OCD in Relationships: Should You Participate in Rituals to Help Relieve Anxiety?
Rita was worried about leaving appliances on. When she and her husband, Tom, got to the car, invariably, she would send him back into the house to check the stove. While he was in the house, she worried that the iron was still on and when he came back out, she would send him in again. This ritual went on for anywhere from 5 to 20 minutes (usually closer to 20 than to 5). Tom was prepared for the ritual and usually didn't mind, after, all, if it was going to relieve Rita's anxiety, he felt it was worth it. The problem was, it didn't relieve her anxiety and the ritual was taking longer and longer.
Sheila had intense anxiety about germs. She usually washed her hands at least 100 times each day. Sheila rarely left the house anymore because she couldn't face all the germs outside. She spent her days scrubbing all the surfaces in the house. Her husband Frank worried about Sheila but wasn't sure what to do. One morning, as he was heading out the door to go to work, Sheila started yelling frantically. She just realized she was almost out of hand soap and didn't think she was going to have enough to get through the day. Although already late for work, Frank agreed to go to the store to get more soap before he went to work.
Tony needed constant reassurance of his wife's love. He asked over and over if she loved him, even though the answer was always "yes" and she hadn't shown any signs of leaving. Joyce patiently answered and reassured Tony, even when he called her at work. She knew that he would obsess over why she didn't answer the phone, call him right back or immediately respond. Although it interrupted her workday and her coworkers found it annoying, Joyce thought it would help relieve Tony's anxiety.
Often, when someone with OCD is married, they want their spouse to participate in rituals, or, the spouse does it out of love, believing it will help reduce the anxiety. But, in reality, this type of behavior usually makes the anxiety worse or increases the compulsions. This type of reaction reinforces OCD behaviors; it makes your spouse even more dependent on the rituals.
How to Stop
Stopping your participation doesn't mean stopping your support. Your spouse still needs you to be encouraging and supportive, just in a way that doesn't enable OCD behaviors. You don't, however, want to suddenly stop all participation as this may cause anger, resentment and confusion for your spouse. It is a good idea to work on changing your patterns of behavior slowly and with the help of a therapist.
One tool to help disengage in enabling and accommodating behaviors is called mapping. This concept was originally introduced in 1998 by a psychiatrist, John March, and a family therapist, Karen Mulle for treating children and adolescents with OCD. It was later modified to help adults as well. Mapping involves family members determining which OCD behaviors they will no longer tolerate - that becomes the target behavior. With the help of a therapist, family members, including the person with OCD, create a systematic plan for slowly ending any participation in rituals. As you stop your participation, your spouse begins to take more responsibility for her own rituals.
This type of program works best when both you and your spouse are involved and working together to eliminate your need to participate in rituals and, hopefully, reducing OCD symptoms overall. However, in some cases, your spouse may not be willing. In these cases, you can still disengage - but be sure to tell your spouse what you are doing and give a time limit for when all participation will end. This will give your spouse some time to get used to the idea and to adjust. While working toward disengagement without the help of your spouse can cause stress, in the end you may find that the result is the same and tensions will slowly disappear or lessen.
"Living with Someone Who Has OCD: Guidelines for Family Members," Date Unknown, Barbara Van Noppen, Ph.D. and Michele Pato, M.D. International OCD Foundation
"Roadmap to Recovery: Families of Adult OCD Sufferers Living at Home," Date Unknown, John Hart and Throstur Bjorguinsson, Beyond OCD: Expert Perspectives