as "your hands are clean and disease-free" on a cue card that the patient can carry with them. Whenever the patient is concerned, it is agreed that they will pull out the cue card and read the response rather than directly asking the family member or friend. While this still represents a compulsion, it reduces distress within the family and improves relationships with others.

With respect to reducing the reassurance seeking itself, one of the most effective strategies can be to teach your loved one with OCD strategies for dealing with uncertainty.

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