Stop Accommodating OCD
Perhaps you’ve already tried a variety of ways to help your family member live with his or her OCD by:
- Getting involved in performing rituals, such as checking door locks,
- Helping decontaminate clothing, food or even entire rooms;
- Providing verbal reassurances to excessive reassurance-seeking requests;
- Providing items necessary to carry out rituals, such as supplying soap for hand washing;
- Allowing/helping the person avoid certain stimuli that serve as OCD triggers, such as taking a longer route to a destination to avoid a feared location;
- Tolerating delays associated with ritual completion, such as waiting in the car to drive to school while the family member completes a washing ritual in the house; or
- Trying to have rational conversations or debates with him or her about the OCD behavior.
None of this will actually make OCD stop. In fact, participating in OCD rituals actually allows or enables the compulsions to persist and even become stronger. Protecting a family member from the negative consequences of obsessions and compulsions can also decrease his or her motivation to obtain treatment. A man who starts to be late for work because family members no longer help him with checking rituals before leaving home, for example, may be motivated to seek treatment.
To make positive changes, you need to realize that the entire family must adopt new behaviors – everyone needs to change the way he or she interacts with the OCD sufferer and stop reinforcing OCD behavior. You can be supportive of the person you love who is suffering, but stop supporting the disorder.
How Do I Stop?
It’s important to talk with your loved one and remind him or her that your participating in the rituals may make him or her feel better temporarily, but that it doesn’t help decrease the symptoms in the long term. In fact, it makes the symptoms worse.
Discuss with your family member the ways you’ve been accommodating the OCD and how important it is to work together as you start to decrease your participation in rituals. Try to help your loved one understand that you’re doing this because you care about and want to support him or her. You’re not doing this to be mean or spiteful; you want him or her to overcome OCD.
Two OCD experts have described the concept of “mapping” as a tool to help family members disengage from accommodating (see full article). In mapping, specific OCD symptoms that both the caregivers and the sufferer agree upon are targeted for treatment. Caregivers identify the symptoms they will no longer tolerate, and a gradual, systematic plan for the caregiver to disengage from accommodating is developed. This plan will allow the individual with OCD to take on more responsibility and reduce the caregiver’s “duties.”
It may be very beneficial for your loved one’s cognitive behavior therapist guide you through the mapping process or any other plan you devise to decrease and ultimately stop your participation in OCD rituals. Doing it with the help of a therapist is important, because sudden changes in responses can cause things at home to spin out of control, creating anger and increased stress that can worsen symptoms.
In fact, many cognitive behavior therapists work with families to develop a written agreement known as a “family contract” or “behavioral contract” to help family members stop accommodating OCD. It’s a “roadmap” you follow when you agree to work together as a team to fight OCD. When all members of the family agree upon the specific OCD behaviors they’ll stop accommodating, the chances of reducing symptoms of OCD can dramatically increase.
Your goal is to help restore balance and normalcy in the home. A better future begins with encouraging your loved one to get treatment, discontinuing accommodating OCD behavior and helping restore self-esteem by supporting the OCD sufferer with understanding and belief in his or her ability to succeed. And remember that taking care of your own physical and psychological needs is critical to being able to help your loved one.