Supporting a person with OCD

Some of my clients have an excellent support network and others don't. For those who have the support of family or friends, this can make a huge difference in their life. It can also sometimes be the case that their supporters really want to help but, unfortunately, what they do is to help the sufferer maintain their OCD cycle.

The most frequent issue I hear about is that of giving reassurance. Of course, if you can see that your loved one or your friend is getting anxious and you know that by answering a simple question you can help them instantly feel better, why wouldn't you do this? These can be questions like:

• "Did I definitely lock the front door before we left the house?"
• "Was I just rude to that person?"
• "Do you think I just ran somebody over with my car?"

Giving the person the answer they need when we know that nothing bad has happened can be very tempting. It may be that the person with OCD wants you to do something for them, to eliminate the feeling of responsibility that they face around this activity. However, what reassurance or helping them out with an activity does, is to help them perform a compulsion.

What is a compulsion?

Compulsions are a form of safety behaviour which help the OCD sufferer to feel temporarily better by reducing their anxiety when they have been triggered. Although this feels helpful in the moment, the result is that it creates more future triggers for the sufferer. Treatment for OCD involves learning how to gradually step away from these safety behaviours in order to start managing OCD better.

Family and friends can begin to help the sufferer by not accommodating their need for answers or other help designed to reassure them. As long as you make it clear to your person with OCD why you are planning to change your approach, this will be more useful to them in the long term.

One thing which people sometimes wonder about is why, when the OCD sufferer knows that their fear around a certain topic is irrational, they don't just stop doing the compulsions. It should be simple, right?

This situation can be difficult to understand. However, it's in the nature of the condition that the sufferer usually understands that what they're doing makes no logical sense, yet at the same time they experience a compelling need to perform a compulsion, just in case. This comes from an emotional place in the shape of ongoing doubt. It's incredibly difficult to resist and is in this sense similar to an addiction. The driver is different, but the urge is every bit as strong.

Another example of how people try to support someone with OCD is when family and friends choose to remove potentially triggering situations for them, to eliminate the opportunity for their anxiety to spiral. This is very understandable, we don't want to see the sufferer triggered and this provides another challenge for us to deal with as well. It can feel extremely hard to resist this 'solution', but then again trying to ensure on an ongoing basis that we remove all potential triggers from the sufferer's world is quite a challenge as well.

How can therapy help?

Rather than do this, it's more helpful for your loved one with OCD to find support from a professional who understands the condition and who has experience in working with Exposure and Response Prevention (ERP) therapy.  This method has been well researched over many years and forms the gold standard treatment for OCD.

ERP helps the person with OCD to understand how the condition operates in their life and teaches them gradually to learn to face scary situations, while not engaging with any compulsions. Over time, this leads our brain to understand that we are not facing ongoing threats in our daily life, that we are safe and that we don't need alarm bells on an ongoing basis.

There are many different ways in which family and friends try to help OCD sufferers to feel better. These are just a few examples. As a rule of thumb, if what you're doing constitutes 'rescuing' your loved one from situations which are triggering, in any shape or form, it's important to know that what you're doing is helping them to maintain their OCD cycle and to enable this to escalate over time.

However, rather than just cutting this out of your daily routine, please encourage your person with OCD to seek help from a professional. As part of their therapy and with the understanding of why this is useful, you can then begin to support them in more positive ways.

For information and support about OCD, please consider reaching out to the charity OCD Action, which is there for families and carers as well as for OCD sufferers.