The Role of Family in OCD Recovery: A Licensed Psychologist’s Guide to Successfully Navigating OCD Treatment
Obsessive Compulsive Disorder (OCD) can be a difficult diagnosis to manage, not only for those who experience it, but also for their families. As a licensed psychologist and OCD specialist, I work with not only those who have OCD but also the family members because everyone in the household has a pivotal role in the overall mental health recovery of the individual. This blog will provide information on the role that families have in the OCD recovery process as well as practical tips and tricks for each person to be able to support their loved one in a healthier, more effective manner.
Understanding OCD: A Quick Overview
OCD is a mental health condition that involves having unwanted, intrusive thoughts (also known as obsessions) and repetitive behaviors (that are also known as compulsions) that individuals feel that they must perform. These obsessions and compulsions unfortunately frequently significantly hinder daily life, leading to distress.
Obsessions can look a lot of different ways. Some common ones include being fearful of contamination, fearing harming others or oneself, needing to identify whether things are in order, concern over whether one may be carrying a disease and infecting others, or wanting to figure out whether something is actually clean. Compulsions may look many ways but often include checking, excessively repeating a behavior such as cleaning, counting, and aligning items in a certain order, seeking reassurance, looking things up online, and ruminating on certain thoughts. Understanding these different behaviors is important for family members, partners, and friends who may see these behaviors and be confused about what is happening and why they are occurring.
The Family’s Journey With OCD
When a loved one is diagnosed with OCD, it may lead to feeling many emotions, including confusion, fear, sadness, and even guilt. It is important for family members to realize these feelings are normal and to feel okay seeing out their own support. It can also be overwhelming to support someone with OCD. It is important for family members to be equipped with knowledge and strategies.
What Should a Family Member Do During OCD Recovery of a Loved One?
Providing Emotional Support
One of the most important roles families can play is providing emotional support to their loved one facing treatment, including compassion and patience. It is common for an individual with OCD to feel isolated or embarrassed. Having family members provide support can be extremely helpful. This support can look like being present and providing active listening. Reassuring your loved one that they are not alone is critical.
Emphasizing and Encouraging Treatment Adherence
Treatment for OCD most often involves Exposure and Response Prevention (ERP) alongside cognitive-behavioral therapy (CBT). ERP is a highly effective evidence-based treatment that involves exposing the individual to thoughts and situations that increase the person’s anxiety and their overall fear (whatever their obsession is). Then, at the same time, the person is prevented or asked to stop themselves from participating in the behavior or ritual that they typically do in response to the obsession. This is known as the response prevention part. Overtime, the individual learns how to face their fears in a very controlled way which ultimately reduces their anxiety over time.
Treatment may also include medication. Family members can be supportive by learning about CBT and ERP on their own, participating in family sessions, helping their loved one do their exposure homework, and reminding them to take their medication. Providing the individual with support, encouragement, and celebration of small milestones is crucial.
Avoiding Accommodation and Reassurance Seeking Behavior
Family members often want to help by providing accommodation to the individual with OCD, sometimes without even realizing it. For instance, an individual with contamination OCD may wash their hands many times an hour and may want their family members to also wash their hands at the same time. While it would be well-intentioned for a family member to do this, in reality, this reinforces the OCD behavior and makes it harder for their loved one to recover. Other accommodations are common. Instead of participating in the loved one’s ritualistic behavior, the family member should encourage the individual to perform the task by themselves and attempt to resist any compulsions.
Family members may also want to provide frequent reassurance that the individual’s fears aren’t valid or telling them that something is not contaminated. Instead of providing reassurance, the family member should encourage the individual to use coping strategies to manage their anxiety.
It is also common for family members to change family routines and schedules to accommodate different compulsions. Unfortunately, this can increase the OCD behavior in the individual. It is actually far more important to maintain normal routines as much as possible, and to help the individual slowly face their fears. Family members might also want to help the individual avoid situations that trigger their OCD, such as helping them not need to touch certain items. Instead, continue encouraging gradual exposure to situations that are considered fearful. Family members should be cognizant of not responding to the same question many times to decrease the individual’s anxiety, such as confirming that something is clean or the door was locked. Family members should set boundaries around answering frequent questions.
Unfortunately, all of these accommodations can ultimately create a cycle that leads to OCD behaviors being maintained and reinforced. It is crucial for families to learn how to break the cycle so they can be the most supportive to the individual.
Educating Themselves
The more knowledge that each person in the household has about OCD, the better it will be. By learning more about OCD, treatment, and symptoms, each person can understand what the individual is going through and how to support them. There are lots of books and support groups that are specifically designed for families. It can also be useful to learn about the science behind OCD as understanding the biological background can reduce stigma.
Learning Effective Communication Strategies
Family members should maintain open and honest conversation with each other and the individual. This also includes setting boundaries and feeling safe to express concerns. Family should learn how to listen and support without judgement. Family members should be on the same page about how to respond to the individual’s request for accommodation and reassurance.
Common Challenges and How to Overcome Them
Learning How to Manage Burnout
It is normal for family members to feel frustrated and/or experience the symptoms of burn out, especially if progress seems to be going slowly. Recognizing these feelings and seeking further support is crucial. For instance, family members should join support groups specifically designed for families of individuals with OCD. The IOCDF webpage has listings of these groups for free. The same page also has many free support groups for those dealing with OCD themselves. Family members should also consider seeking their own professional support from a therapist if they need help navigating their own emotions.
Dealing with Treatment Resistance
Some individuals with OCD may be resistant to treatment due to their own fear or hopelessness. Families can play a large role in support by providing their concern and support and being there for them. Connecting the individual to those have been in treatment for OCD and been successful at it can also be helpful at reducing resistance.
Balancing Support and Independence
It can be very hard to find the right balance between providing support and encouraging the individual’s independence. Slowly but surely allow the individual to take more control of their recovery as they become more confident.
Conclusion: How the Family Can Help in OCD Treatment
Overall, the journey for an individual to recover from OCD can be long and challenging. However, families play a big role in the individual’s recovery. By reducing accommodations, encouraging treatment adherence, and providing emotional support, families play a crucial role in helping the individual make real changes in their life.
If you or a family member has OCD, please don’t hesitate to reach out for more support. As a licensed psychologist who is an OCD expert, I provide individual therapy across Florida (Orlando, St Petersburg, Tampa, Gainesville, Miami) as well as across 40 states, including Maryland, Texas, North Carolina, and New Jersey. In addition, I can provide therapy for those dealing with Anxiety, Depression, Trauma/PTSD, and Work Stress.
If you are ready to take the next step, please schedule a free consult call here.