Caring for family members with OCD

Caring for family members with OCD

Living with someone who has OCD can be a taxing experience. Family members not only are unable to handle problematic behaviours, they also end up feeling stressed out themselves at times.  It is important to strengthen relationships between patients and their families. Keeping in mind the following points would empower families dealing with obsessive –compulsive behaviours:

Recognizing signals

Family members should learn to recognize the warning signs of OCD. Changes in behaviour are easily observable, even thoughts which are not expressed freely can lead to behaviour changes. Taking long time to finish tasks, such as in bathroom, getting dressed, doing self study, repeating certain things, repeated questioning, staying up late to get things done, inability to sleep properly, avoiding certain activities, and extreme emotional reactions to small things are signs that should be watched out for.


Differentiating between OCD and the person

People with OCD usually report that their symptoms get worse the more they are criticized or blamed, because these emotions generate more anxiety. So, it is essential that the family learns to view these features as signals of OCD and not as personality traits. This way, the family can join the person with OCD to combat the symptoms rather than become alienated from them.

Having realistic expectations

People with OCD report that change of any kind, even positive change, can be experienced as stressful. It is often during these times that their symptoms tend to increase. Family can help in reducing stress by modifying their expectations during these times of transition. Family conflicts result in increasing symptoms. Validating that the person may be undergoing stress as his or her life is undergoing change is reassuring. The path of recovery is never a straight line. Even while improving the person with OCD may slip and needs support as well as encouragement. Suddenly expecting too much from the person who is showing improvement may prove to be counter-productive.

Recognize “Small” Improvements

Persons with OCD often complain that their family members do not understand what it takes to achieve even small improvement. Cutting down time taken to have a bath or starting buying groceries may involve huge efforts for the person. While these gains seem insignificant to family members, it is really a big step for the person suffering from OCD. Acknowledgment of these seemingly small accomplishments is a powerful tool that encourages them to keep trying. This lets them know that their hard work to get better is being recognized and can be a powerful motivator.

Support the person; not the illness

It is understandable that OCD can be unnerving for both the sufferer and family. However, please remember that the more you can avoid personal criticism, the better it is.
It is not so that acceptance and support means ignoring the compulsive behavior. Do your best to not participate in the compulsions. In an even tone of voice explain that the compulsions are symptoms of OCD and that you will not assist in carrying them out because you want them to resist as well. Make the person understand each time that you are against OCD and not against the person who is suffering.


Supporting Treatment

Before you ensure that the person with OCD is regular with medicines, it is important to be convinced yourself that it is helpful to take these medicines. Passing comments such as “No matter how much money we spend, these medicines are doing no good to you!” will only propel the patient to leave medicines or undermine their importance. Also understand that medicines cannot make the symptoms evaporate overnight. Medicines take time to have effect on brain functioning and it is important to remember that periodical review with your Doctor is of utmost importance. Stopping the medicines or reducing the dosage on your own can prove to be counter-productive. Remind the patient of these facts when he or she loses hope.

During therapy/counselling, certain limits on obsessive and compulsive behaviours might be set. Family members can help the patient stick to these limits. As per the suggestions by the therapists, family members may find that they have to be firm about:
1) Prior agreements regarding assisting with compulsions;
2) How much time is spent discussing OCD;
3) How much reassurance is given; or
4) How much the compulsions infringe upon others’ lives.

Limit setting works best when these expectations are discussed ahead of time and not in the middle of a conflict.

Communicating with person suffering from OCD

It is beyond doubt that the family means well for the patient. However, it may not be possible to communicate your good intentions to the patient all the time. He or she might feel that the family does not understand what he or she is going through. Avoid lengthy explanations and rationales. It is likely to upset the person and thus might result in an increase in anxiety and consequently the symptoms. While communicating; separate the illness from the person. Instead of starting a sentence by saying “you always keep on checking the door”, try saying “I understand that you always feel like checking the door again and again”.

Individuals with OCD report that their mood determines the extent to which they can divert obsessions and resist compulsions. When the patient is having an irritable mood, or a low mood, it is best to back off, unless there are chances that the person might hurt himself or herself.

Family members often have the natural tendency to feel like they should protect the individual with OCD by being with him all the time. This can be destructive because family members need their private time, as do people with OCD. Give them the message that they can be left alone and can care for themselves. It may seem obvious that family members and individuals with OCD are working toward the common goal of symptom reduction, but the ways in which people do this varies. Creating goals as a team along with your treating team reduces conflict, preserves the household, and provides a platform for families to begin to “take back” the household in situations where most routines and activities have been dictated by an individual’s OCD. By improving communication and developing a greater understanding of each other’s perspective, it is easier for the individual to have family members help them to reduce OC symptoms instead of enabling them. It is essential that all goals are clearly defined, understood, and agreed upon by any family members involved with carrying out the tasks in the contract. Families who decide to enforce rules without discussing it with the person with OCD first find that their plans tend to backfire.

World Brain Center Hospital provides not only pharmacological and psychological treatment for OCD, but family counselling for family members of patients suffering from OCD as well.



About Neelesh Tiwari

Dr. Neelesh Tiwari is working as Managing Director of World Brain Centre & Research Institute. Dr Neelesh Tiwari has recently received the prestigious Jansanskriti Award from Dr. G.B.G Krishnamurthy, Ex- Chief Election commissioner of India.

Posted on March 5, 2014, in Mental Illness. Bookmark the permalink. Leave a comment.

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