This post first appeared on my blog in 2011 (wow, I’ve been blogging a long time!):
At times I’ve mentioned that you should trust your instincts when helping a loved one deal with obsessive-compulsive disorder.
Turns out that’s not always true – especially when dealing with family accommodation.
Family accommodation refers to a family member’s participation or assistance in the rituals of their relative with OCD. Some common examples of family accommodation include reassuring (continually responding to questions such as, “Will I be okay if I do this or don’t do that?”), altering a family’s plans or routines, and giving in to your loved one’s OCD related requests. By accommodating in these ways, we are basically adding fuel to the fire. While we might help reduce our loved one’s anxiety in the short-term, we are actually prolonging the vicious cycle of OCD. Many studies, including this one, conclude that more family accommodation leads to more severe cases of OCD, and more distress among families.
My family and I were as guilty as can be when it came to accommodating, especially before our son Dan began proper treatment. This is where the instincts came in. As a mother, I just wanted to make everything all right and relieve my child’s pain. That was my instinct. So if Dan wanted to sit in a certain seat or eat only peanut butter and jelly sandwiches at midnight, I let him. What harm could it do? Turns out – plenty. By allowing these rituals to continue, I was validating his irrational thoughts, lowering my expectations of him, and giving him no incentive whatsoever to fight his OCD.
A light bulb moment occurred when my husband spent an afternoon shouting basketball scores to Dan in another room because Dan’s OCD would not allow him to view the television. It was at this point that we realized what we were doing was wrong and it was time to go against our instincts. “You want to know the score, Dan? Then come watch the game!” was the assertion that began our conscious attempt to not willingly accommodate him. I say “willingly” because it was often difficult to know what was OCD related and what wasn’t. When Dan wanted to do errands at 1:00 PM instead of 11:00 AM, was it really because he was busy, or was that just what his OCD was dictating at the time?
We’ll probably never know how much we unknowingly accommodated our son. But it wasn’t a problem for too long. Once Dan began his intensive exposure and response prevention (ERP) therapy and better understood what needed to be done to free himself of OCD’s grip, he made sure to let us know whenever we were inadvertently accommodating him. We worked as a team (though all the really hard work was his) to beat his OCD.
There is so much truth in this post. I’ve lived it. When you were researching treatment centers, were you able to find good outcomes data?
Hi Judy, We actually never researched treatment centers (though we absolutely should have at the time!) and never reviewed outcome data. I believe these statistics can often be misleading for several reasons. I’d be happy to discuss more with you if you want to email me at firstname.lastname@example.org