“Make sure you wash your hands!”
“Are you sure I’m not going to die?”
“Say that again, I don’t know if I heard you correctly.”
These are only a few examples of how a person with OCD may involve their family and friends in their disorder.
Obsessive-compulsive disorder (OCD) is a mental illness characterized by intrusive, persistent thoughts called obsessions and the repetitive behaviors, compulsions, done to neutralize the anxiety caused by obsessions. OCD doesn’t just affect the individual who has it, but often their loved ones too. This is often most evident within the individual’s family system. The term “family accommodation” refers to the assistance families give to their loved one with OCD in performing compulsions and avoiding anxiety-provoking situations.
It’s important to know that family accommodations arise out of a place of wanting to help, however they can be really harmful to the person with OCD and ultimately the entire family system. When a parent sees their child in distress over falling asleep, for example, it is natural for them to reassure their child that they won’t die in their sleep. Or if a teenager witnesses their parent crying over cleaning the bathroom, it’s understandable that they would offer to clean it for them. Such accommodating behaviors may seem to alleviate the individual’s anxiety temporarily, however they actually worsen the disorder in the long run.
For example, a teenage girl is afraid to use knives out of the fear of accidentally stabbing someone. Therefore, she has her mom cut all of her food for her and then hide the knives in locked drawers. Although the daughter’s anxiety goes down temporarily after her mom performs these behaviors, the obsessive fear actually returns stronger the next time knives must be used. This is because when we perform compulsions or have others perform them for us, our brains learn that the threat is real, when in reality that may not be the case.
Further, family accommodation often creates extra stress for family members without OCD.
Thankfully, there are ways for families to help their loved one with OCD without enabling the disorder. The first step is for the family to educate themselves on OCD and family accommodation. OCD Gamechangers has a list of OCD resources on their website! Second, the family can support the individual in seeking proper treatment for their disorder.
It’s important to note that suddenly removing all family accommodation may result in overwhelming distress for the individual with OCD. Instead, family accommodation should be weaned away, and an OCD therapist can help with this process.
Finally, it’s important to validate the fears of your loved one with OCD rather than reassure them or accommodate their behaviors. Validation involves recognizing the person’s fear for what it is and empathizing with them. For example, instead of hiding knives from her daughter, the mother could say, “I understand why that thought would make you afraid to use knives.” Further, she can support her daughter by encouraging her to take small steps towards using knives again.
Family accommodation in OCD is a common yet tricky phenomenon to navigate. With the right education and help from professionals, it’s possible to learn how to manage it and make a better life for the entire family.
Maya Tadross
Author
