Living Everyday Life with Your Loved One
Avoid enabling behaviors. A family member or loved one with OCD can heavily influence the household atmosphere and schedule. It is just as important to know which behaviors reduce anxiety but enable the cycle of OCD to continue. It is tempting for family members to participate or allow rituals to continue. By accommodating your loved one in these ways, you are perpetuating their cycle of fear, obsession, anxiety, and compulsion. In fact, research has shown that accommodating the person’s request to comply with rituals or alter routines actually produces worse presentations of symptoms of OCD. Some rituals that you may need to avoid enabling include: answering repeated questions, reassuring the person about his fears, allowing the person to dictate seating at the dinner table, or asking others to perform certain things several times before serving food. It is easy to fall into this enabling behavior because the rituals and behaviors are seen as harmless. However, if the enabling has been going on for a long time, suddenly stopping all ritual involvement and reassurance may be too abrupt. Inform the person you will be decreasing your involvement in their rituals, then create a limit for how many times a day you will help with rituals Then slowly reduce this number until you are no longer a participant. It may be helpful for you to keep an observation journal, noting when symptoms seem to come up or worsen. This is especially helpful if the family member with OCD is a child.
Keep your regular schedule. Though it's a stress point for this person and it'll be difficult not to succumb to his desires, it's important that you and others around this person continue life as normal. Instead, come up with a family agreement that your loved one’s condition will not alter the family routines or schedules. Make sure that your loved one knows you are there to support him, and you see that his distress is real, but you will not support his disorder.
Request that your loved one limit OCD behaviors to certain areas of the house. If your loved one needs to engage in certain OCD behaviors, suggest that these happen in certain rooms. Keep communal rooms free from OCD behaviors. For example, if your loved one needs to check that the windows are locked, suggest that he does this in the bedroom and bathroom, but not in the living room or kitchen.
Help distract your loved one from their thoughts. When your loved one is faced with the urge to engage in compulsive behavior, you can help by offering some type of distraction such as going for a walk or listening to music.
Don’t label or blame the person for his OCD. Try to avoid labeling your loved one as his OCD condition. Avoid blaming or chastising your loved one when his behavior becomes frustrating or overwhelming. This is not productive for your relationship or for your loved one’s health.
Create a supportive environment for your loved one. Regardless of how you feel about the OCD, you need to be encouraging. Ask your family member about his specific fear, obsession, and compulsion. Ask him how you can help him decrease his symptom (outside of complying with his rituals). Explain in a calm voice that the compulsions are a symptom of the OCD and tell him that you won't participate in the compulsions. This gentle reminder may be just what he needs to resist the compulsions this time, which can lead to more instances where he is able to resist them. This is very different than accommodating your loved one. Being supportive does not mean allowing the behaviors. It means holding the person accountable in a supportive way and offering a hug when he needs it.
Involve your loved one in decisions. It’s important that your loved one feels involved in decisions that are made about his OCD. This is especially true for a child with OCD. Talk with your loved one to find out if he wants to tell his teachers about his OCD, for example.
Celebrate small steps. Overcoming OCD can be a difficult road. When your loved one makes small improvements, congratulate him. Even if it seems like a small step, such as not checking the lights before bed, your loved one is making improvements.
Learn ways to reduce stress in the household. Many times, family members become involved in a loved one's rituals in an attempt to reduce the person's distress or to avoid confrontation. Reduce stress by encouraging your family to learn relaxation techniques, such as yoga, mindful meditation, or deep breathing. Encourage them to exercise, adopt healthy eating habits, and get adequate sleep, which can help reduce stress and anxiety.
Taking Care of Yourself
Find a support group. Find support for yourself in a group setting or through family therapy. Groups for people who have loved ones with a mental health condition can provide you with support for your frustrations as well as further education about OCD. The International OCD Foundation has a directory of group resources.
Consider family therapy. Family therapy can be helpful in that the therapist can educate you on your loved one’s OCD as well as make a plan to help bring balance back to the family system. Family therapy looks at the family system and evaluates relationships between family members in an effort to understand which behaviors, attitudes, and beliefs are contributing the presenting problem. For OCD, this may be examining which family members are helpful in reducing anxiety, which are unhelpful, which times of day are most difficult for your loved one with OCD and for other members of the family and why. Your therapist can also offer suggestions about behaviors that will not reinforce rituals, and what to do instead that is specific to your loved one’s situation.
Take time away from your loved one. Give yourself time away from your loved one to relax. Sometimes worrying about your loved one’s condition can make you feel as though you have OCD as well. Time away from your loved one can give you a moment of relaxation and recentering in order to be better prepared to deal with the stressors of your loved one’s anxiety and behaviors. Plan outings with friends once a week to give you a short reprieve away from your loved one. Or, find your own space at home in which you can relax. Squirrel yourself away in your bedroom to catch up on a book, or carve out time for a bubble bath when your loved one is out of the house.
Pursue your own interests. Don’t get so wrapped up in your loved one’s OCD that you forget to pursue the things that you enjoy. In any relationship, it’s important to have your own interests separate from the other person, and when you are dealing with someone’s OCD, it’s especially important to have your own outlets.
Remind yourself that your own feelings are normal. Remember that feeling overwhelmed, angry, anxious, or confused about your loved one’s condition is very normal. OCD is a tricky condition and often produce confusion and frustration for all involved. It is helpful to remember to aim these frustrations and feeling at the condition itself and not the person you love. Although his behavior and anxiety can become irritating and overwhelming, remind yourself that your loved one is not OCD. He is much more. Be sure to separate this for yourself in order to prevent conflict or bitterness toward your loved one.
Suggesting Professional Help for Your Loved One
Suggest that your loved one get a diagnosis. Getting an official diagnosis can help your loved one deal with the disorder and begin to treat it. Start with the person’s physician, who will perform a complete physical, lab tests, and a psychological evaluation. Having obsessive thoughts or exhibiting compulsive behaviors doesn't mean you have OCD. To have this disorder, you need to be in a state of distress where the thoughts and compulsions interfere with your life. To be diagnosed with OCD, there must be a presence of obsessions or compulsions or both. The following are signs that must be met for a professional diagnosis: Obsessions include thoughts or urges that never go away. They are also unwelcome and intrude on everyday life. These obsessions can cause significant distress. Compulsions are behaviors or thoughts that an individual repeats over and over. This can include compulsions such as hand-washing or counting. The individual feels that he or she must comply with certain rigid rules that are self-imposed. These compulsions are enacted in order to reduce anxiety or in hopes of preventing something from happening. Typically the compulsions are unreasonable and ineffective at actually reducing anxiety or prevention. Obsessions and compulsions are usually performed more than one hour per day or otherwise intrude on daily functioning.
Encourage your loved one to see a therapist. OCD is a very complex condition, and it is one that often requires professional help in the form of therapy and medications. It is important to encourage your loved one to seek help for their OCD from a therapist. One method of therapy that can be very helpful in treating OCD is Cognitive Behavioral Therapy (CBT). A therapist will use this method to help individuals change how the perceived risks and challenge the reality of their fears. CBT helps people with OCD examine their perceptions of potential risk which influence their obsessions, to build a more realistic perception of their fear. Additionally, CBT helps to examine the individual's interpretation of their intrusive thoughts, because it is often the amount of importance they place on these thoughts and how they interpret them that causes anxiety. CBT has been shown to be helpful to 75% of clients with OCD.
Look into exposure and response prevention treatment. One portion of cognitive behavioral therapy can help reduce ritual behavior and come up alternative behaviors when exposed to the fear's image, thought, or situation. This portion of CBT is called Exposure Response Prevention. This type of treatment gradually exposes the individual to what he fears or obsesses over while refraining from acting on compulsions. During this process, the individual learns to cope with and manage their anxiety until it eventually does not induce anxiety at all.
Suggest medication for your loved one. Medications used to treat OCD include different types of antidepressants such as SSRIs, which help to increase the available amount of serotonin in the brain in order to reduce anxiety.
Recognizing OCD
Look for signs of OCD. OCD manifests in thoughts, and these thoughts play out in a person’s behavior. If you suspect someone you care about has OCD, look for the following: Large blocks of unexplained time that the person is spending alone (in the bathroom, getting dressed, doing homework, etc.) Doing things again and again (repetitive behaviors) Constant questioning of self-judgment; excessive need for reassurance Simple tasks taking an effort Perpetual tardiness Increased concern for minor things and details Extreme, unnecessary emotional reactions to small things Inability to sleep properly Staying up late to get things done A significant change in eating habits Increased irritability and indecisiveness
Understand what obsessions are. Obsessions can be about fears of contamination, fears of being harmed by another person, fears of by persecuted by God or other religious leaders because of thoughts that contain unwanted images such as sexual images or thought that would be blasphemous. The fear is what drives OCD, even if the fear is unlikely with low risk, people with OCD are still very much afraid. This fear creates anxiety which drives compulsions, and the person with OCD uses compulsions as a way to pacify or control their anxiety caused by their obsession.
Learn what compulsions are. Compulsions are usually acts or behaviors such as saying a certain prayer a certain amount of times, checking the stove repeatedly, or checking the locks on the house a certain number of times.
Understand the types of OCD. When most of us think of this disorder, we think of those who wash their hands 30 times before leaving the bathroom or those who switch the light on and off exactly 17 times before bed. In actuality, OCD rears its head in many different ways: People with a washing compulsion are afraid of contamination and usually wash their hands frequently. People who check things repeatedly (oven turned off, door locked, etc.) tend to associate everyday objects with harm or danger. People with a strong feeling of doubt or sin may expect that terrible things will happen and they might even be punished. People who are obsessed with order and symmetry often have superstitions about numbers, colors, or arrangements. People with a tendency to hoard things may be afraid that something bad will happen if they throw even the smallest thing away. Everything from trash to old receipts gets saved.
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