Hi there! I'll try to keep this as brief as I can but there's a bit to unpack, so please bear with me...
My husband (44M) and I have been together for 5 years. When we first met, he was very open about the fact that he had OCD (he was diagnosed at 12 and has been medicated since then). He told me he was in weekly therapy with a psychiatrist and that it was under control, and we both trusted that that was true.
Fast forward 5 years, and things are not good. It escalated slowly, and for a long time I didn't realize what exactly the problem was (why is everything so difficult? Why are we fighting all the time?) He dumped his therapist 3 years ago because he was not finding it helpful. I have since found out that said "therapist" was not actually treating my husband with ERP or any other OCD-specific therapy. In my husband's words, they "just talked." So, of course it wasn't helpful. My husband was not given therapy for OCD as a child, so he has essentially never had proper therapy. We also recently discovered that the medication he has been on since age 12 is only about half the dose that is needed to actually help with OCD symptoms. So, essentially, he has never really been treated, at least not properly. The medical system totally failed him. Realizing this has been upsetting for both of us.
He is open to getting treatment now and is working with his family doctor. So far, she has doubled his medication dose, and they're going to have a check-in in 6 weeks. She hasn't been helpful with getting him any kind of therapy (she recommended he order an OCD workbook). My concern is that I don't think he (and, by extension, his doctor) realizes the severity of his condition. The more research on OCD I've done (and I've been doing A LOT), the more I've realized that nearly everything he does is a compulsion. But when I try to bring this up, he gets very defensive and claims that his behaviours are not actually compulsions, and that I don't understand what OCD is. I'm worried that he is downplaying his symptoms when talking with his doctor, and that she doesn't realize the seriousness of the situation.
A good friend of mine who has (treated) OCD recommended I make a list of all his compulsive behaviours. I was able to list about 70 things, and I'm still adding more as they come up. He spends at least a couple hours daily on his compulsions, and I am involved in a lot of them. I've realized that I've been enabling him by carrying out his compulsions, but if I try to stop, even if I explain why, he gets really upset and again insists that most of these behaviours are not actually compulsions and that I don't know what I'm talking about. I think he's so deep in it that he can't really see, and also probably can't remember who he is without these behaviours. That must be really scary for him.
I love him and I really want him to get the help he needs, and I want to stay married. But I feel that the OCD has totally taken over our lives, and I'm scared he won't get proper help if he can't even see how bad it really is.
Any advice would be hugely appreciated... or even just knowing there might be others out there who are in a similar situation. This is really so, so isolating and upsetting. Thank you if you've made it this far.
EDIT: I thought it might be helpful to include some examples of things he does that he insists are not compulsions, but that I believe are compulsions.
- Excessive handwashing (also requires me to wash my hands after touching certain things)
- There is a "correct" way of doing absolutely everything around the house. Scooping the cat litter, making the bed, doing dishes/loading dishwasher, dealing with recyclables, doing laundry... literally everything has a system and if the systems aren't followed, he gets very upset
- Checking that things are locked (house, shed, car) even if he sees me lock them. Asking me to check if things are locked, or asking how I locked them (there is a special way that he likes to lock the car)
- Everything must be tracked and recorded. He has saved every email he's ever received and everything is organized into one of hundreds of folders. His calendar (and our shared calendar) always needs to be up to date and everything must be recorded, even if it's just a dinner with friends. He hoards receipts and must collect a receipt for every purchase, even something as small as a coffee, and he gets upset if I don't collect receipts.
- Is constantly asking me questions (have the cats been fed, do the cats have fresh water, did you check the litter, did you check the mail, is that a new crack in the wall, what's that noise, did you have any dreams, did you put your computer away...the list goes on)
These are just a few examples.
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I am SO glad that your husband has someone caring like you to go the extra effort and seek out help beyond what he is doing. I can totally relate to a lot of the same symptoms you mentioned your husband as having. Seems to have obsessions around contamination and checking which is very common. I would encourage you to keep reading everything you can about this- there is so much info online and books available to help you and he understand OCD better. Please encourage him to check out this forum as I have found it very helpful and comforting to be able to relate to other OCDers. There is hope that he can overcome most if not all of his worries and lead a fulfilling life for both of you. Thank you for reaching out and I’m sure you will get lots of responses from others.😊
It’s my understanding, and perhaps a mistaken one, that medical treatment for OCD only lessens the distress and anxiety caused by particular obsessions. It makes exposure therapy more tolerable. More efficient.
Without it, or without a proper dosage, isn’t necessarily a bad thing. If your husband is stuck in some level of denial, seeing “normal” may require a little walk through hell first. When I abandoned a good paying career and settled for a part time job, when I started taking a taxi to the grocery store, and when my hands began bleeding from every fingerprint, I knew my behaviour wasn’t normal. That was NOT the life I wanted. I didn’t need medication to start exposure therapy. I needed my quality of life back, so, I started challenging my obsessive thoughts and resisting their compulsive suggestions. You’re right. It’s scary.
I hope your husband finds the help he needs, and I hope your marriage survives the extent of that search. Is he aware of your feelings, and the threat that OCD poses to your marriage? Requiring YOU to exercise the same measure of vigilance needs to stop. I used to ridicule my loved ones for being careless, and felt like the only rational person in a room. I quickly learned that my pendulum had swung a little past reasonable, that I had become “abnormal” (obsessive). I started to see how bad things really were.
I wouldn’t pass too much blame on the medical system. Your husband is a victim of his own obsessive thinking. Nothing more. That endless OCD cycle of obsession, compulsion, and reward (relief). Stop rewarding it, practice fewer compulsions, and watch the obsessions slowly deflate. It takes time, and starts by acknowledging how bad things are. Is your husband happy? He needs to think about that long and hard.
Thanks for the thoughtful reply. It sounds like you've made a lot of progress and are doing better than you once were - I'm happy for you.
To answer your question, no, my husband is absolutely not happy. I would describe him as chronically depressed - something I know is very common for someone with untreated OCD. By the time he has carried out all of his compulsions in a day, he has no time or energy left for actual life stuff (showering, house chores, feeding himself, quality time with me, etc.) Things get indefinitely put off, because the thought of taking the time to do things "properly" is too overwhelming for him. He struggles to shower and brush his teeth. We argue a lot, and it's almost always because he believes that he "should be allowed to hold me accountable" for things, because that's what people in a relationship do. The problem is, the things he wants to hold me accountable for are things like making sure every drop of water is wiped up from the edge of the tub after a shower, or scooping the cat litter according to his rules, or loading the dishwasher properly. I could give endless similar examples.
He is well aware of my feelings and the threat that OCD poses to our marriage...at least, he should be aware because I've told him (as compassionately and lovingly as possible).
As I mentioned, he is seeking help. I just worry that he doesn't understand why so many of his behaviours aren't normal, and therefore is downplaying his symptoms when speaking to healthcare professionals. And if they don't understand the severity of the situation, how can they effectively treat him?
You said that you quickly learned that your behaviour had become abnormal. How did you learn this? Did people tell you? What made you believe them? I'm genuinely curious, because it seems like I'm dealing with someone who can't just take my word for it.
Perhaps the severity and theme of OCD being discussed (experienced) can explain the difference between your husband and I. No two people are alike. With that said however, it’s interesting to read you describe the hardships of OCD in such a familiar way. For example, the way things get put off because the thought of taking the time to do them "properly" is too overwhelming. To think that something as simple as taking a shower or brushing our teeth could be such a struggle. I can very much relate to this.
Personally, I believe my biggest theme is harm, so, washing my hands is often a courtesy to the health of self and others. I don’t have a fear of germs. I have a fear of not caring enough. Negligence. Like most OCD themes, my intrusive thoughts are powered by self-doubt and derived (it seems) from the imagination. For example, your husband can’t see germs. He imagines them, and estimates (to an extreme) when they’ve been washed sufficiently.
Finding “normal” may be more challenging to someone who’s been struggling since the early age of twelve, but like your husband, I eventually grew miserable, unhappy, and tired of my behaviour. Passive suicidal thinking may have also played a role in my renewed faith of “normal.” My own perfectionism (as loving and well-intentioned as it will always be) was taking my life. It certainly robbed it of any quality. I decided if a little dirt on my hands was going to kill me, so be it. As long as I’m happy.
If your husband can agree to reduce the count at which he performs compulsions, or the amount of compulsions for any one task, that would be a huge accomplishment. I used to insist on washing my hands three times after touching a can of soup. I’m not fond of the glue keeping the labels affixed. I’ve now reduced that number to a single hand washing, and occasionally, I can even survive without washing at all.
The mind is a powerful thing. It can complicate something as simple as cooking a can of soup. While I feel like a brave knight wielding his sword to vicious fire breathing dragons (OCD), others only see a young man with a bottle of soap standing quietly at the kitchen sink. Thinking.
It’s a journey. Your husband is lucky to have someone with him, holding the map.
As you may already know, there is obsessive-compulsive disorder (OCD) and obsessive-compulsive personality disorder (OCPD) where a person is preoccupied with rules, orderliness, and control. The main difference is that OCD is ego-dystonic (people are distressed by their unwanted intrusive thoughts, sensations, or urges) whereas OCPD is ego-syntonic (people generally perceive their obsession with orderliness, perfectionism, and control, as reasonable and even desirable).
This distinction may be helpful because what would look like compulsions to many people doesn't appear as compulsions to your husband, as you said. "There is a "correct" way of doing absolutely everything around the house" is, for instance, a sign of OCPD. I'm not trying to make a diagnostic. I'm just saying that's important to make the difference because people with OCPD lack self-insight. They refuse to see reality as it is, so they may lack motivation to change.
What could help them change is to postpone the satisfaction of their need to control everything. For instance, instead of constantly asking others whether some tasks were performed, defer asking those questions until a certain time in the day, and ask less and less questions with the passing of time. The momentum needs to be broken. Same thing with the recording of events and collection of receipts unless there is a valid reason for it. If you don't record an event right away, the need to do it may eventually weaken. While in a calm state of mind, rules could be established about which receipts to keep and which ones to throw away. I know, when the time comes to discard receipts, it won't be easy. If people remind themselves they do it to improve their relationships and quality of life in the long term, they may be more willing to do it.
It's okay to have rules and order in a house, but some flexibility is also important. If you postpone performing problematic behaviors, they often feel less compelling and appear less important later on. At the same time, one shouldn't wait too long to replace them with more adaptive and sensible behaviors. It's two-pronged strategy against the disorder. There is a time to question one's present way of doing things and a time to be decisive. It’s like the Stoics from Ancient Rome and Greece used to say, “Never to seem in a hurry, nor yet to be dilatory” (Marcus Aurelius).
I have come across OCPD in my research and wondered if this might be at play as well as OCD, given his rigidity when it comes to performing tasks. He is going to raise this issue when contacting potential therapists.
OCD is more cyclic. OCPD is more consistently rigid. So, I think it's a good idea to raise this issue with potential therapists because with OCPD you need first to recognise there is a problem, which may take some work and "talk therapy".
I have had OCD for decades and it is very easy to get complacent with one's compulsions, or to not even realize they are compulsions. It can also be difficult to see just how disruptive they are, because the sufferer is so used to dealing with them all the time.
I am very grateful to those who have pushed me to get treatment over the years (my parents, my wife and daughter), because they could better see how much misery the OCD was causing me (and them). Your husband may genuinely believe that his compulsions are not really compulsions, or deep down he may know that they are but doesn't want to consciously admit it.
Either way, since he is open to treatment, I'd suggest that both of you go to an OCD specialist together to talk about the situation. Describe his behaviors to the specialist in a way that you and your husband both agree are accurate, and let the therapist decide whether they sound like OCD or not. (Spoiler: they do.) As you may know, there is a rating scale (Y-BOCS) for OCD symptoms that therapists use to determine the severity of the disorder and whether it warrants treatment.
His denial of the problem seems to be the main sticking point, and if that is overcome then good ERP treatment and medication should be able to help get him (and you) to a much better place.
I think you're right; because he has gone for so long without proper treatment, the OCD has gotten a hold on him to the point where he doesn't necessarily recognize his compulsions as compulsions anymore. We're in this weird place where he hasn't actually started therapy yet, but we know the OCD is a problem and that it needs treatment. I'm feeling conflicted because I recognize his OCD behaviours and I want to point them out or refrain from giving him reassurance, but he's not in a place where he can accept that yet (though I do believe he'll get there with help from a therapist).
I agree that it's a good idea for us to see an OCD specialist together, and we're committed to finding one who will work with both of us. Even aspects of our relationship have become compulsions at this point, so we need to figure out how to break the cycle together.
He needs to see a professional ERP therapist. All the things you listed to me seem like compulsive behaviors. deValentin has made a very good point about OCD and OCPD, although the means of the treatment are probably very similar anyway - to help patient break out of the obsessive compulsive hamster wheel.
I grew up with a mother who I am almost sure has OCPD (and maybe OCD) and aside from a few bright moments, I remember my childhood as pure suffering with endless "rules" about how to do things right to the smallest detail. I started to rebel outrageously against her in my teenage years as I grew into feeling that I couldn't take it anymore. But by then, thanks to both genetics and this kind of environment, I had a full blown OCD myself.
I'm 36 years now, and when I celebrated my birthday this year I noted to myself that I was being moulded for 18 years into somebody that I am not, and it took another 18 years or so to gradually get out of that hamster's wheel, retrain my brain and rediscover who I truly am. I'm still on this discovery journey and probably I'll be on it till the end of my days, but I am glad to say that at this point OCD does not affect my life most of the time. I still have onsets of it, but usually they don't take more than a couple of days, in rare occasions a week or two.
Be open to your husband in a kind manner about the way his obsessive compulsive personality affects your relationship, your feelings and well-being. Sometimes love does miracles. But don't expect too much, healing takes a lot of time and courage.
I'd say the women that came along my path in the last 20 years and especially a few of them who loved me in the pure version of it were crucial to my healing. Although, I often couldn't understand it at the time, and treated some of them very badly. I thank my higher power for them. But in the end, I have to learn to love myself, it is the only way.
I know from my own experience how OCD affects not just the sufferer, but those around them - I know that my own OCD hasn't always made things easy for friends and family!
The problem is that, unchecked, OCD simply takes over - it's not satisfied with just one or two rituals, it has to bleed into each facet of the sufferers life. It's like Alexander the Great, constantly wanting new territory to conquer!
I too have experience of inappropriate treatment - I had a lousy therapist who didn't tell me I had OCD (he knew - I had to self-diagnose from a book my mother gave me) and sat there smoking and drinking coffee while I spilled out the contents of my brain. No suggestion on his part that CBT might help. The fact is, as you and your husband realize, that talking therapies simply don't work for OCD.
The standard medication for OCD is an SSRI anti-depressant - and high doses are needed for OCD. For sertraline, which is what I'm on, 200 mg a day is pretty standard, though some doctors are licensed to increase it - I'm on 300 mg a day. It can go up to 400 mg a day.
If possible, go to appointments with your husband - obviously, he has to consent to this, but if you can get him to agree, you can make monitor (and if needs be, gently correct) his account of his symptoms to the doctor or therapist. Make sure you point out, too, the impact it has on your own life and wellbeing. Don't blame him - but make sure he understands!
And ask for a referral to a therapist whose area of expertise is OCD, and who uses CBT/ERP.
CBT/ERP is effective - it's difficult, but it works. It can stop the OCD from bleeding into other areas of his (and your) life and take back normality. It isn't always easy to do, but it could help to make a list of rituals and compulsions, and tackle the easiest ones first. Just gaining a bit of ground from the OCD can make a huge difference. And it makes CBT/ERP easier.
It's important to set boundaries. Perhaps start with telling him you won't reassure him if he asks if the cat has been fed, or that you've locked a door. He has to learn to trust you to do these things.
Therapists tell us that partners, family and friends must in no way assist or facilitate the OCD - but in practice this is almost impossible. So gradually withdraw your co-operation with his OCD, with his agreement. Perhaps negotiate your right to start doing things your way, whether it's loading the dishwasher or taking care of the cat, and ask him to accept this. It's tricky, this negotiating, but give him no option but to negotiate, and OCD doesn't like compromise or uncertainty, but that's part of the treatment - learning to accept compromise and uncertainty.
It also appears he has a problem with hoarding, at least where emails and receipts are concerned. If he can learn to let go of these, he should feel a sense of relief - a cleansing. I once helped a friend to order something online, and noticed he had over 3000 undeleted emails - he too was a hoarder! If he can start with the easiest - the junk files - and learn to keep on top of incoming emails, that should be a start. As for receipts, tempted though you might be simply to put them in the trash - don't. Again, ask him to relinquish some of the older ones, and keep on top of the new ones.
Compelling someone with OCD to not do a compulsion or ritual, or forcing them to get rid of stuff, can be traumatic. Negotiation is important, so it's his decision, or at least he feels it is. I had a therapist who made me go through a box of old bills of my mother's, with her writing on them. I had only recently lost her, and would have dealt with them in due course, but being forced to do it and shred them before I felt ready was too much - I felt as though my heart was being ripped out.
Another problem is getting him to admit the problem. Having OCD often involves a lot of effort in appearing 'normal' and it can come to feel 'normal' too. It can be hard to admit you have a problem, because that means doing something about it, and that's scary.
Please feel free to write in this forum - there are lots of us here with direct experience either of OCD or of having a close family member with OCD. Best of luck with this!
I appreciate your reply so much - thank you! It's very encouraging to receive this kind of insight and support from people who really get it. I can't talk to many people in my life about this, so being able to talk about it here feels like a big weight lifted already.
Some big progress was made in the last couple of days: my husband had a long phone call with a friend of the family who actually is a trained OCD therapist. She can't treat him - that would be a conflict of interest - but she did give him a lot of really helpful insight and information. She has told him what kind of therapy he needs to look for, and has given him the names of a couple of good therapists who specialize in this kind of work. She also gave him the name of a couples therapist who specializes in relationships where neurodivergence is at play in one or both parties (this could be helpful since I have diagnosed ADHD and suspected autism).
So, he now has clear next steps, which is great. He's really struggling with the knowledge that his OCD has effectively gone untreated for his entire life. When I think about it and put myself in his shoes, I would be seriously angry. He was diagnosed as a child, and no one made sure he got proper treatment. He says he feels like his entire life has been a waste and that the OCD has become so ingrained in his personality that he doesn't even know who he would be without the compulsions. My heart is really breaking for him.
BUT... this is a much better place than we were in a year ago, when everything was terrible but we were both oblivious to what was actually going on. Now it feels like there's a light at the end of the tunnel.
I definitely plan to attend some therapy appointments with my husband - I think it's crucial for me to be involved in the treatment, actually. Thank you for all your great advice, and your openness. It really helps.
That's really great to hear! I know how he must feel, because I went for so many years without a diagnosis or proper treatment. He needs to know that he can get back his life and rediscover himself underneath all the OCD.
I stress negotiation, because OCD is partly about control. And if your husband feels he has no control over how he deals with his OCD, he will just dig his heels in and the OCD will get worse. But if he feels he has some control, he can get better.
So negotiate a treatment and behaviour plan with him (don't give him an option here!) so that the OCD is curbed but he doesn't feel under external compulsion.
When you say don't give him an option, do you mean that a treatment plan needs to be obligatory, but that he should get to have some say in what that plan looks like? That seems reasonable. I'm hoping it won't be too difficult to find a therapist who will work with both of us.
That's about right - make him understand that going on as before is not an option, but also let him know that he has a big say in how you move on together.
It might help to make a start by the two of you listing some of his compulsions and for him to decide which are the least distressing to tackle first. Then set aside time each week to go over how he has progressed and what next to do.
It's amazing how much progress you can make on your own - or in this case, working together.
And then when he has a therapist, perhaps she or he could also be involved.
I can also recommend self help books. A really helpful one is The OCD Workbook, which also has a section aimed at partners, family and friends. It has examples and exercises that could serve as a blueprint for what you and your husband decide.
Most therapists are happy, I think, to work with spouses/partners.
hello. It is soo difficult watching someone suffer with severe OCD yet refusing to do anything about it (which in effect your husband is doing if he won’t admit his compulsions).
You already had some great advise, I’d only add that I think you should stop doing the compulsions he demands of you - eg washing hands when you don’t feel it necessary. My complying with his requests you are reinforcing his beliefs (I think you’ve acknowledged this). This is the only direct control you have over the situation, you can choose to change your behaviour.
Good luck, I know what I have suggested is easier said than done!
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