A common question we encounter here at the Houston OCD Program from the family members is “How can I help my loved one? What can I do?” We often find that the family members of individuals with anxiety are well intended – they want to ease their loved one’s suffering from anxiety. However, what is recommended for family to do can seem counter-intuitive and often comes as a surprise for the family to hear. We actually recommend that the family does not purposefully do things to make their loved one feel less anxious.
What we are referring to is specifically reducing accommodation. Accommodation means doing things to try to make our loved ones feel less anxious. This can take a variety of forms. Perhaps it means repeatedly answering the same question to try to reassure the person that they are okay and that nothing bad is going to happen to them. Perhaps it is assisting in rituals (for example, washing your hands in front of your loved one to show that you are not contaminated and can thus “safely” prepare food). It might be assisting in helping the loved one avoid things such as avoiding school, elevators, certain people, etc.
The next point we often hear from family is – “But these things HELP my loved one feel better!” And, yes, we agree that this is true in the short term. The problem with accommodation is that it actually maintaining your loved one’s anxiety and can likely make the anxiety worse in the long term. Without confronting what they are afraid of, your loved one is unable to learn that they can feel anxious, that they can manage it, and that anxiety will naturally decrease on its own without doing a thing (a process called habituation).
Reducing accommodation is also a tricky process. While we want the family to reduce accommodations, we also recognize that we do not want to overwhelm (flood) the loved one with anxiety with things that are not manageable yet. In fact, our treatment here at the Houston OCD Program emphasizes a gradual, hierarchical approach to exposing oneself to anxiety provoking situations (Exposure and Ritual Prevention). Working with a treatment provider can help assist family members with effective strategies to reduce accommodation in a manner that balances challenging your loved one but in a way that feels manageable to them.
Do you want to learn more about accommodation and ways to help your family member? A great read is the book “Loving Someone with OCD: Help for You and Your Family.”