What Families Can Do for a Member With a Problem

Vijai P. Sharma, Ph.D.

This is the seventh article in a series of eight obsessive compulsive disorder.

When a person with a physical or emotional illness needs help, the whole family needs help.  Families need education about the disorder and the special needs of the member who is ill as well as significant emotional support.  What is discussed here applies to all families who have a troubled member among their own.

Persons with obsessive compulsive disorder can maintain caring and positive relationships.  In one study, OCD sufferers reported being as happy with their marriages as couples in the general population -- in spite of the burden OCD places on individuals and families.  On the other hand, frequent arguments, absence of communication, separation or even divorcee occur on account of OCD.  It is also know that anxiety and stress resulting from such family tensions can worsen OCD symptoms.

If family members are overly angry and critical, more OCD patients drop out of treatment, fail to do their self-help assignments, and are more likely to have relapses.  We know this to be true in the case of other emotional and behavioral disorders as well.  Patients whose families are perceived as highly critical in family interviews are more likely to drop out of treatment compared with those whose families are supportive.  Without family support, patients will not show sustained commitment to professional treatment or to a self-help program.  A general guideline to families is, "Be more supportive and less critical."  Specific do's and don't are stated below.

1)  Support and encourage the OCD person to endure the situation, with comments such as, "Give it a try, you might just be able to do it."  Ask questions and offer suggestions so that they can devise a plan how best to expose themselves to an avoided situation and how not to give in to the compulsions in order to reduce the anxiety:"

2)  Have patience.  OCD has phases.  It gets better at some times and worse at others.  People with OCD vary greatly in the severity of symptoms and the speed of recovery:" 

3)  Give positive feedback for even small gains without a hint of criticism.  For example, appreciate washing hands only 10 times instead of the usual 15, and for taking only 20 minutes instead of 30 to get dressed, or for daring to touch a "contaminated" object, though it may be only for a few seconds.  In contrast, it defeats the purpose to say, "I know you have done better this week, but do you know how long I still have to wait for you to get through your rituals?"

4)  If you get upset over OCD behaviors, direct your frustration toward the behavior and not toward the person:

5)  When OCD persons come in contact with the feared situation, they tend to seek relief in compulsions.  Monitor and discourage such a behavior as the tendency to revert back to compulsions may erase the gains made:  and 

6)  Draw attention to the automatic compulsive behavior that an OCD person may no longer be conscious of performing.

1)  Don't participate in the OCD person's rituals.  If you have been participating in the rituals, discuss how unhelpful it really is and stop doing it by a mutually agreed plan;
2)Don't take over the tasks that OCD people try to avoid doing.  Encourage them to do it for themselves.  But don't push too hard or too fast:

3)  Don't say, "If you would only try it harder..."  Nothing upsets an OCD sufferer more than to hear that he or she is not trying hard.  Get anger and blame out of the way so treatment can be carried out without the interference from such emotional setbacks:

4)  AND OCD person may obsessively seek reassurance from family.  For example, asking over and over again if a situation is safe of is something has been checked properly.  Don't give in.  Politely refuse such request for reassurance.  Tell him or her that you don't want to be an "enabler" or foster dependence on yourself.  Do encourage the person to rely on his or her own ability to control anxiety without  seeking relief through reassurance and compulsion.  When obsessions and compulsions decrease, a person with OCD will have more time available.  Have a few ideas about family activities, hobbies, and projects up your sleeve to utilize the newly saved time.

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Copyright 1996, Mind Publications 


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