Obsessive-Compulsive Disorder (OCD) presents many challenges – not only for the person living with the mental health disorder, but also for those in a supportive role. Family members, friends, and others supporting someone living with OCD may at times feel powerless, discouraged, guilty, embarrassed, frustrated, and stuck. Learning more about OCD, and how to be an effective support, can help.

OCD is a type of anxiety-related disorder characterized by the presence of obsessions and compulsions.

Obsessions are repetitive and intrusive thoughts, images, or impulses experienced by someone living with OCD that cause distress, while compulsions are the behavioural responses that aim to get rid of that distress. The content of someone’s obsessions is specific to each person, but some examples of the types of obsessions people living with OCD may experience include obsessions about contamination, sexuality, religion, and harm.

An example of a contamination-related obsession-compulsion cycle may be someone experiencing repetitive and intrusive thoughts about germs that trigger intense emotional distress (an obsession), and whenever these thoughts arise, they complete a hygiene ritual (e.g. hand-washing for five minutes) to neutralize their thought and ‘get rid of’ the resulting distress (a compulsion). Obsessions are often based in fear of the unknown and loss of control, while compulsions provide a sense of certainty and control. Most people with OCD are aware that their obsessions and compulsions do not truly control what will or will not happen in reality, and would rather not have them at all. However, the intense distress caused by obsessions followed by the intense relief someone with OCD experiences after performing their compulsion make it a difficult cycle to break out of. Because of this, many people living with OCD feel more controlled by this cycle, than in control of it.

It is not uncommon for those that support people with OCD to also feel controlled by this cycle.

Imagine knowing that someone you care about is suffering, and that if you help them in this one way or with this one thing, you can make it all go away. Poof. Of course, you’d want to help. You may be asked to accommodate their compulsion, or you may become the compulsion itself. For example, you may be asked to modify your work schedule to allow time for someone with OCD to complete their morning ritual, or the reassurances you provide, for example, that nothing bad will happen or that the stove is definitely turned off, become the compulsion. Often, the requests appear quite reasonable, and in seeing the relief it brings the person living with OCD, you are compelled to fulfill such requests. In doing this, you likely feel that you are helping the person with OCD, however, the more OCD is accommodated, the bigger it grows, and the more demands it’ll make of the person living with OCD and the people around them.

Although refusing to accommodate the OCD may feel like going up against the person living with OCD, it’s really taking a stance with them against the controlling grasp of OCD. This is one of the most powerful ways you can support someone living with OCD to regain control of their life and how they respond to distress.

Here is a summary of ideas on how to be an effective support to someone living with OCD:

• Don’t ‘go along with’ compulsions by accommodating or being part of them. This helps fuel OCD symptoms over time. If you are already caught up in a compulsion, try to gradually put limits around your involvement (ex/ “I will only reassure you one time”).
• Don’t forget that you can refuse to accommodate OCD, while still offering lots of empathy for the distress someone is experiencing.
• Avoid convincing people that their obsessions and/or compulsions are irrational – they likely already know this, and will only feel worse.
• Don’t underestimate the effects of OCD. OCD is not a quirky personality trait – it is a mental health disorder that disrupts people’s day-to-day functioning, relationships, and overall quality of life.
• Encourage people living with OCD to find ways to tolerate uncertainty and cope with their distress while limiting compulsions as much as possible.
• Help connect someone living with OCD, and possibly their family, to a therapist with relevant knowledge, training, and experience.
• Discuss medications as a possible treatment option and help connect someone living with OCD to a physician if desired.
• Celebrate any and all improvements – seemingly small improvements likely took a lot more strength and determination than you may know.

Although there is no ‘OCD cure’, with the right types and combination of supports, people can and do live full and meaningful lives despite the effects of OCD. By reading this blog on how to support someone living with OCD, you may be an important part of that journey.

For more information on OCD and how to support people living with it, visit: https://iocdf.org/