You, Me, and OCD
So, “your person” has Obsessive Compulsive Disorder. Depending on what stage of recovery your partner is in, you might be feeling helpless, frustrated, saddened, or alone. Not only has your best friend and bae/hunny/shmoopie/(insert pet name here) been distracted by this third party of obsessions and compulsions, but you have also seen and heard things from them that are hard to forget.
Take, for instance, the wife who physically removes her husband from the shower because he has spent 80 minutes compulsively washing himself. Or the new father who is overwhelmed by the typical responsibilities of caring for a newborn PLUS caring for his partner who is suffering from intrusive thoughts about harming their baby. Instances like these are scarring for the OCD fighter and their loved ones, alike.
There may be times when you notice a look on your partners face in the midst of an OCD spike when it seems they are somewhere else entirely. On some far away battlefield, they are being swarmed by intrusive thoughts and fighting off inappropriate images—but it’s not far away. It’s in your home. At your dinner table. In your bed. OCD can be like a third party in your relationship: “I want to go to the show Hun, but OCD needs me to stay home.”
What Is Happening?
Think of anxiety as an alarm system. The alarm is there to get our attention. If an intruder is trying to break into our house, the alarm goes off and inspires action in us. But what if the alarm system went off when rain hit the roof or a breeze lightly rattled the window? Without knowing it is a breeze, our body would respond to that alarm the same way it would if there were an actual threat.
Having OCD is like having faulty wiring in this alarm system. The system is in place to protect, but faulty wiring may cause a person to respond to a harmless stimulus as if it were a terrifying and catastrophic threat. For that person, it is hard not to take the signal seriously and spring into action.
Compulsive behaviors are the OCD fighter’s attempts to “spring into action” by keep himself/herself safe. Compulsions may be external behaviors (i.e. hand washing, skin picking, counting, asking others for reassurance), or internal behaviors (i.e. never-ending thought loops, self-reassurance). The obsession increases one’s anxiety, and the compulsion decreases anxiety (even if just for a short period). That is why it is so difficult for some fighters to let go of their compulsions – the ritual or compulsion is the only short term relief that they know. Exposure and Response Prevention therapy aims to stop that cycle and introduce new ways of coping with distress.
How Can You Help?
There is a term used in ERP therapy called “accommodation,” which sounds nice but this is something that you, as the support team, want to avoid. When you accommodate your loved one’s OCD symptoms, you prevent them from facing their fear and stand in the way of their recovery. To help break the cycle, here are some Do’s and Don’ts:
Do not refrain from saying or doing things out of fear of triggering your partner
Instead, do what you need to and say how you feel while encouraging your partner to build tolerance for distress. You won’t be doing them any favors by sheltering them from reality and it is up to the OCD sufferer to work through these triggers with their therapist.
Do not encourage your partner to engage in rituals because it makes them feel better.
Instead, let them know you feel for them in this moment and encourage them to push through the discomfort — “I know this is hard, but you can do it! You are stronger than you think.”
Do not allow your partner to avoid things that they feel too anxious about.
Instead, remind them about the importance of living based on their values, not fears. Provide them with support so that they feel empowered to do hard things.
Do not provide reassurance: “Yes, you turned the stove off,” “Touching the door knob will not give you HIV,” “No, we did not hit someone with the car.”
Instead, try to give vague or ambiguous answers, “Maybe,” “I’m not sure,” or “We’ll see.” You can also explain to your partner, “This sounds like you are asking for reassurance, and I’m sorry I can’t give you any.”
Do not significantly modify your family’s routine due to your loved one’s OCD.
Instead, build a routine based on your family’s values and encourage your partner to live with these values in mind, even when fears try to take them off track.
Please understand that your partner may become irritable, angry, or upset when you choose to help them by refusing accommodation. This can be a normal reaction to increased anxiety. Stay the course! Be encouraging, consistent, and patient.
Remember to take care of yourself in order to be a better support for your partner. If you are feeling tired, irritated, or frustrated, you are more likely to respond poorly which will not be helpful to your partner (and you’ll probably feel bad afterward). Make sure your tank is full, emotionally speaking, by doing what works for you, i.e., exercise, gratitude, reading, alone time, time with friends, meditation, nature walks.
At times it can be hard not to accommodate our partner because we want to provide them with comfort, but remember: short term pain = long term relief. Do not rob your partner of their short term pain. If you have more questions, speak to your partner’s therapist about how you can best support him/her during a spike.
