Find out:

Should I accommodate?  Should I reassure?

What is a tool I can use to help them at the moment?

Laurie: Hi! My name is Laurie Groh. I'm co-owner at Shoreside Therapies and today we have again with us, Julie Abdullah, and we are going to talk about OCD.

Julie: Hi!

Laurie: Hi Julie! We're going to talk about the do's and don'ts of supporting a loved one that is suffering from OCD, and I'm really excited to talk about this today because there are a lot of people in situations where they're the caretaker or they're the spouse or they're the friend of somebody that has OCD, and and they might not know exactly what to do, how to help. A question that I get a lot in sessions is: How do I not enable it? But at the same time be loving and caring and supportive? And sometimes those two things kind of... they kind of mismatch. So I'm very excited to talk about this today.

Julie: Yeah, yeah, that's a great intro to this, because you know, if we have someone in our lives that struggle with OCD, we just want them to feel better, whether that's our kids or our spouse, and feeling better can look a few different ways so we'll talk kind of about the do's and don'ts of that. How to support in a healthy way.

Laurie: That sounds great. Thanks again for being here.

Julie: Yeah, thanks for having me! So I think the first thing I say is really just to encourage your loved one to go to therapy. So we talked last week about what kinds of therapy is helpful for OCD- that being exposure and response prevention and so doing that therapy as soon as possible, if you have a child, or encouraging your partner to seek exposure and response prevention therapy is the number one way that you can be supportive if they're not, you know, doing therapy already. So that is what I would say is kind of the best way to begin that support.
Laurie: Hi! My name is Laurie Groh. I'm co-owner at Shoreside Therapies, and today we have again with us, Julie Abdullah, and we are going to talk about OCD.

Julie: Hi!

Laurie: Hi Julie! We're going to talk about the do's and don'ts of supporting a loved one suffering from OCD. I'm really excited to talk about this today because there are many people in situations where they're the caretaker, or they're the spouse, or they're the friend of somebody that has OCD. They might not know exactly what to do how to help. A question that I get a lot in sessions is: How do I not enable it? But at the same time, be loving and caring and supportive? And sometimes those two things kind of... they kind of mismatch. So I'm very excited to talk about this today.

Julie: Yeah, yeah, that's a great intro to this, because you know, if we have someone in our lives that struggle with OCD, we just want them to feel better, whether that's our kids or our spouse, and feeling better can look a few different ways so we'll talk kind of about the do's and don'ts of that. How to support in a healthy way.

Laurie: That sounds great. Thanks again for being here.

Julie: Yeah, thanks for having me! So I think the first thing I say is really just to encourage your loved one to go to therapy. So we talked last week about what kinds of therapy are helpful for OCD- that being exposure and response prevention and so doing that therapy as soon as possible. If you have a child, encouraging your partner to seek exposure and response prevention therapy is the number one way that you can be supportive if they're not, you know, doing therapy already. So that is what I would say is kind of the best way to begin that support.

Laurie: Yeah, so maybe if, if you were a parent or a spouse, I mean that might be similar as far as researching to find someone. I mean, obviously, you'd be a wonderful resource for somebody. But you know, looking around and seeing who might be the right fit for their spouse or child. So that's like the number one thing, right? We talked a little bit last time on... It just gets worse. It's not something that just kind of gets better on its own. So that treatment piece and getting them in there as soon as possible is that number one.

Julie: Yeah, absolutely!

Laurie: All right.

Julie: Yeah, so other ways, like I mentioned and you were talking about in the beginning. We want to help our loved one experience less anxiety, which is really just the core of OCD, feeling that anxiety at pretty intense levels a lot of the time, and so a lot of us will kind of naturally want to reassure our partner or our child or a friend and help them feel better in the moment. So it might look like saying something like 'everything is going to work out or 'you did nothing bad,' 'everything is going to be okay, and these are things that a lot of us love to hear, and they help bring down that anxiety pretty quickly in the moment. This can get tricky with OCD because it gets in the way of re-learning that anxiety isn't dangerous, and then it can come down over time. And so reassurance kind of cuts that short and does reduce the anxiety, but it's really more of a short-term fix and doesn't end up having that person develop a healthy relationship with their anxiety.

Laurie: Yes, that part is so important, right? And you're saying it in such an interesting way. What it's (reassuring) doing is stopping that potential, natural, maybe self-regulation that could occur. Reassuring or saying "it's going to be okay", "don't worry about it:, "it's fine". Nobody here is sick, for example. "It's okay, nobody's sick", to calm somebody down when they're feeling that anxiety. But so what you're saying is that after the treatment or during treatment, because you want to do that first before probably using some of those techniques, but during that course of treatment. Talking to the provider but making sure that you're not doing some of the reassuring in order to help that anxiety reduce. You want that to be more internal for the client, for them to not be so scared about it.

Julie: Absolutely, yeah, and this is really hard at first for both parties. The person that's struggling with anxiety wants to be reassured, of course, and then you know, if it's our child or our spouse, we want to reassure them. And so, breaking that cycle can be really difficult in the beginning. But, like you said, it's most important to help them through the anxiety rather than reduce their anxiety. So there are ways that we can be supportive, and I'll talk about that, of helping them through it without reducing it.

Laurie: I love that difference right there because it doesn't mean you're not helping. It just means that it looks different.

Julie: Yeah, before we get into that, I'll say another common way that we can kind of get in the way of therapy for OCD with our loved one is by accommodating. So this can look a little bit more like behavior that we're doing to help them reduce their anxiety. For kids, this could be helping them avoid a place or a chore, maybe at home, that does cause a lot of anxiety for them. Maybe again, it could be reassurance as well. It could be, you know, accommodating your schedule so that they are able to perform their rituals and feel better for the day. Again, more of a short-term fix, not going to help their treatment in the long term.

Laurie: That's really important. Yes, go on; I didn't mean to cut you off.

Julie: That's okay, yeah, so that could look like.. those are ways to accommodate in children. If it's a partner, we could be reducing their responsibilities with work, or things around the house may be doing things for them because of the anxiety that they're experiencing. Maybe you're censoring yourself and avoiding certain topics or words because of how triggering it could be for them. So these are things that we want to watch out for because they can really get in the way of re-learning that anxiety is something that they can tolerate. Help them build their own self-confidence around being able to do that.

Laurie: And that part is tough, I think too, especially. You know I'm kind of looking in the lens of a parent and how that could be really tough to distinguish because sometimes you don't know exactly if the child's having anxiety about something if they're going to start like gymnastics or something, and they're feeling pretty anxious. And at first, they said, yeah, I want to go, that seems fun and then, as time gets closer, now that that seems boring or I don't want to do it. And so that sometimes is tricky, to know.. is it really that they're just thinking it's going to be boring or is there more to it? Is there more of an anxiety situation going on and that can be tricky.

Julie: That can be really tricky. I think you bring up a good point because there's a lot that underlies underneath the surface of that. So as much as you can, have a conversation with your kid about maybe what is the reason why they want to avoid something and hopefully get down to the kind of core fear of it. If it feels like the reason is related to an obsession for ODC, or a prediction that something bad could happen or that they won't be able to handle it? That would be something I'd encourage you to have them challenge themselves with.

Laurie: Right, to check in with what they're feeling. Maybe their physical symptoms or sensations. You could check in and see, okay, is your stomach.. you know, one thing with kids right is like stomach issues or headaches or just not feeling well, because they don't know exactly how to describe it and just kind of zeroing in. Okay, what exactly are you feeling, and then you know deciphering that way? But I think encouraging somebody to kind of move forward into what they're feeling anxious about is usually a good thing. It is just as a matter of how do you support? Because it can feel really much like shoving, and that's not going to be helpful either. That might bring up a lot of resentment or anger and frustration. But how do you kind of make sure that you're being supported without pushing too far.

Julie: Yeah, so let's talk about support so that those are some things not to do. We don't want to rest or accommodate. But what we do want to do is be there through the process for our loved ones. So if they are in therapy and they're doing these exposures, these things that cause anxiety for them, ideally, like we talked about last week, that's going to be kind of a medium level of anxiety. So the things we want to encourage them to do are going to be midrange activities. So maybe if going to gymnastics is something that causes them like ten out of ten for anxiety, it wouldn't be very supportive to force that, and you know, maybe just driving to the parking lot is something that they can tolerate for the day. So really doing it in a gradual way can be supportive and encourage them to challenge themselves while also being mindful that they're not ready for the hardest thing yet.

Laurie: Right right, those parts are so important, and I hope I'm not skipping ahead to what you might already be saying. But would it be helpful for a parent to check in with the child as far as their anxiety for something?

Julie: Absolutely, yeah, we don't want to mind read. So as much as you can, like asking what level of anxiety they're at and just kind of going from there, based on what they feel like they can tolerate.

Laurie: And I do love that you gave that example of going into the parking lot as something maybe like a step towards, because it doesn't mean that you just don't do the thing, potentially, but it might be.. you know, what would bring it down from ten to maybe more of that range you were talking about of maybe four or five and maybe that means that you walk them in or that you stay that day, but the next day or the next time you kind of pull back and figuring some of those things out.

Julie: Absolutely yeah, another way that can be really helpful for kids or adults that are struggling really in the moment of just a high level of anxiety from their OCD is to walk them through a breathing exercise. So again, this is not to reduce the anxiety at the moment, but just to help them go through that experience. And breathing can be really helpful to kind of reregulate and be able to challenge themselves or kind of think logically about what to do next. So what I like to instruct people is, really slowly, maybe about four seconds in, five seconds of an exhale out. Whatever works for you, everyone's a little bit different, but doing something together that can help them really feel reregulated is helpful.

Laurie: Right, I love that, because it's something simple that we can all do, but at the same time it's very effective and powerful, and at least from my experience, I don't know if you feel the same with clients when they're starting those breathing exercises, they might not exactly work right away, but as you practice, it could only be one breath, and it's something they can always have with them that they can always return to, and, like, I'm going to spend some time with myself, bring my heart rate down, activate the sympathetic nervous system, and there's some calming, yeah.

Julie: Yeah, it's a very portable skill, so.. everyone breathes, everyone can do it, so it's just really great to have.

Laurie: Yeah, that's awesome. Yeah, all right, so other do's and don'ts.

Julie: You know, I think keeping it simple is best as far as how to support. We don't want to get in the way of their ability to experience anxiety. So, breathing is great because it's not too distracting, but it is helpful to get down from those really high levels and then from there, exposure therapy is pretty simple. We just want to let time pass and let the anxiety be there. So sometimes, being just another person in the room can be what's most supportive for your loved one.

Laurie: Yes, I love that. Just being there can sometimes be enough because a lot of it they're going to have to learn how to be okay with anxiety. It's basically that work is how do I be friends with the scary thing? That isn't really scary when you start to realize what it is, but the avoiding makes it so much bigger.

Julie: Yes, you hit the nail on the head.

Laurie: So, Julie, is there anything else you want to add or any other resources, anything we didn't touch upon today?

Julie: Yeah, as far as resources go, I wanted to share that iocdf.org, so the International OCD Foundation, is a great resource for parents or spouses or people with OCD. They've got videos, books... you can look up therapists that practice exposure and response prevention. They have a yearly conference that you can attend. They've got lots of different things. So going to that website, they have a special section for kids with OCD as well there, so that can be a great resource. There's also a book that I would recommend. It's called Loving Someone With OCD. It's by doctor Karen Landsman, and that can help support kind of that journey that you go on with your child or spouse that has OCD.

Laurie: Oh, that's wonderful, okay, so I'll put that in the comment for anyone, some links so that you make them nice and easy for people to find those things. Those resources are great. I feel like that's... I mean, I've never read that book, but it sounds like I might be reading that book. It really sounds like it's a good, good resource.

Julie: Yes, yes, absolutely, because everyone needs to be supported, even those that are being the supporters.

Laurie: Right, right, and that brings me to one more question I have. So if you're working with a client, is it something where a spouse or a parent could be included in that treatment, and how do you do that?

Julie: Yeah, absolutely; I think having whoever is in the home in for a session every now and then to first educate them on what is accommodation and why is it not helpful is really powerful to make sure that that treatment continues at home. It's not that they have to be included in every session, but getting that initial education and then kind of checking in on how progress is going and if they've been having struggles with holding up their end of the support can be a great way to involve the whole family.

Laurie: Yeah, I think it just would make treatment so much easier and recovery so much easier, because then that person, that loved one, knows exactly what to do and that they are also being held accountable. You know, so I think that that would be really useful.

Julie: Yeah, for sure.

Laurie: All right, well, thanks again, Julie. I really appreciate you taking the time to meet with me today. So if any of you would like to speak with Julie, set up an appointment, just go to www.shoresidetherapies.com. Also, on Facebook, we have all of our information. You can text or email or call whatever is easiest for you. And you can schedule right online as well. So thanks again, and we'll talk soon.

Julie: Sounds good, bye!

Laurie: Yeah, so maybe if, if you were a parent or a spouse, I mean that might be similar as far as researching to find someone. I mean obviously you'd be a wonderful resource for somebody. But you know looking around and seeing who might be the right fit for their spouse or child. So that's like the number one thing, right? We talked a little bit last time on.. It just gets worse. It's not something that just kind of gets better on its own. So that treatment piece and getting them in there as soon as possible is that number one.

Julie: Yeah, absolutely!

Laurie: All right.

Julie: Yeah, so other ways, like I mentioned and you were talking about in the beginning. We want to help our loved one experience less anxiety, which is really just the core of OCD, feeling that anxiety at pretty intense levels a lot of the time, and so a lot of us will kind of naturally want to reassure our partner or our child or a friend and help them feel better in the moment. So it might look like saying something like 'everything is going to work out' or 'you did nothing bad', 'everything is going to be okay' and these are things that a lot of us love to hear and they help bring down that anxiety pretty quickly in the moment. This can get tricky with OCD because it gets in the way of re-learning that anxiety isn't dangerous and then it can come down over time. And so reassurance kind of cuts that short and does reduce the anxiety, but it's really more of a short-term fix and doesn't end up having that person develop a healthy relationship with their anxiety.

Laurie: Yes, that part is so important right? And you're saying it in such an interesting way, because what it's doing is stopping that potential, natural, maybe self-regulation that could occur, reassuring or saying like it's going to be okay, don't worry about it, you know it's fine or, depending on what is actually the behavior, it could be related to the behaviour as well of.. you know, you don't need to do that. Nobody here is sick, for an example. Like it's okay, nobody's sick, to calm somebody down when they're feeling that anxiety. But so what you're saying is that after the treatment or during treatment, because you want to do that first before probably using some of those techniques, but during that course of treatment, probably also talking to the provider but making sure that you're not doing some of the reassuring in order to help that anxiety reduce. You want that to be more internal for the client, for them to not be so scared about it.

Julie: Absolutely yeah, and this is really hard at first, for both parties. The person that's struggling with anxiety wants to be reassured, of course, and then you know, if it's our child or our spouse, we want to reassure them. And so breaking that cycle can be really difficult in the beginning. But, like you said, it's most important to help them through the anxiety rather than reduce their anxiety. So there's ways that we can be supportive, and I'll talk about that, of helping them through it without reducing it.

Laurie: I love that that difference right there, because it doesn't mean you're not helping. It just means that it looks different.

Julie: Yeah, before we get into that, I'll say another common way that we can kind of get in the way of therapy for OCD with our loved one is by accommodating. So this can look a little bit more like a behaviour that we're doing to help them reduce their anxiety. For kids, this could be helping them avoid a place or a chore, maybe at home, that does cause a lot of anxiety for them. Maybe again it could be reassurance as well. It could be, you know, accommodating your schedule so that they are able to perform their rituals and feel better for the day. Again, more of a short-term fix, not going to help their treatment in the long term.

Laurie: That's really important. Yes, go on, I didn't mean to cut you off.

Julie: That's okay, yeah, so that could look like.. those are ways to accommodate in children. If it's a partner, we could be reducing their responsibilities with work, or things around the house may be doing things for them because of the anxiety that they're experiencing. Maybe you're censoring yourself and avoiding certain topics or words because of how triggering it could be for them. So these are things that we want to watch out for, because they can really get in the way of re learning that anxiety is something that they can tolerate and helping them build their own self-confidence around being able to do that.

Laurie: And that part is tough, I think too, especially. You know I'm kind of looking in the lens of a parent and how that could be really tough to distinguish, because sometimes you don't know exactly if the child's having anxiety about something, if they're going to start like gymnastics or something, and they're feeling pretty anxious. And at first they said, yeah, I want to go, that seems fun and then, as time gets closer, now that that seems boring or I don't want to do it. And so that sometimes is tricky, to know.. is it really that they're just thinking it's going to be boring or is there more to it? Is there more of an anxiety situation going on and and that can be tricky.

Julie: That can be really tricky. I think you bring up a good point because there's a lot that underlies underneath the surface of that. So as much as you can, having a conversation with your kid about maybe what is the reason why they're wanting to avoid something and hopefully getting down to the kind of core fear of it. If it feels like the reason is related to an obsession for ODC, or a prediction that something bad could happen or that they won't be able to handle it? That would be something I'd encourage you to have them challenge themselves with.

Laurie: Right, to check-in with what they're feeling. Maybe their physical symptoms or sensations. You could check-in and see, okay, is your stomach.. you know one thing with kids right is like stomach issues or headaches or just not feeling well, because they don't know exactly how to describe it and just kind of zeroing in. Okay, what exactly are you feeling and then you know deciphering that way? But I think encouraging somebody to kind of move forward into what they're feeling anxious about is usually a good thing. It just as a matter of how do you support? Because it can feel really much like shoving, and that's not going to be helpful either. That might bring up a lot of resentment or anger and frustration. But how do you kind of make sure that you're being supported without pushing too far.

Julie: Yeah, so let's talk about support, so that those are some things not to do. We don't want to rest or accommodate. But what we do want to do is be there through the process for our loved one. So if they are in therapy and they're doing these exposures, these things that cause anxiety for them, ideally, like we talked about last week, that's going to be kind of a medium level of anxiety. So the things we want to encourage them to do are going to be that midrange activities. So maybe if going to gymnastics is something that causes them like ten out of ten for anxiety, it wouldn't be very supportive to force that and you know, maybe just driving to the parking lot is something that they can tolerate for the day. So really doing it in a gradual way can be supportive and and encourage them to challenge themselves while also being mindful that they're not ready for the hardest thing yet.

Laurie: Right right, that parts so important, and I hope I'm not skipping ahead to what you might already be saying. But would it be helpful for a parent to check-in with the child as far as their of anxiety for something?

Julie: Absolutely yeah, we don't want to mind read. So as much as you can, like asking what level anxiety that they're at and just kind of going from there, based on what they feel like they can tolerate.

Laurie: And I do love that you gave that example of going into the parking lot as something maybe like a step towards, because it doesn't mean that you just don't do the thing, potentially, but it might be.. you know, what would bring it down from ten to maybe more of that range you were talking about of maybe four or five and maybe that means that you walk them in or that you stay that day, but the next day or the next time you kind of pull back and figuring some of those things out.

Julie: Absolutely yeah, another way that can be really helpful for kids or adults that are struggling really in the moment of just a high level of anxiety from their OCD is to walk them through a breathing exercise. So again, this is not to reduce the anxiety in the moment, but just to help them go through that experience. And breathing can be really helpful to kind of reregulate and be able to challenge themselves or kind of think logically about what to do next. So what I like to instruct people is, really slowly, maybe about four seconds in, five seconds of an exhale out. Whatever works for you, everyone's a little bit different, but doing something together that can help them really feel reregulated is helpful.

Laurie: Right, I love that, because it's something simple that we can all do, but at the same time it's very effective and powerful, and at least from my experience, I don't know if you feel the same with clients when they're starting those breathing exercises, they might not exactly work right away, but as you practice, it could only be one breath, and it's something they can always have with them that they can always return to, and, like, I'm going to spend some time with myself, bring my heart rate down, activate the sympathetic nervous system and there's some calming, yeah.

Julie: Yeah, it's very portable skill, so.. everyone breathes, everyone can do it so it's just really great to have.

Laurie: Yeah, that's awesome. Yeah, all right, so other other do's and don'ts.

Julie: You know, I think keeping it simple is best as far as how to support. We don't want to get in the way of their ability to experience anxiety. So, breathing is great because it's not too distracting, but it is helpful to get down from those really high levels and then from there, exposure therapy is pretty simple. We just want to let time pass and let the anxiety be there. So sometimes being just another person in the room can be what's most supportive for your loved one.

Laurie: Yes, I love that. Just being there can sometimes be enough, because a lot of it they're going to have to learn how to be okay with anxiety. It's basically that work is how do I be friends with with the scary thing? That isn't really scary when you start to realize what it is, but the avoiding makes it so much bigger.

Julie: Yes, you hit the nail on the head.

Laurie: So, Julie, is there anything else you want to add or any other resources, anything we didn't touch upon today?

Julie: Yeah, as far as resources goes, I wanted to share that iocdf.org, so the International OCD Foundation, is a great resource for parents or spouses or people with OCD. They've got videos, books... you can look up therapists that practice exposure and response prevention. They have a yearly conference that you can attend. They've got lots of different things. So going to that website, they have a special section for kids with OCD as well there, so that can be a great resource. There's also a book that I would recommend. It's called Loving Someone With OCD. It's by doctor Karen Landsman and that can help support kind of that journey that you go on with your child or spouse that has OCD.

Laurie: Oh, that's wonderful, okay, so I'll put that in the comment for anyone, some links so that you make them nice and easy for people to find those things. Those resources are great. I feel like that's.. I mean I've never read that book, but it sounds like I might be reading that book. It's really sounds like it's a good, good resource.

Julie: Yes, yes, absolutely, because everyone needs to be supported, even those that are being the supporters.

Laurie: Right, right, and that brings me to one more question I have. So if you're working with a client, is it something where a spouse or a parent could be included in that treatment, and how do you do that?

Julie: Yeah, absolutely, I think having whoever is in the home in for a session every now and then to first educate them on what is accommodation and why is it not helpful, is really powerful to make sure that that treatment continues at home. It's not that they have to be included in every session, but getting that initial education and then kind of checking in on how progress is going and if they've been having struggles with holding up their end of the support, that can be a great way to involve the whole family.

Laurie: Yeah, I think it just would make treatment so much easier and recovery so much easier, because then that person, that loved one, knows exactly what to do and that they are also being held accountable. You know, so I think that that would be really useful.

Julie: Yeah, for sure.

Laurie: All right, well, thanks again, Julie. I really appreciate you taking time to meet with me today. So if any of you would like to speak with Julie, set up an appointment, just go to www.shoresidetherapies.com. Also on Facebook we have all of our information. You can text or email or call, whatever is easiest for you. And you can schedule right online as well. So thanks again, and we'll talk soon.

Julie: Sounds good, bye!