It’s All in the Family: OCD and the Importance of Family Work During Treatment for OCD

Treatment for OCD involves many important aspects. Families with loved ones with OCD often face challenges in their relationships due to the interference of OCD beliefs and rituals. Treatment for OCD can help. People will say their partners are frustrated with them because their rituals take up a lot of time. Partners might also be asked to complete compulsions and rituals to satisfy their loved one’s OCD. Or there might be be restrictions on behaviours that are allowed for family members in the home environment. 

Even though only one person in the family is experiencing symptoms of OCD, everyone feels like their lives are impacted. And OCD is constantly calling the shots. What is the best treatment for OCD in situations such as this? Read on to learn more about how we can approach treatment for OCD and anxiety when it lives in the family.

What is family accommodation in OCD?

Family accommodation is a term used to describe the ways in which family members support a loved one’s OCD. For example, a parent may assist their child in doing their rituals to decrease the burden to their loved one.

A partner might return home from work and shower and wash clothes to accommodate fears of contamination entering the home. Although these behaviours are carried out with the best of intention, they result in maintenance of the OCD itself. When a loved one engages in rituals, it only temporarily decreases the anxiety experienced by the individual with OCD. The obsessive thought will return as will the urge to engage in the compulsion again. Rituals, whether performed by the individual with OCD or a loved one, serve to perpetuate and feed the OCD cycle.  

A recent review of the literature found that family accommodation is very common in OCD. Its occurrence is also associated with the level of severity of the OCD. 

Accommodating OCD behaviours might begin slowly and increase over time. It could become a pattern of behaviour in the family that seems natural and part of the way the family operates. These behaviours often help to “keep the peace” within the family too. When loved ones with OCD are asked to refrain from rituals, they might experience distress and anxiety.

Anger can also be an emotion that is unleashed within the family when rituals can’t take place. In all these situations, family members are in need of different strategies to help their loved one cope with OCD. Yelling and arguing are never helpful in these situations.The best treatment for OCD can often be to involve family members. This is true during OCD treatment for teenagers as well as individuals of all ages who live with others and engage in asking for accommodations for their OCD. 

Why is it important to involve family members in treatment for OCD?

Research has also shown us that helping to decrease family accommodation can help increase the effectiveness of OCD therapy. As mentioned, family accommodation maintains the OCD cycle. Therefore, when an individual’s family member performs rituals, it is keeping the cycle of OCD alive. It also takes away from work that an individual is doing in therapy to decrease their compulsions if others around them are continuing to do these types of behaviours.. 

For example, let’s say an individual is working on increasing their tolerance to contamination in treatment for OCD. Their OCD therapist has helped them to no longer wash their hands for as long as possible when entering the home. They have also stopped changing outside clothes to inside clothes when they come home. However, they still insist that their partner launders their clothes upon arrival. 

When their partner launders their clothes, it actually undoes some of the hard work they are doing during their treatment for OCD. When engaging in exposure and response prevention (ERP) therapy, they are refraining from washing and changing clothes. When their partner engages in showering, it takes away anxiety they would otherwise experience and learn to tolerate. It also can cause relational issues between the individual and their partner. Therefore, the work of OCD therapy needs to happen for all family members in a situation such as this one.

OCD treatment for teenagers should often involve family members to ensure that accommodating behaviours are being addressed. Teenage OCD treatment can provide parents with helpful coaching strategies that can be used during exposure therapy work. In this way, youth feel supported and parents feel empowered to help their loved ones manage their OCD rituals in a constructive way. This is much more therapeutic than parents arguing with their teens or threatening punishment.

It is important to remember that ritualistic behaviour is not being done to hurt other people. It is often being done due to fear and anxiety. Individuals often speak about how their rituals “protect” those they love. It is important for parents to understand how these rituals are motivated during the course of OCD treatment for teenagers.

There are other important benefits to family involvement in treatment for OCD as well. Allowing family members to decrease their involvement in rituals, also gives family members back feelings of freedom. Family members will often report feeling they are being “held hostage” by the OCD. Of course, this is not done purposely. Nevertheless, it does have an impact on people when they cannot live their lives in a meaningful way. And it can cause significant problems within relationships. Decreasing accommodation ensures that individuals with OCD are learning to decrease their rituals and not rely on others to maintain the OCD cycle. This provides for effective treatment for OCD.

When OCD makes the rules, people are often left making decisions that are not their own. Decreasing the involvement in rituals is hard work, but allows for everyone to have a better quality of life in the long term.

How can I help my loved one with OCD?

There are many ways to help a loved one with OCD:

• Learn more! Look for education on OCD that is from a reliable source. For example, the IOCDF contains excellent information for family members who have loved ones with OCD
• Talk to a professional with or without your loved one. Ideally, everyone will receive help on reducing OCD behaviours. Sometimes it is not the right time for an individual with OCD. However, family members can still receive parent coaching and family therapy that can be most useful
• Remember that doing rituals for your loved ones takes care of things quickly but does not provide a long-term solution. Instead, you are supporting their OCD and not their long-term recovery
• Realize that things might get more difficult before they get easier. Accommodation has allowed for your loved one to temporarily decrease their anxiety because you are helping them with their rituals. When you stop, they might feel additional distress. Professional treatment for OCD in the form of CBT and ERP can really help with this!

What are the next steps for OCD and my family?

If you or your family member feels ready to make a change, then it is time to find a trusted professional who can help! When someone feels motivated to make a change, it is wonderful and will allow them to jump into the ocean of change! Treatment for OCD can help your loved one, family members as well as improve the overall dynamics within the family.

Reach out to us at Forward Thinking Psychological Services™. We are ready to work with you and your loved ones on symptoms of OCD. We will bring you closer to a life that is of value to you. We look forward to hearing from you!