4 Ways to Help a Loved One with OCD

Avoiding Common Pitfalls

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When a loved one is in distress, it is normal to want to do whatever one can to help them feel better. Unfortunately, when a loved one is struggling with obsessive-compulsive disorder (OCD), the ways in which one might typically help someone in distress can be counterproductive to OCD treatment and recovery.

Below are 4 tips to avoid falling into the trap of helping a loved one’s OCD, but rather to help your loved one overcome OCD and remind yourself of how to best provide them with support.

1.Resist the urge to provide reassurance. For example, one might reassure someone who checks to ensure security that the front door is locked, or, tell someone who is concerned about contamination that they will not get sick, if they touch something they perceive as laden with germs.

OCD is a disorder of uncertainty. It thrives on creating doubt in the minds of those who struggle with it. Providing reassurance, whether it is being actively sought (via compulsive reassurance-seeking) or not, serves as a means to decrease anxiety and satisfy, to some degree, OCD’s need to gain certainty.  Learning to live with uncertainty is a goal in successfully overcoming OCD; thus, providing reassurance for a loved one with OCD not only helps to reduce their immediate distress but, moreover, it serves to maintain their need for reassurance in order to feel better in the long-term.

2.Resist the urge to engage in rituals. It is not uncommon for an individual with OCD to ask loved ones or others around them to accommodate their OCD by asking them to follow OCD’s rules.

For example, someone who is concerned about flooding the bathroom by mistakenly leaving the faucet on may ask a loved one to check the sink to make sure the water is off. Or, someone who’s OCD demands “just right” behavior, may ask that a loved one do or say something in a particular way or sequence.

 

Following OCD’s demands, whether as carried out by the individual struggling with OCD, or, by someone else who has OCD demands placed upon them, serves to reinforce the obsessive-compulsive behavior and perpetuate the impact of the disorder.

3.Resist the urge to avoid. For example, avoiding public restrooms with someone who struggles with toileting/washing rituals, or avoiding eating in public with those who have compulsions that revolve around eating may contribute to the continuation of these difficulties.

Not only does avoidance send a message that these situations need to be avoided, but it also does not afford the person an opportunity to work through the anxiety.  Although avoiding situations, objects, or other potential triggers of a loved one’s OCD may help the day or given activity proceed more smoothly and without difficulty, avoidance can serve to unintentionally teach the individual that that which is being avoided is threatening in some way and worthy of being avoided. Thus, it creates an increased misperception of danger, likely increasing associated anxiety, need for avoidance, and/or need for ritualization to neutralize or decrease the distress when confronted with this trigger.

4.Resist the urge to adapt to the OCD. Changing what would be considered typical behaviors or activities in favor of rigid routines or other preferences required by OCD should be avoided. For example, following a rigid and unnecessary routine as laid out by a loved one’s OCD, changing one’s own plans or routines, or tolerating the abnormal behaviors and preferences of a loved one’s OCD in order to avoid upsetting the individual is also unhelpful.

Conceding to the rigidity of OCD strengthens the individual’s perception of how something must be done in order for them to feel okay and/or ensure safety and/or certainty.

Accommodating OCD is counterproductive. Although it may seem as though accommodating OCD in these ways will quickly and easily decrease a loved one’s distress - providing comfort and support, treating OCD in this way serves to reinforce the misperceived danger and perpetuate the obsessive-compulsive cycle.

Let a loved one know that you care and that because you care, you cannot help the OCD. Remind them that even though something may be distressing, it is okay to feel that distress. When asked for reassurance, let then know you will not reassure the OCD or reinforce the notion of uncertainty or the possibility of something unexpected or unlikely happening. Remind them that no matter how anxious they feel or how strong their OCD urges seem, they ultimately are in control of their choices. 

Recommended Reading

Amir, N., Freshman, M., Foa, E.B. Family distress, and involvement in relatives of obsessive–compulsive disorder patients. Journal of Anxiety Disorders. 2000;14:209–217.

Peris, T.S., Bergman, R.L., Langley, A., Chang, S., McCracken, J.T., Piacentini, J. Correlates of accommodation in pediatric obsessive–compulsive disorder: parent, child, and family characteristics. Journal of the American Academy of Child and Adolescent Psychiatry. 2008;47:1–9.

Storch, E.A., Geffken, G.R., Merlo, L.J., Jacob, M.L., Murphy, T.K., Goodman, W.K., Larson, M.J., Fernandez, M., Grabill, K. Family accommodation in pediatric obsessive–compulsive disorder. Journal of Clinical Child and Adolescent Psychology. 2007;36:207–216.

Van Noppen, B. & Pato, M. 2014. Living with Someone who has OCD. IOCDF.  https://iocdf.org/expert-opinions/expert-opinion-family-guidelines/

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