Advice for spouses and partners with obsessive compulsive disorder

Julia Samton, MD Director of Manhattan Neuropsychiatric and Board Certified in Psychiatry & Neurology Manhattan Neuropsychiatric
Advice for spouses and partners with obsessive compulsive disorder

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

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
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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.


More expert advice about Obsessive-Compulsive Disorder

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Julia Samton, MDDirector of Manhattan Neuropsychiatric and Board Certified in Psychiatry & Neurology

Dr. Julia Samton is Board Certified in Psychiatry and Neurology and is currently the Director of Manhattan Neuropsychiatric, P.C. Dr. Samton is a voluntary faculty member at New York Hospital Weill Cornell and Lenox Hill Hospital in New York Cit...

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