The most important thing that people with obsessive-compulsive disorder and their loved ones need to know first is that effective treatments are available for this condition.
It is very important to distinguish between dwelling on things and obsessive-compulsive disorder. Obsessive-compulsive disorder does not mean ‘dwelling on everything’.
How should you treat someone with obsessive-compulsive disorder?
First, you should be as kind and understanding as possible towards the patient. Otherwise, negative and harsh behaviour can worsen their condition.
Praising the person for their efforts to resist the illness and helping them feel positive is very important and gives them strength. It should be understood that the patient’s compulsive behaviours are not voluntary. The patient is making a great effort not to carry out these compulsive actions.
They believe that they can relieve the distress caused by thoughts, feelings or images that enter their mind involuntarily and cause considerable discomfort only through certain ritualised behaviours (compulsive actions), yet they also know that these compulsions cannot be explained logically. The person’s main difficulty here is stopping these actions, even though they recognise them as absurd and irrational.
The harm caused by labelling
Although families mean well when they advise the patient to ‘try not to think about it’, this statement can reinforce the illness. The person believes they can suppress these involuntary thoughts and should be able to prevent them, which can lead them to label themselves as “troubled, inadequate or a failure” because they cannot stop them.
Daily life should be planned around the patient’s condition
In addition, you should avoid building a relationship with the patient that centres on the illness. The family’s entire life should not be planned around the patient’s condition, nor should the family’s behaviour be organised around the illness and compulsions.
The patient may avoid certain situations in daily life; for example, if they avoid going out to keep from getting dirty or avoid having guests to keep the home clean, the family should not reinforce this avoidance, and should instead be included in the treatment team and encouraged to cooperate in managing the illness by addressing the avoided situations to an agreed extent after consulting the doctor (gradually and according to a hierarchy agreed with the psychiatrist).
How to respond to the patient’s questions
The patient may seek reassurance while carrying out compulsions. For example, they may ask questions seeking reassurance, such as “Have I washed my hands enough? Am I clean now?” These questions should not be answered either positively or negatively. Although telling the patient ‘yes, they are clean’ provides brief, temporary relief, in the long term it reinforces the illness and leads to an increasing need for reassurance.
Treatment for obsessive-compulsive disorder
Obsessive-compulsive disorder is a persistent mental illness that can be resistant to treatment. It is important to cooperate with the treatment team at all times, encourage the patient, accept that symptoms may sometimes subside and sometimes flare up, avoid blaming the patient, maintain a supportive attitude and highlight positive developments.
