OCD Awareness Week October 14-20,2013

Esther and Karyn are sisters, and they just spent the afternoon painting together. Now dinner is ready, and so Mom tells both of them to wash their hands, which are full of paint stains. Esther quickly runs to and from the bathroom, and she sits down in her favorite chair at the kitchen table. A few minutes go by, and Karyn is still in the washroom. The food is getting cold, so Mom walks over to the washroom. She finds Karyn washing her hands multiple times – even after the paint has been fully washed off. Mom gently tells Karyn that her hands look squeaky clean and that she can now join the rest of the family for dinner. 

Washing your hands before dinner might seem like a simple task, but Karyn has obsessive-compulsive disorder, and for someone with OCD, it is not so easy, and can be extremely stressful and emotionally tasking.  Having OCD in a family brings a unique environment that will require patience, love, acceptance without unhealthy enabling.  Navigating the sometimes fine line between expressing patience and "feeding" an OCD by enabling it can be tricky.

Defining OCD

OCD is an anxiety disorder that consists of obsessive thoughts, impulses, and repetitive behaviors. While these compulsions are aimed at reducing anxiety, they tend to produce more distress. OCD can consume a great deal of time in a person’s day, often affecting his or her academic performance, tasks at work, and social interactions (Better Health Channel, 2013).  Very frequently, people without OCD can be repulsed by people who do, and so it can be devastating on relationships.   The person with OCD can suffer great pain and loneliness due to these broken relationships and frequently may feel helpless in knowing what to do.

OCD and Family Dynamics

Those with OCD can feel embarrassed, distressed, and frustrated about their compulsions, which is why family members should seek to be patient and supportive.

Imagine how much more distress Karyn – the child in the example above – would have felt if her mother had been insensitive or unsympathetic towards her. How would Karyn have felt if she had been approached aggressively or angrily, rather than gently and calmly? How would this have affected this mother-daughter relationship?   

Family members should understand that OCD is not voluntary, and neither the person with OCD nor the family is responsible for these compulsions. Becoming upset with someone because of their OCD can worsen associated symptoms and behaviors.

Guidelines for Family Members of Someone with OCD

It is important for your family to understand how OCD affects your loved one. He or she likely recognizes that his or her behaviors are irrational, causing more feelings of helplessness, discontentment, and alienation (Van Noppen and Plato, 2012). By having open and sensitive discussions about OCD, your family can help reduce feelings of embarrassment about the condition. Also, siblings should never tease or make fun of them for this.

Creating a supportive environment is vital and this means having realistic expectations about the progress of someone with OCD. These expectations should also be adjusted according to your family’s situation. Have you recently moved to a new city? Are you going on family vacation? Changes like these can often increase symptoms of OCD, meaning parents and children should adjust their expectations accordingly (Better Health Channel, 2013; Van Noppen and Plato, 2012).

Focus on the person, and not the label.   Resist labeling someone as "OCD" because someone who struggles with this may actually identify themselves around it.  Instead, build up their personal identity around who they are inside, their heart, their talents, their gifts, their positive traits.  A healthy and positive self identity is a huge step in healing.   

Family members should also learn to respond to OCD in a helpful way. Imagine now that, after washing her hands, Karyn sat down at the dinner table and began to obsess about whether or not she had turned off the tap of the bathroom sink. Rather than giving a lengthy explanation about how she witnessed Karyn turning off the tap, her mother should simply say, “Yes, you turned off the tap.” Those with OCD tend to become more concerned and anxious when those around them try too hard to offer long, detailed, and logical explanations.

Helping Vs. Enabling

Though progress should be valued over perfectly curing OCD, families should gain awareness as to whether their responses to OCD are helping treat the anxiety disorder (Singer, 2011). There is a fine line between supporting the person and supporting OCD. By accommodating to all OCD-related behaviors, family members can actually help worsen the symptoms.   

Someone with an OCD is just like someone who may have the flu.  Does the flu define that person?  Should we label someone with the flu as "oh you're the sickly person".  Eventually, that person will begin to identify themselves as such.  So be wary of enabling and labeling.  Focus on the inner person, the character of the person, and build that up.  Do not create an environment in your home that simply accommodates compulsive behaviors, instead create an environment that elevates the positive traits of the person instead, and use loving resistance to help dissuade compulsive acts.  This is going to take a lot of work and effort from loved ones, but in the long term, it is worth it, not just for you, but for the person struggling.

Allow me to refer back to the example of Karyn. If she decided that she had to sit in Esther’s chair, then the family should not accommodate to this request. While accommodating can decrease anxiety in the short-term, it can aggravate the condition in the long-term.

Therapy and Treatment

Individuals with OCD can seek help from a doctor and a therapist experienced in treating OCD. There are even treatment programs specifically designed for those with OCD. Your family should also continue to learn about how to help your loved one feel supported, so that he or she might gradually decrease the effect of OCD on their daily life.  A therapist can give you very specific guidance that will be a far better source of help than any self-help article.  This is just to give you an outline of how to approach OCD, but a licensed therapist is the best place to go.   You can find help by going to www.theravive.com and entering your ZIP code, then select a therapist who is right for you.

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2012. Van Noppen, B, and Plato, M. Living With Someone Who Has OCD: Guidelines for Family Members (From Learning to Live with OCD). International OCD Foundation. [online] Available at: <http://www.ocfoundation.org/EO_FamilyGuidelines.aspx>

2011. Singer, J. Helping or Enabling? A Fine Line When Dealing with OCD. Psych Central. [online] Available at: <http://psychcentral.com/lib/helping-or-enabling-a-fine-line-when-dealing-with-ocd/0008640>

2013. Obsessive compulsive disorder – family and friends. Better Health Channel. [online] Available at: <http://www.betterhealth.vic.gov.au/bhcv2/bhcarticles.nsf/pages/Obsessive_compulsive_disorder_family_and_friends>