OCD and Romantic Relationships

[Daniel E.]

Overcome the Impact of OCD on Your Relationship
By Owen Kelly, Ph.D.
About.com: Obsessive Compulsive Disorder

OCD Can Put a Damper on Your Love Life, But There are Ways to Cope

If you have OCD, you know that your symptoms can often get in the way of establishing and maintaining romantic relationships. Indeed, many individuals with OCD are single, and those who are in a relationship or married often report a significant amount of relationship stress. Of course, not every person with OCD is the same. But if symptoms of your OCD are posing a serious challenge to your love life, there are ways of coping.

OCD Symptoms Can Create Barriers to Romantic Relationships
There are many ways in which OCD can get in the way of romantic relationships. For example, you may have challenges maintaining your self-esteem and may struggle with feelings of shame around your symptoms, which can lead you to avoid contact with others.

In addition, you may feel that you have to conceal the nature of your obsessions and compulsions to avoid rejection by a potential or current romantic partner. Your obsessions or compulsions may even revolve around your romantic partner, which can make it especially difficult to reveal the nature of your symptoms. Clearly, this secrecy is going to stand in the way of an open, honest and intimate relationship. Symptoms of depression, which are not uncommon in OCD, can also make it difficult to establish and maintain intimate relationships.

Of course, for many individuals, sexual intimacy is a crucial aspect of any romantic relationship. However, as you may have experienced, OCD symptoms can often interfere with sexual relations. For example, you may experience obsessions related to contamination (like the cleanliness of your partner’s genital area) or disturbing sexual themes (e.g., sexual assault) that make it very difficult to engage in sexual relations with your partner. Not surprisingly, people with OCD are often sexually avoidant and sexually dissatisfied in their relationships.

How to Cope

Although OCD does pose many challenges to forming, maintaining and enjoying a romantic relationship, there are ways to cope:

• Manage Your Symptoms - The severity of OCD symptoms is positively associated with the inability to establish and maintain a romantic relationship. As such, an important and necessary first step toward working a little romance into your life is to effectively treat your symptoms. Be sure to review your treatment plan with your doctor, psychologist or other mental health professional to ensure you are undertaking the best possible course of treatment.
• Consider Psychotherapy – In addition to managing symptoms of OCD, psychotherapy can provide a useful framework for working on areas of challenge such as low self-esteem, difficulty being assertive, poor social skills and a lack self-confidence that could be impeding your ability to start or maintain a stable, long-term relationship.
• Get Your Partner Involved – If you are already in a romantic relationship, it may be helpful for your partner to take a more active role in your treatment. The doctor or therapist’s office can be a safe and neutral venue to discuss the symptoms you are experiencing, particularly those that might be embarrassing or standing in the way of establishing or building intimacy. The more your partner understands your symptoms, the more you will be able to will trust one another.
• Maintain Open and Honest Communication – Whether you have OCD or not, open and honest communication is the foundation of any romantic relationship. This is especially important when your symptoms are intensifying or have changed. Your partner needs to know what you are experiencing. Not being aware of the challenges you are facing could lead to misunderstandings (like "he/she doesn’t find me attractive anymore") that get in the way of building intimacy and trust.
• Join a Support Group - Community support groups for OCD can be excellent sources of social support and provide an opportunity to hear how others are dealing with feelings of isolation or embarrassment. Although it may be tempting to date someone you have met through support group, proceed with caution. Many support groups have rules in place to protect the confidentially of attendees and may actively discourage relationships (even casual friendships) outside of the group setting. In addition, if you find the support group to be of value and the relationship ends, it may be difficult for one or both of you to return to the group.

You can also find support from people just like you right here on About.com by visiting our OCD Forum.

Related articles:
OCD and Sexual Intimacy
Dating Someone With OCD

 

[Daniel E.]

You, Your Spouse and OCD: Three?s a Crowd

You, Your Spouse and OCD: Three’s a Crowd
OCD Chicago: Expert Perspectives
By Karen J. Landsman, Ph.D., Kathleen M. Rupertus, PsyD. and Cherry Pedrick, R.N.

The cumulative effects of OCD on a marriage can result in a relationship burdened by stress and conflict. If left alone and not shared openly, the challenges of OCD moments combined with OCD’s threats to the couple’s emotional and physical intimacy, financial stressors, interference in social relationships and activities, and fears for the future can shake the very core of your relationship.

Failure to communicate with each other openly about these stressors serves as a form of avoidance that, whether purposeful or inadvertent, creates the opportunity for the roots of the problems to grow while creating even greater opportunity for devastating and painful effects on the relationship.

Interference in Marital Roles

In many marriages, OCD can impact the distribution of household responsibilities between the two spouses. The spouse who has OCD may experience difficulties fulfilling previous household responsibilities because these responsibilities trigger obsessions and compulsions. For example, a spouse who has OCD fears of germs and contamination could have great difficulty taking the garbage cans out to the curb, cleaning the bathroom, or washing the laundry. A spouse who has fears of accidentally contaminating or poisoning others might find preparing three meals a day for the family overwhelming. Someone with fears of making a mistake could spend hours balancing the checkbook and writing out checks to pay the bills, making it easier to have the spouse take care of these chores. Consider, too, the spouse who spends long periods of time checking all the outlets before leaving the home out of fear of causing a fire. How might these OCD fears and rituals interfere with leaving the house to run errands, go food shopping, or chauffer the children to their different activities?

Oftentimes the burden of added responsibilities falls on the other spouse. With no end in sight to enduring the stress of these additional responsibilities, the other spouse may become overwhelmed, exhausted, hopeless, and even resentful over time. The daily reminders of his or her inability to fulfill previously held household responsibilities can leave the spouse who has OCD feeling weak, ashamed, and inadequate; ineffective as a partner in the relationship.

You and your spouse need to work together to fight against OCD. You can regain the former balance in your distribution of roles and responsibilities. Together you can identify problem areas, define short-term goals that support E/RP and reduce accommodating behaviors, and eventually work toward longer-term goals that will re-establish balance and decrease stress within your relationship.

Interference in Social Relationships and Activities

OCD can create obstacles to maintaining a social life and participating in activities outside of the marital relationship. Some people with OCD fear becoming “stuck” in an OCD ritual in public, revealing their dysfunction. They fear others’ judgments and the subsequent experience of shame and humiliation. In many instances, they may find it simpler to just avoid such situations and activities. Other social interactions or activities are avoided because they may require contact with an OCD trigger. A person with OCD fears of germs and contamination might find it too difficult to use a public restroom at a restaurant or amusement park. Someone with fears of accidentally harming children might find attending a child’s birthday party or baseball game too distressful.

OCD can also have a negative impact on the other spouse’s social relationships and activities. The other spouse may fear the potential for painful and misguided judgments directed toward their loved one should OCD reveal itself to others in a social situation. Attending social activities alone due to a loved one’s avoidance not only interferes with one’s own ability to enjoy the occasion but also serves as one more painful reminder of OCD’s unwelcome presence. The result for the couple is one less experience to share together and the threat of a growing sense of isolation from each other.

The spouse may choose to avoid attending social events alone out of a sense of loyalty, guilt, or support for the loved one. Offering up creative excuses for declining social invitations and opportunities may become second nature for some couples. As a result, the couple may find themselves lonely and withdrawn from people who once held important places in their lives; friends and family members alike.

As you and your spouse recover from the effects of OCD, you may experience further challenges as you adjust to the changing roles and responsibilities in your relationship. For the spouse who has OCD, reestablishing balance may involve assuming previously held spousal and household responsibilities and renegotiating decision-making roles within the marriage. It may also involve adjusting to and applying a newly developed sense of independence from reliance upon others, including the supportive spouse.

As the supportive spouse, re-establishing balance might mean surrendering previously held responsibilities despite your own fears or anxieties. This may be especially true if you were significantly dependent upon for accommodations and enabling. Despite the subsequent relief you may experience in the short term, you might find that your spouse’s newly developing sense of strength and independence functions as a “threat” to your own sense of usefulness and self-worth. After all, your role in supporting your spouse through OCD helped to establish an unwritten agreement regarding roles within the marriage. Feelings such as these may be considered “normal” given the history of the relationship, but they may in turn threaten further recovery from OCD. This is especially likely when the feelings are not shared with your spouse. When feelings are left unresolved, they can inadvertently undermine your ability to be supportive of your spouse’s recovery.

As you and your spouse continue on the road to recovery, your roles will need to be re-established and re-defined over and over again. Importantly, you are on a journey with your spouse that can strengthen your connection and bring you closer in ways that feel refreshing and healthy.

Building Family Resilience

Resilience is the ability to withstand adversity, challenges, and stress. There are things you and your family can do to build resilience that will help you confront OCD and other difficulties that threaten your family. We all face adversity and challenges. Resilience prepares us ahead of time to face them.

Take Care of Your Mind

An important factor in building and maintaining resilience is the way we look at the world and interpret events. Certain thinking traps adversely affect people’s ability to respond to the challenges of life. Learning not to jump to conclusions, overlook the big picture, assume what other people are thinking, blow things out of proportion, or minimize problems helps us become more resilient. Learning to stop blaming ourselves for everything or, conversely, blaming others for our problems builds confidence, self worth, and resilience.

Challenging our own false beliefs and the negative thoughts they cause can be important factor in how we all handle daily stress. What one person considers extremely stressful may be considered only a slight challenge or perhaps even an opportunity to another person. What makes a situation stressful is our perception. It is stressful when we perceive it as a threat to our physical or psychological well-being and believe we can’t cope with the threat. Since situations and events don’t cause stress, the answer is not changing the circumstances, but changing our perceptions, our learned beliefs about them. Recognizing this will help you choose how you perceive life. You’ll be more resilient and able to handle stress.

The next time you face a stressful situation, step back and observe your negative thoughts. Are you falling into a thinking trap; blowing things out of proportion or jumping to conclusions? Can you reframe the situation as a challenge or an opportunity for growth? If you look really hard, you might even be able to find the humor in the circumstances. How often have you been able to look back and laugh about things that seemed devastating at the time? Laugh now! Laughter can decrease stress, relieve anxiety, and give us a more positive perception of life.

Summary

Everyone has problems to deal with. They can help build resilience and prepare us for the next challenge. Often, families become stronger because of shared experiences. It can break you or make you stronger. You have a choice. Make resilience and strength your choice.

It’s important to consider yourself a partner in your spouse’s battle against OCD. Joining together to fight OCD will build resiliency and strengthen trust and emotional intimacy within your marriage. Discuss with your spouse how OCD has affected your relationship through emotional and social interferences. This discussion is a step toward more effectively managing family relationships and responsibilities.

Excerpted from Loving Someone with OCD: Help for You and Your Family (2005) by Karen J. Landsman, Ph.D., Kathleen M. Rupertus, PsyD., and Cherry Pedrick, R.N. Karen J. Landsman, Ph.D., a clinical psychologist and anxiety disorders specialist, can be reached at (973) 895-2442 and practices in Westfield and Chatham, New Jersey. Kathleen M. Rupertus, PsyD. can be reached at (302) 388-7515 and practices at The Anxiety & OCD Treatment Center in Wilmington, Delaware.

 

[Daniel E.]

Tainted love: Exploring relationship-centered obsessive compulsive symptoms in two non-clinical cohorts
November 2011

Obsessive-compulsive disorder (OCD) is a disabling anxiety disorder with a wide range of clinical presentations. Previous research has examined a variety of obsessional themes within OCD including contamination fears, sexual or aggressive obsessions and scrupulosity. Absent from current literature of OCD, however, is an investigation of obsessive-compulsive (OC) symptoms centering on intimate relationships. The present investigation reports on the development and evaluation of the Relationship Obsessive Compulsive Inventory (ROCI), a 12-item measure assessing the severity of OC symptoms centering on three relationship dimensions: the individual’s feelings towards his or her partner, the partner’s feelings towards the individual, and the ‘‘rightness’’ of the relationship experience. Factor analysis supports a 3-factor structure of the ROCI above two alternative measurement models (Study 1). The ROCI was found to be internally consistent and showed the expected associations with OCD related symptoms and cognitions, mood and relationship variables (Study 2). Moreover, the ROCI significantly predicted depression and relationship related distress, over-and-above common OCD symptoms, and other mental health and relationship insecurity measures. Relationship-centered OC symptoms may be an important theme for further OCD research.

Full Text


from the Relationship Obsessive Compulsive Inventory:

Love for the partner
(1) I feel that I must remind myself over and over again why I love my partner
(2) I feel a need to repeatedly check how much I love my partner
(3) The thought that I do not really love my partner haunts me
(4) I continuously doubt my love for my partner

Relationship ‘‘rightness’’
(5) I constantly doubt my relationship
(6) I am extremely disturbed by thoughts that something is ‘‘not right’’ in my relationship
(7) I check and recheck whether my relationship feels right
(8) I frequently seek reassurance that my relationship is ‘‘right’’

Being loved by the partner
(9) I am constantly bothered by the thought that my partner does not really want to be with me
(10) I keep asking my partner whether she/he really loves me
(11) I am constantly looking for evidence that my partner really loves me
(12) I find it difficult to dismiss doubts regarding my partner’s love for me

 

[Daniel E.]

Living With Someone Who Has OCD. Guidelines for Family Members
International OCD Foundation

From Learning to Live with OCD
By Barbara Van Noppen, PhD and Michele Pato, MD

This article was initially published in the Spring 2009 edition of the OCD Newsletter.

In an effort to strengthen relationships between individuals with OCD and their family members, and to promote understanding and cooperation within households, we have developed the following list of useful guidelines. These guidelines are meant as tools for family members to be tailored for individual situations, sometimes more powerfully employed with the help of a therapist with expertise in working with OCD.

1. Recognize Signals
The first guideline stresses that family members learn to recognize the “warning signals” of OCD. Sometimes people with OCD are thinking things you don’t know about as part of the OCD, so watch for behavior changes. It is important to not dismiss significant behavioral changes as “just their personality.” Remember that these changes can be gradual, but overall different from how the person has generally behaved in the past.

Signals to watch for include but are not limited to:

• Large blocks of unexplained time that the person is spending alone (in the bathroom, getting dressed, doing homework, etc.)
• Doing things again and again (repetitive behaviors)
• Constant questioning of self-judgment; excessive need for reassurance
• Simple tasks taking longer than usual
• Perpetual tardiness
• Increased concern for minor things and details
• Severe and extreme emotional reactions to small things
• Inability to sleep properly
• Staying up late to get things done
• Significant change in eating habits
• Daily life becomes a struggle
• Avoidance
• Increased irritability and indecisiveness

People with OCD usually report that their symptoms get worse the more they are criticized or blamed because these emotions generate more anxiety. So it is essential that you learn to view these features as signals of OCD and not as personality traits. This way you can join the person with OCD to combat the symptoms, rather than become alienated from them.

2. Modify Expectations
People with OCD consistently report that change of any kind, even positive change can be experienced as stressful. It is often during these times that OC symptoms tend to flare up; however, you can help to moderate stress by modifying your expectations during these times of transition. Family conflict only fuels the fire and promotes symptom escalation, (“Just snap out of it!’). Instead a statement such as “No wonder your symptoms are worse— look at the changes you are going through,” is validating, supportive and encouraging. Remind yourself the impact of change will also change; that is the person with OCD has survived many ups and downs, and set backs are not permanent. You must adjust your expectations accordingly which does not mean to not expect something!

3.Remember That People Get Better at Different Rates
There is a wide variation in the severity of OC symptoms between individuals. Remember to measure progress according to the individual’s own level of functioning, not to that of others. You should encourage the person to push him/herself and to function at the highest level possible; yet if the pressure to function “perfectly” is greater than a person’s actual ability it creates more stress which leads to more symptoms. Just as there is a wide variation between individuals regarding the severity of their OC symptoms, there is also wide variation in how rapidly individuals respond to treatment. Be patient. Slow, gradual improvement may be better in the end if relapses are to be prevented.

4. Avoid Day-To-Day Comparisons
You might hear your loved ones say they feel like they are “back at the start” during symptomatic times. Or you might be making the mistake of comparing your family member’s progress (or lack thereof) with how he/she functioned before developing OCD. It is important to look at overall changes since treatment began. Day-to-day comparisons are misleading because they don’t represent the bigger picture. When you see “slips” a gentle reminder of “tomorrow is another day to try” can combat self destructive labeling of “failure,” “imperfect,” or “out of control” which could result in a worsening of symptoms! You can make a difference with reminders of how much progress has been made since the worst episode and since beginning treatment. Encourage the use of questionnaires to have an objective measure of progress that both you and your loved one can refer back to (for example, the Yale Brown Obsessive Compulsive Scale) Even a 1-10 rating scale can be helpful. Ask “How would you rate yourself when OCD was at it’s worst? When was that? How is it today? Let’s think about this again in a week.”

5. Recognize “Small” Improvements
People with OCD often complain that family members don’t understand what it takes to accomplish something, such as cutting down a shower by five minutes, or resisting asking for reassurance one more time. While these gains may seem insignificant to family members, it is a very big step for your loved one. Acknowledgment of these seemingly small accomplishments is a powerful tool that encourages them to keep trying. This lets them know that their hard work to get better is being recognized and can be a powerful motivator.

6. Create a Supportive Environment
The more you can avoid personal criticism the better – remember that it is the OCD that gets on everyone’s nerves. Try to learn as much about OCD as you can. Your family member still needs your encouragement and your acceptance as a person, but remember that acceptance and support does not mean ignoring the compulsive behavior. Do your best to not participate in the compulsions. In an even tone of voice explain that the compulsions are symptoms of OCD and that you will not assist in carrying them out because you want them to resist as well. Gang up on the OCD, not on each other!

7. Set Limits, But Be Sensitive to Mood (refer to #14)
With the goal of working together to decrease compulsions, family members may find that they have to be firm about:

Prior agreements regarding assisting with compulsions;
How much time is spent discussing OCD;
How much reassurance is given; or
How much the compulsions infringe upon others’ lives.

It is commonly reported by individuals with OCD that mood dictates the degree to which they can divert obsessions and resist compulsions. Likewise, family members have commented that they can tell when someone with OCD is “having a bad day.” Those are the times when family may need to “back off,” unless there is potential for a life-threatening or violent situation. On “good days” individuals should be encouraged to resist compulsions as much as possible. Limit setting works best when these expectations are discussed ahead of time and not in the middle of a conflict. It is critical to minimize family accommodation to OCD.

8. Support Taking Medication as Prescribed
Be sure to not undermine the medication instructions that have been prescribed. All medications have side effects that range in severity. Ask your family member if you could periodically attend their appointments with the prescribing physician. In this way you can ask questions learn about side effects and report any behavioral changes that you notice

9. Keep Communication Clear and Simple
Avoid lengthy explanations. This is often easier said than done because most people with OCD constantly ask those around them for reassurance. “Are you sure I locked the door?” or “Did I really clean well enough?” You have probably found that the more you try to prove that the individual need not worry the more he disproves you. Even the most sophisticated explanations won’t work. There is always that lingering “What if?” Tolerating this uncertainty is an exposure for the individual with OCD and it may be tough. Recognize that the person with OCD is triggered by doubt, label the problem as one of trying to gain total certainty about something that cannot be provided, this is the essence of OCD and the goal is to accept uncertainty in life. Avoid lengthy rationales and debates.

10. Separate Time Is Important
Family members often have the natural tendency to feel like they should protect the individual with OCD by being with him all the time. This can be destructive because family members need their private time, as do people with OCD. Give them the message that they can be left alone and can care for themselves. Also, OCD cannot run everybody’s life; you have other responsibilities besides “babysitting.” You need and deserve time to pursue your interests too! This not only keeps you from resenting the OCD it is also a good role model to the person with the OCD that there is more to life than anxiety.

11. It Has Become All About the OCD!
Whether it is about asking and providing reassurance to the family member with OCD or talking about the desperation and anxiety that the illness causes, families struggle with the challenge of engaging in conversations that are “symptom free,” an experience that feels liberating when achieved. We have found that it is often difficult for family members to stop engaging in conversations around the anxiety because it has become a habit and such a central part of their life. It is okay not to ask ”How is your OCD today?” Some limits on talking about OCD and the various worries is an important part of establishing a more normative routine. It also makes a statement that OCD is not allowed to run the household.

12. Keep Your Family Routine “Normal”
Often families ask how to undo all of the effects of months or years of going along with OC symptoms. For example, to “keep the peace” a husband allowed his wife’s contamination fear to prohibit their children from having any friends into the household. An initial attempt to avoid conflict by giving in just grows; however, obsessions and compulsions must be contained. It is important that children have friends in their home, or that family members use any sink, sit on any chair, etc. Through negotiation and limit setting, family life and routines can be preserved. Remember it is in the individual’s best interest to tolerate the exposure to their fears and to be reminded of others’ needs. As they begin to regain function, their wish to be able to do more increases.

13. Be Aware of Family Accommodation Behaviors (refer to #14)
First there must be an agreement between all parties that it is in everyone’s best interest for family members to not participate in rituals (Family Accommodation Behaviors). However, in this effort to help your loved one reduce compulsive behavior, you may be easily perceived as being mean or rejecting, even though you are trying to be helpful. It may seem obvious that family members and individuals with OCD are working toward the common goal of symptom reduction but the ways in which people do this varies. Attending a family educational support group for OCD, or seeing a family therapist with expertise in OCD, often facilitates family communication.

14. Consider Using a Family Contract
The primary objective of a family contract is to get family members and individuals with OCD to work together to develop realistic plans for managing the OC symptoms in behavioral terms. Creating goals as a team reduces conflict, preserves the household, and provides a platform for families to begin to “take back” the household in situations where most routines and activities have been dictated by an individual’s OCD. By improving communication, and developing a greater understanding of each other’s perspective, it is easier for the individual to have family members help them to reduce OC symptoms instead of enable. It is essential that all goals are clearly defined, understood, and agreed upon by any family members involved with carrying out the tasks in the contract. Families who decide to enforce rules, without discussing it with the person with OCD first, find that their plans tend to backfire. Some families are able to develop a contract by themselves, while most need some professional guidance and instruction. Be sure to reach out for professional assistance if you think that you could benefit from it.

Barbara Livingston Van Noppen, PhD is an Associate Professor in the Department of Psychiatry and Human Behavior and Assistant Chair of Education Keck School of Medicine University of Southern California.Dr. Van Noppen provides CBT supervision and didactic education to psychiatric residents in the USC Keck School of Medicine program.

Michele Tortora Pato, MD is the Della Martin Chair in Psychiatry and Associate Dean for Academic Scholarship at the Keck School of Medicine-USC.

 

[Daniel E.]

Advice for spouses and partners with obsessive compulsive disorder
by Julia Samton, MD

OCD is a relatively common mental illness, affecting about 1/40 individuals. The characteristic symptoms are the presence of obsessions and compulsions. Obsessions are unpleasant and persistent thoughts, images, and/or urges. Examples include involuntary thoughts about contamination, germs, violent images, and or violent urges. The affected individual attempts to neutralize these thoughts by either suppressing them or performing a behavior or compulsion. Compulsions usually take the form of repetitive behaviors such as hand washing or counting. Although these behaviors are not necessarily related to obsessions, for example, arranging items symmetrically to prevent harm to ones family, they are an attempt to eliminate the anxiety and distress caused by excessive rumination.

Having a spouse or partner with OCD can be very overwhelming. Research shows that about 60% of family members are involved, to some extent, in the obsessions and compulsions of an individual affected by OCD. Ironically, the compulsions are often misguided attempts to keep loved ones safe, but they often create distance and replace the intimacy in a romantic relationship.

Do

• learn about OCD
• help your partner get treatment
• maintain open and honest communication
• seek couples/family therapy
• talk to your children about your spouses OCD

Don't

• isolate
• participate in rituals
• take your spouse’s behavior personally
• overlook the big picture
• forget the long view

Do:

Do learn about OCD
Do your best to educate yourself about your partner’s illness. There are many well written books and publications about OCD. In addition, there are a number of organizations such as National Alliance for the Mentally Ill (NAMI) and Center for Addiction and Mental Health (CAMH) that provide helplines, education, discussion groups, and social networks for those suffering from or affected by OCD. These organizations also have programs for special populations such as spouses, veterans, and students. Joining a support groups can also be beneficial. Sharing perspectives and strategies with other in a similar position can reduce the stress that isolation creates.

Do help your partner get treatment
Obsessive Compulsive Disorder does not go away on its own. Encourage your partner to get help from a mental health professional. Often a combination of behavioral strategies and medication can greatly reduce the suffering of an individual with OCD. Unfortunately, affected individuals are often reluctant to seek treatment. Perhaps they fear that a professional might diagnose them as “crazy.” Others feel hopeless and skeptical if anyone can alleviate their symptoms. This is rarely the case. There are a number of different treatments that reduce the pain and suffering of OCD.

Do maintain open and honest communication
Encourage your spouse to talk about his/her symptoms. It is essential that you know the challenges your partner is facing. This will keep him/her from turning inward during times of difficulties. The more open you are, the easier it will be to identify triggers and stressors that exacerbate your partner’s OCD.

Do seek couples/family therapy
It is natural to feel frustrated or resentful when your spouse’s OCD interferes with your family life. When this occurs, it is critical to take steps to restore your relationship. A therapist’s office is a safe place to discuss the impact of your spouses symptoms on your relationship. Explaining how you are affected can often provide motivation for your spouse to address lingering symptoms. It can also remove some of the pressure feelings of isolation created by being a caretaker.

Do talk to your children about your spouses OCD
Children have an intuitive sense when something is stressing the family unit. They also are prone to blame themselves for any perceived disturbance. It is important to tell them that that their mommy or daddy has a sickness, similar to a cold or flu, that makes him/her worry a lot. You can explain that their illness does not affect their throat or ears, but rather the way that they feel and think. It makes them want to check things over and over or be concerned about cleanliness and order. Reassure the child that they did nothing to make their parent sick, and that the doctors are working hard to make their mommy or daddy better.

Don't:

Do not isolate
It is important for you to maintain a social life and relationships outside of the home. Make sure you have your own support when your spouse’s symptoms escalate. OCD tends to run in families, and many affected individuals have first generation family members with either OCD, anxiety disorder, or depression. Discussing your spouse’s symptoms with family members may help to form a small, naturally occurring support group with others affected by a similar process.

Do not participate in rituals
It is common for individuals with OCD to involve their spouses in their compulsive rituals. This might take the form of helping out with checking, ordering, or cleaning. It can be tempting to collude with your spouse in order to “keep the peace.” However, in order for your partner to make progress, it is important for him or her to resist these behaviors and eventually work on extinguishing them completely. Accommodating your spouse might feel better in the moment, but in the long run, it reinforces the compulsive behaviors.

Do not take your spouse’s behavior personally
It can be easy to assume that when your partner is acting rigid and inflexible that he/she is not listening to you, being stubborn, or not motivated to change. It is important to not take his/her behavior personally. Try to remain calm and avoid losing your temper. Communicate directly that you are frustrated and that this is challenging for you as well. Try not to criticize, be defensive or contemptuous. When possible, mix humor with support and caring to defuse a tense atmosphere.

Do not overlook the big picture
Remind yourself that OCD is an illness that afflicts your spouse, but it does not define him/her. At times, the symptoms can be overwhelming, but they are not synonymous with your partner’s character. The former is unaffected by your obsessive thoughts or compulsive rituals. Your partner’s underlying true self is what is left when these symptoms are not overshadowing them.

Do not forget the long view
Recognize that progress does not mean perfection. Incremental positive steps are sometimes hard to see, but, as long as your spouse is trying to move forward and receive treatment, he or she can expect to improve. Try not to keep score or make comparisons in your mind. Remember that each of us are trying to ameliorate our own limitations and personal obstacles. Having compassion and patience for you and your spouse can keep you from feeling angry and defeated.

Summary
OCD is a relatively common psychiatric disorder, affecting about 1/40 individuals. It is characterized by repetitive, intrusive thoughts and behaviors aimed at reducing the impact of these negative ruminations. It can be very difficult to have a spouse with OCD. At times your partner’s rigidity and inflexibility can be overwhelming. Nevertheless, it is possible to maintain a loving relationship by engaging in behaviors such as learning about OCD, keeping open communication, helping your partner seek treatment, and consulting a family therapist when necessary.

It is important to keep perspective by recognizing that although your partner or spouse is affected by OCD, he or she is not defined by OCD. Your partner’s true personality characteristics endure and are unaffected by his/her illness.