Updated: Nov 23, 2021
Supporting someone with mental health issues isn’t easy. Let’s start there.
Secondly, If you are supporting someone with OCD, you will already know that your role involves a unique set of challenges. Challenges that are specific to OCD and seem counter intuitive to anyone’s idea of the supportive, caring role.
For any partner who has been followed around the house until they give in to the escalating demands for reassurance, you will know what I mean. For any parent who has been banned from stepping foot into numerous rooms in their own house, this will resonate. For any friend who has received 47 texts asking the same question, this will sound familiar. For those of you who haven’t experienced this, I can tell you that OCD is very lifestyle invasive with symptoms often extending to the immediate environment.
At best, OCD can be entirely covert and the person with OCD seems distracted and inwardly suffering. At worst, the OCD symptoms are overt and the whole family is unable to function, disabled by the OCD. I’ve worked with grandparents dealing with the nightly humiliation of witnessing a teenage grandchild showering at 4am, to ensure each body part is adequately cleansed. Or a partner out at 6am to check that no one was harmed overnight on the train tracks. Carers, families, partners, children caring for someone with OCD can themselves suffer significant mental health issues as a result. However bad the situation, it is never too late for them to set boundaries. Setting boundaries can often be the very first step in the person with OCD realising they need to take action. In my experience, here are the most impactful boundaries to start with:
Try to remember that OCD distress manifests as anxiety. Whilst it is distressing to witness in a loved one, it is harmless & furthermore, efforts to avoid or escape it only make the situation worse. The solution lies in the person learning to tolerate & accept it.
Seeing OCD as a disease or illness might not be conducive to the person recovering. Disease or illness can imply the situation is outside the control of the person with OCD. Seeing it as a condition is more accurate. It reflects the episodic nature of OCD which needs to be managed and leads to…
The severity of OCD isn’t a biological phenomenon. There aren’t more aggressive forms of OCD (except for childhood cases of PANDAS) and the severity is determined by a person’s ability to adapt their environment and the people within it around the OCD.
OCD is the one condition where it doesn’t always help to talk. A person with OCD will want to talk, to describe their thoughts, their feelings, ask questions, check or seek reassurance. They are unlikely to be able to stop. Learning how to communicate, what to say and what not to say, will make a huge difference to their recovery…
Beware of questions. They will often be reassurance based and reassurance is highly addictive for the person with OCD. Try to respond with closed-ended answers & never imply that certainty is possible. You can either kindly decline to respond or don’t be afraid to say, ‘I don’t know.’ or ‘Who knows?’. Be especially careful of their assurance which will sound like, ‘This isn’t OCD, but….’
Try to learn the difference between empathetic and sympathetic support. Empathy would be ‘I can see how tough this is for you but I know you can do it’. Whereas sympathy would be ‘You are right. Your life is terrible and I don’t know how you will cope.’
Try not to change your own behaviour even if the person with OCD becomes very demanding. For example, they may insist that you shower at particular times or that you stop using knives or going to specific shops or venues. Be aware that once you agree to change your behaviour, it will be tougher to reset this boundary later on. Furthermore, the more you adapt your life around the OCD, the greater the danger that you will normalise dysfunction.
If you agree to carry out daily tasks for the person with OCD, the situation is likely to deteriorate. This includes cleaning, checking, avoiding or other organisational tasks. As they become more discomfort intolerant, your responsibility for their tasks will increase, having a detrimental impact upon their ability to cope. Similarly, if you take long-term financial responsibility for them, so that they no longer have to work or attend school, this will ultimately be unhelpful for their recovery.
Understand your limitations. Manage your expectations. You can’t change another human being and you can’t make them want to recover or seek help. You can inform yourself and encourage them to seek help but they may decide not to follow your advice. In this case, you will need to make decisions about how you will cope in the future and what steps you might need to take to protect your own mental health, even if you are a parent.
Finally, do not ignore or neglect your own well-being. You are as entitled to support and help as the person with OCD. You cannot support others if your own mental health is deteriorating. Try to seek local or online support in the guise of help groups or therapy for yourself. They can help you set appropriate boundaries and support you implementing those in difficult circumstances. Try to set aside you time where you see friends or carry out pursuits and interests that provide relief and enjoyment.
Most of our enquiries are from carers, families and friends so please be kind to yourself and thank you for supporting someone with OCD.
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