Hello, I'm new to the community here and hoping for some help finding resources and guidance on how to cope with my partner's OCD and to best support him.
Some background on his condition:
He has contamination OCD and has been treated with high levels of Prozac for many years in addition to ineffective on-again-off-again therapy. About six months ago he weaned off the medication, wanting to try alternative treatments, but his symptoms have worsened considerably. At this point the OCD is fully untreated and unchecked and at times debilitating for him. Quality of life is very low and he suffers from regular depression and bouts of anger.
My ability to support him is waning. Often I become the target for frustration related to OCD triggers that are otherwise unrelated to me. He insists that I should not accommodate him, but also that I should better recognize and be sympathetic towards what triggers him. It feels like an impossible position to support him in. I often don't know what is OCD-related and what is just frustration.
He is amenable to treatment, in particular exposure therapy, but has been resistant or hesitant to take any real steps because of OCD-related triggers (for example the initials of the potential therapist are "contaminated" or the address of the office has numbers he doesn't like).
I read a lot about OCD and feel I have a good grasp of the condition and the treatments. What's difficult is knowing what's best as a partner. Everything I read says not to accommodate and to set boundaries. This is easier said than done, and with the 100 different day-to-day decisions I have to make of how to avoid his triggers or face his wrath, it feels impossible to do alone. There are no support groups in my area and I have no one to talk to that really understands OCD.
Anything this community can direct me towards is welcome.
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Plant_Man
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It can be really difficult for partners, other family members and friends of an OCD sufferer! I've always tried to minimize the effects my OCD has on those close to me, but I know that my behaviour can be downright awkward.
I think the first thing your partner needs to do is to go back on the meds. They really can damp down the OCD and make other treatments such as CBT and ERP easier to do.
Exposure therapy is hard to do - it isn't ineffective in itself - it's just that it is really difficult to do. I know, because I've often struggled with it. But it can make a real difference.
Therapists do say partner and family should not enable or accommodate the OCD, but it really is difficult in practice, as you say. And it's hard to avoid triggers, as old ones disappear and new ones take their place.
Best of luck with this - there's a lot of OCD experience on this forum, if you have more questions or just want to vent! He's lucky to have you in his life.
Thanks so much for your reply and sharing your experience. For the ERP (and other therapy) do you feel there is value in me participating in that on some level? I don't necessarily want to be a part of his therapy, but as involved in his life as I am, it seems that I would need to have some understanding or participation in that in order to support him in the right ways.
I think it does help to have support! For me (and I can't speak for anyone else) I've found it most supportive if someone is just there for me - not actively encouraging, not participating, and certainly not criticizing - just being there as a friendly and supportive presence.
As I said, CBT and ERP are difficult, and while attempting them your partner is likely to make numerous attempts before succeeding with it. It's important that neither you not he think of these attempts as 'failures'. Each little attempt, no matter whether one succeeds or not, helps to undo the OCD.
Don't gee him on or tell him how brave he is, or at least while he's doing the ERP. The ERP often takes quite a lot of concentrated effort and comments from someone else can be distracting. But knowing that you're there for him is a help in itself.
Although OCD is a debilitating condition, it is treatable and sufferers can get back some sort of normality to their lives. I feel for you both - anger and frustration are common side issues with it. Keeping busy, as far as he is able to, can also help. Going back on the meds should help lift him out of his depression.
I do get why people want to try alternative remedies, and some of these may be of value (check out inositol, which in large doses has had good results in some really intractable cases and can be bought over the counter in drug stores and health food shops - it also appears to be safe with few side effects) but on the whole the standard treatments work best.
This is very helpful. I really appreciate hearing your experience with ERP. I am convinced it is the right treatment for him. Avoidance and anger at irrational emotional triggers are his most common OCD behaviors, and it seems to me a concerted and strategic approach to facing those triggers and re-learning how to productively process them or dismiss them altogether would be immensely helpful for him.
But here’s the problem we are in now. He is open to ERP treatment but unwilling to take the next step to get started because the treatment itself is now a trigger. I have found two local clinics, both very respected and both with a focus on OCD and ERP treatments. But he will not use them because they are “contaminated.”
The first is a large mental health center that he applied for a job to several years ago. He never interviewed or anything, but he never got a response from them. He had a nursing career then and he links this clinic with some of the OCD problems he had as a nurse.
The second is a smaller OCD focused clinic. I at least was able to convince him to have an assessment there. He did (and I was very proud of him and made him a nice dinner). But apparently when he met with the clinic director for the assessment he shared that his biggest fear and the root of his OCD triggers is multiple sclerosis. The clinic director, who had OCD and now treats it, was taken aback and (perhaps unprofessionally) shared that, coincidentally, his root fear with OCD was also multiple sclerosis. Now this clinic is contaminated because of that.
I don’t know where to turn next. I feel like he can find a reason with any clinic why it’s contaminated. But it’s not the individual clinics that are a problem. They’re just clinics. It’s the meaning he is prescribing to them. I’ve tried to gently help him see this but it seems he is blinded by the OCD. He says he feels like there is some invisible force that is making these coincidences happen. It’s all irrational and I have no qualifications to try to work through this.
I’m sure this probably isn’t what you’re trained for either, oh wise Sallyskins, but do you have any thoughts on how to overcome this next step? I don’t want to push him (too hard) but he needs help and he isn’t able to do it himself.
It's really difficult, and I've been there - not the clinics aversion, but the shutting down of options. It's as though one is in a room full of doors, each one opening onto a way out. And as you try each door, OCD shuts it and locks it.
So each clinic offers a way out - and OCD shuts it down for him. It almost feels like OCD is lying in wait to get to the door before you do! Contamination can be a mental thing as well as a physical thing with germs. And OCD is very good at finding 'patterns' where no real pattern exists - coincidences really do happen!
Could he perhaps do a therapy course online or at home out of a book? The problem might be that these too would become 'contaminated'.
If he could get over his aversion to just one clinic, then he could start to improve rapidly. Don't push him, or try to rationalize it for him - that sort of thing often brings out OCD's stubborn side (and I'm sure you've encountered OCD's stubborn side with your partner) and makes the sufferer dig their heels in. Perhaps the odd gentle hint, though. A big incentive is the thought of being able to do lots of things that OCD stops one from doing.
For example, I got to a point many years ago where I avoided particular shops, and then the whole town centre where I live, and could only go to very local shops. I broke it down by imagining all the pleasure I could have going into shops full of nice things, until I was ready to take the plunge. And now I go in all those shops regularly.
I spent four months in hospital being treated intensively for OCD. In the run up to my hospitalization I really unravelled - I didn't like the though of going into hospital at all! Not a contamination thing, but rather being away from my home and my things. But once I got there, it turned out to be all right - helpful - and I actually enjoyed it there.
If he could understand that the opportunity for some sort of freedom from OCD lies on the other side of a clinic door, then he could perhaps get up the will to make the move and break down that door in his mind.
I appreciate how hard this must be for you, though. It's exhausting having OCD - but it must be just as exhausting for a partner.
So it's been a bit, but he decided to continue with one of the clinics and is beginning an ERP treatment program. He had an assessment last week and his first session is today! I'm excited and hopeful for him, but also trying to be a bit reserved about it because I don't want to put any additional external pressure on him. I'm wondering now how I can best support him through this process.
He seems to have one foot in, one foot out. He says he has resigned himself to just try the treatment and see if it helps. I'm hopeful he will see some progress and show some more commitment as it goes on, but at the moment I'm just happy he's willing and getting started.
I've read a few articles about what to expect with ERP, but I can't find anything that is helpful about what to expect and how to respond as a partner. My instinct is to just stay out of the way -- not to encourage or discourage any practicing outside of the therapy sessions, and to try not to react if he gets emotional (angry, frustrated) as he encounters challenges and setbacks. I feel like the nature of the therapy is that he has to do this himself and experience emotions that are good or bad. Anything I do or say can be influencing that, so I plan to just tell him I'm proud of him and listen if he wants to talk.
In your experience, do this sound like a good approach as a partner? I want to help him be successful, but my instinct to "help" feels like it would be counterproductive. Any thoughts on how a partner can best support ERP treatment or things that I should or should not do as he is challenged?
That sounds just the ticket! I think knowing that support and encouragement are there if it is needed is really important, but while someone is actually doing the ERP it is most helpful just to stay out of the way, not interfering - not criticizing, certainly, but not actively egging on.
It's always nice to know you have support, and you can be there for him and occasionally tell him that he's done really well today, and such like. But actually doing ERP is quite intensive emotionally, and takes a lot of concentration, and if you have someone telling you that you're doing really well, that can be very distracting. And congratulating them afterwards is also unhelpful - they just want to put the experience behind them, not go over it!
Just knowing that someone is there for you, uncritical and patient, is a help. For me, if I feel the need to repeat something or do an OCD thing, I prefer for friends or family members just to let me get on with it! No help, no criticism!
It can be difficult, I know - I've tried the patience of other people often enough! It helps to set boundaries - he should know that he shouldn't rope you into doing his rituals with him or for him. But he will, I think, appreciate knowing that you will be patient while he does them.
So, in short, I think you are doing the right things already. Do keep us updated on how he gets on - each attempt at ERP, no matter whether he manages to do it or not, is an attack on the OCD. Sharing the life of someone with OCD is difficult, but you have the right approach and he's lucky to have you there.
Thought I would give a quick update and maybe seek some more perspective.
My partner has been seeing his new therapist for about 5 weeks now and is 2 weeks into the ERP program. He is still not convinced it will help him, but is still committed to going through the program. At least in principle.
The first week went ok. He was assigned to post a could of stickers of things that bothered him in the house then just live with them for the week. He was a wreck leading up to the stickers arriving, then once they did and were posted he handled it pretty well.
This week has been different. He was assigned to write and print out a script of the traumatic period that led to the beginning of his OCD issues. He has to read it over and over for 20 minutes every day. He's been doing it, but by last night he was convined the ERP isn't working and that it's only making him suffer and feel like things are worse. He said he's depressed, constantly anxious, and bored with everything in his life. It's hard to know how to respond to all of that or how to talk with him, if I should at all.
For my sake, I feel like I've seen some progress, even if it's just that he is appearing more self-aware. I also understand that the ERP treatment is supposed to make him feel bad (or at least experience the bad feelings he so often tries to avoid) and that it gets worse before it gets better.
But I'm concerned he will convince himself that the ERP doesn't work or that this therapist isn't the right one for him. Both of which could be true, but there's no way of knowing.
For now, I'm still trying to just stay out of the way, but encourage him to keep with the treatment. But it's sure hard to watch him suffer, and just as hard to be around such a constantly angry and miserable person.
Please tell him that ERP and CBT are painful and traumatic in themselves, but that they do work and will make him feel better!
I have often likened it to when I had a frozen shoulder. The slightest movement was excruciatingly painful and it ached along my whole arm, from neck to wrist. I had quite a long wait of some weeks for physio, but was told I could make a start on it myself. Stretching it when I could barely move it was very painful, but I persisted - I got more movement in it and the aching subsided a little. At home exercises and physio got it moving normally and without pain.
Sorry for the long story - but I'm trying to say that a little extra pain now means a lot of gain.
Bad feelings don't have to stay with him. I've been taught a technique where you think of the surge of anxiety that you get when you go against the OCD as being like clouds overhead, or a wave coming into shore or anything else you can think of. Allow it to gain momentum, knowing that it will subside, just as the clouds overhead will move on and disperse, and the wave will break up on the shore.
It involves accepting the feelings, but not hanging onto them, or going over them in your head.
And remember that OCD, and the therapy for it, fluctuate. There are good days and bad ones - he may feel like giving in to it, but then may feel a lot better the next day.
Also, as OCD restricts a sufferer's life in so many ways, stopping them from doing things they need to do or enjoy doing, boredom can easily set in. If he can keep occupied without overdoing it, he may feel less frustrated. Just a few things he can manage - the odd household chore, going for a short walk - or anything else. It could help to motivate him and start doing more.
It's hard for you, as well - OCD people can be hard to live with! But it sounds like you've got it right with your support and response. Remind him of the fluctuating nature of OCD and that each ERP attempt is a small victory. Persistence is what counts - and being gentle with oneself, and not demanding too much at once or beating oneself up for perceived 'failures'.
I’m so sorry to hear about what you and your partner are going through.
Even though it can be hard at times, the main thing is just to be patient with your partner and understand that it’s so hard for them to be living in constant fear.
My advice is to reassure your partner at first, rather than set boundaries, as sometimes it’s good to be patient and build up resilience over time. So maybe when your partner goes to carry out a compulsion, just remind him that he is safe, and that things will be alright. Or give him a hug. I find it best when people calm me down, as it reduces fear and therefore the need to do compulsions. You could also try distracting him, whenever you notice he is about to do a compulsion, ask him to do something else, like start cooking dinner or turning on a TV show.
Thank you, kind Dolphin. You’re advice is a lot of how I’ve approached his OCD behaviors for a long time. Unfortunately, I myself and becoming worn down and running out of steam to constantly try to be patient and understanding. I know it’s selfish, but I need a little understanding myself of how hard it is to be a party to the disorder for so long. I need him to have professional help guiding this so it’s not all on my back. I wish I had a support group locally to help me stay strong and be there for him, but I can’t find any resources like that.
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