Obsessive-compulsive disorder (OCD) is a serious mental illness that is commonly misunderstood in popular culture. Maybe someone you know has been diagnosed with OCD, and you are unsure what this disorder truly entails and how to best support them in what they are going through.

The first step towards being able to support an individual with OCD is gaining an understanding of how this condition works. 

Understanding OCD

OCD is a neurobiological disorder that involves intrusive thoughts, urges or mental images (known as obsessions) and engaging in repetitive behaviours (known as compulsions) as an attempt to neutralize the anxiety. However, engaging in compulsive behaviour signals the brain to keep responding to the perceived threat, which exacerbates anxiety and perpetuates this vicious cycle.

There are many ways in which OCD can manifest. There are various OCD subtypes such as contamination, symmetry/perfectionism, harm OCD, pure O, scrupulosity, sexual orientation OCD and relationship OCD (just to name a few). The content of an individual’s obsessions is often related to what they value the most. This can be extremely distressing as intrusive thoughts tend to be in direct opposition to one’s values and true desires.

Compulsions are mental or physical behaviour that an individual does to get rid of the discomfort caused by obsessions. This can look like anything from decontamination (washing hands, cleaning), repetitive checking, mental compulsions (such as counting), repeating activities or body movements, reassurance seeking or avoidance behaviour.

There is no known cause for OCD, however, there are several risk factors including genetics, differences in brain structure/functioning and environmental factors such as trauma.

Treatment for OCD typically looks like a combination of psychotherapy and medication. The most effective treatment has been proven to be exposure and response prevention therapy (or ERP). The goal of ERP is to help an individual to tolerate discomfort and anxiety caused by intrusive thoughts without engaging in compulsive behaviour. Clinical studies have noted the effectiveness of ERP in comparison with traditional cognitive behavioural therapy.

Living with OCD can be debilitating and significantly impact an individual’s ability to carry out daily responsibilities. It can also take a toll on one’s personal relationships. (For more information about relationship health, click here). 

At the same time, supportive relationships can play a crucial role in an individual’s recovery from OCD. Now we will discuss some ways that you can support someone you care about who is living with OCD.

5 tips for supporting someone living with OCD

• Listen to what they are experiencing without judgement. Provide a safe space for this individual to be open about how they are affected by OCD if they are comfortable doing so. Despite how irrational their thoughts or fears may be, don’t try to counter what they are experiencing with logical reasoning. It won’t work.  It is also important to show non-judgment as an individual may share the content of obsessive thoughts that could be taboo or distressing. Remember that their OCD thoughts are not reflective of who they are or their true desires.
• Encourage them to seek professional treatment. It is extremely difficult for an individual to try to recover from OCD on their own. If they are not already receiving treatment, encourage them to discuss options with their doctor or mental health professional. It is common for individuals to feel hesitant about undergoing treatment. Be there to discuss their concerns and show support along the way. ERP (exposure and responsive prevention) treatment can be distressing at times due to having to learn to tolerate overwhelming feelings of anxiety and discomfort. Keep reminding this individual of their motivations for wanting to get better when things get difficult.
• Do not accommodate their OCD. When seeing a loved one in distress, it is only natural to want to help them in whatever way possible. Sometimes this may mean assisting them as they engage in compulsions such as sanitizing items around the house or waiting for them as they check the locks on the door numerous times. However, acting in a way that accommodates their OCD perpetuates the cycle, reinforcing that compulsive behaviour is the only way to manage anxiety. You might consider discussing with this person what you could do at that moment to help them challenge the urge to engage in compulsions or otherwise support them.
• Be careful about providing reassurance. Many individuals with OCD ask recurring, repetitive questions as a way to seek reassurance and minimise distress caused by intrusive thoughts. While it may offer temporary relief, providing reassurance is not actually helpful in the long run as it is never enough to satisfy the certainty they are looking for. Instead of offering reassurance, try using statements like ‘I’m not sure’ or ‘I guess we will have to see’ in order to move this person towards being OK with uncertainty.
• Be patient. Recovering from OCD is a process. Remember to be patient with your loved one, knowing that some days will be better than others. It is also crucial to take care of yourself during this time by prioritising self-care and setting appropriate boundaries. 

Ellen Diamond did her degree in psychology at the University of Edinburgh. She is interested in mental health, wellness, and lifestyle.