“You’ve checked the door five times now, and you’re going to make us late!”
“I’ve told you repeatedly that I’m not angry, but now I am actually getting angry because you won’t stop asking me if I am angry!”
“No, I will not rewash your clothes just because the laundry basket was set on the floor.”
“Why can’t you just stop checking?”
These sorts of statements are not uncommon in homes where someone with OCD resides.
You just don’t understand why your loved one ritualizes, repetitively asks for assurance, can’t leave the house without checking the locks or the stove over and over, or “overreacts” to situations that seem so insignificant. You try to assure them that things are ok. For a brief moment, it helps, but soon your loved one’s questions, fears, and compulsions return. You find yourself frustrated because the OCD intrusions are taking over, and family functioning is thwarted.
First: Help your loved one find appropriate treatment from a licensed professional counselor (LPC), psychologist, or licensed social worker (LCSW) who specializes in OCD. OCD requires specific therapeutic interventions that go beyond mere “talk therapy.” Qualified therapists can be found through the International OCD Foundation (IOCDF) website, as well as other places. When you interview possible therapists, make certain that they use Exposure and Response Prevention and/or Inferential Cognitive Behavioral Therapy (I-CBT).
Second: Educate yourself on the realities of what OCD is and what it is not.
OCD is known as “the doubting disease.” Your loved one doubts their safety, what they know about themselves and the world around them, and what they experience in their senses. Your loved one’s torment of mind and body is real, and it can be debilitating. The intrusive thoughts can be unrelenting; danger feels like it's around every corner.
Through thought-action-fusion, the OCD mind takes an “ordinary” passing thought and turns it into what feels like an actual possibility. For example, someone sees a knife on the kitchen table and is triggered by the thought, “What if I could kill my boyfriend?” This thought sets off the body's alarm system, triggering emotions and bodily sensations as if the thinker could possibly commit murder. In this very paranoid state, your loved one struggles with trusting what they know about themselves. They might even doubt their own memory.
Compulsion then ensues, holding out the promise to the OCD sufferer of relief from their fear, for example, that they could commit murder or even might have already done so. Compulsions can take the form of excessive reassurance-seeking, rituals, mental rumination regarding where they have been or what they have done, research, washing, counting, or other various behaviors.
These cycles of obsessing and compulsing present a horrific experience for the sufferer and a confusing ordeal for those who love them.
OCD is a very lonely disorder, as others simply cannot grasp what their loved one’s “problem” is. Your ability to understand will help lead you to compassion and will reduce your frustration. Your loved one is already distressed, and your frustration, although understandable, will exasperate their feelings of isolation. To educate yourself subscribe to this blog, as new information is published regularly. Further recommended reading would be Jonathan Grayson’s book Freedom from Obsessive Compulsive Disorder.
Third: Do not accommodate your loved one’s compulsions. Although it’s difficult not to, do not give assurance. Appropriate responses to such behavior need to be kind but not reassuring. For example, if your loved one asks over and over, “Are you mad at me?” an appropriate response would be, “I will not be answering that question,” or “Maybe, maybe not.” Your loved one doubts what they know, and your reassurance will keep them spiraling.
The only way to stop the cycle of OCD questioning is for your loved one to sit with the uncomfortable feelings and not compulse.
Do not do anything that will allow your loved one to avoid triggers.
For example, if they are afraid of germs, do not open the door for them so that they don’t have to touch the knob. Don’t offer hand sanitizer. Don’t change your routines or schedules to accommodate their anxiety. It’s okay for them to leave the house feeling like things are “not right.”
It will be painful for you to watch them suffer, but if you step in, the OCD brain will never learn that it doesn’t need to set off the alarms. Supportive statements such as “You can do this” and “I see you are struggling” can be helpful.
Fourth: Be supportive. Create space for open dialogue for your loved ones to speak about their “weird” thoughts and feelings. Don’t react to what they might say. Support the plans for Exposure and Response Prevention that were created between the therapist and your loved one. Ask your loved one what might be helpful for them. Don’t correct or coach them. Recognize that overcoming OCD may not be a short or easy process, and adjust your expectations. Recovery from OCD is “simple,” but it’s not easy. Your responses can either help or hinder the recovery process. Trust me, your loved one is suffering more than you could possibly know. Their freedom depends on doing “the hard thing.” Exposure and Response Prevention is the gold standard treatment for OCD, and when applied consistently and appropriately, it works. It really does.
For further understanding of what it's like to have OCD, watch this intriguing testimony from Ethan Smith about his journey through the recovery process.