5 things you can do to support a loved one with OCD, BFRBs, or Tic disorders
If you’re reading this, you love someone with OCD, a BFRB, or tic disorder—maybe you’ve tried countless times to support them as well as you can, but you feel like something is not working. No matter how many times you say “Stop!” or “Don’t do that!”, they only get frustrated or upset with you and even themselves.
You’re not alone—the loved ones of people suffering from mental health conditions like these often struggle to figure out the best ways to support the people they care about. Here are five things to consider when supporting your loved one.
1. Stop saying “stop”
When parents and partners start to notice that their loved ones are doing compulsions, skin picking, hair pulling, or tics, they may think that they are easy to stop at first. By saying “stop,” they hope to help the person build awareness and learn to stop. Unfortunately, this may only lead to shame and embarrassment, which actually has the opposite effect. In fact, shame can cause one to do compulsions, BFRBs, and tics even more.
What’s challenging at first for people who are just starting to learn how to manage compulsions, BFRBs, or tics, is that they themselves may not be aware that they are doing the behavior. Instead of telling them to stop, it’s important to first acknowledge what’s happening inside them and empathize. You don’t need to be their therapist, but you can help them build awareness. With compulsions and BFRBs, it should be noted the behaviors are sometimes more easily controlled by the person if they have a certain level of awareness. However, for tics, these are involuntary and often not easily controlled. To help them build awareness, try to center the way they’re feeling when they engage in these behaviors:
- For compulsions: “I’m noticing that you’re repeating this behavior. Something really tough could be going on right now, but that’s just a guess. Do you notice any feelings or thoughts right now that may be affecting it? Maybe we can log this together and see what your therapist says.”
- For BFRBs: “I’m noticing some picking and pulling. I wonder what feeling you’re having right now? Could it be boredom, anger, nervousness? Maybe we can log it and see what your therapist says.”
- For Tics: A simple hand raise or gentle acknowledgement could help them build awareness about urges/feelings/triggers that may occur before the tic, which can help build awareness. Tics can cause one to feel helpless at times, because they’re not voluntary. It’s important to come up with a gentle reminder, code word, or signal with a therapist and your loved one to see what they would like as a reminder to gain awareness of their tics.
2. Validate their feelings, but don’t provide reassurance
A loved one may be asking you questions in a compulsive way, like: “Am I crazy? Am I bad? Did I do something wrong? Are you mad at me? Will I die?” The answer should never be “No, you’re okay. Don’t worry!”
Instead, you should try to say something along these lines: “I notice you’re seeking reassurance or wanting to feel okay right now. Your anxiety wants me to give you reassurance, but I’m going to help you beat it by not saying anything. Let’s sit here and do nothing until you can stop asking for reassurance.” You can even create a code word for OCD that makes you both laugh or stops compulsions like these in their tracks.
Effective, specialized OCD therapy is hereLearn more
For BFRBs, a loved one may ask you after they picked or pulled, “Do I look weird or ugly?” Instead of answering, you can say something like, “I know it’s hard to see a scab or hair missing. What can help you resist the urge next time?” For tics, a loved one may ask, “Am I always going to be messed up or weird?” You can say, “This is a lifelong challenge and we will try to find competing responses to make it easier to manage.”
3. Provide alternatives
Sometimes it’s hard for a loved one to remember ways to resist their compulsions, or use competing responses for BFRBs or tics. In these cases, visual reminders around the house can be helpful. Like this from Natasha Daniels’s AT Parenting:
Reading books can be a great way to bond, but also to remind loved ones how to handle OCD: Billie v. the OCD Monster, Blink, Blink, Clop, Clop, Wilma Jean the Worry Machine, Something Might Happen, and Don’t Feed the Worry Bug are some great examples. If you’re a partner, sharing podcasts like OCD Stories or Parenting Survival Podcast can be a great way to share and talk about challenges, too.
4. There will be challenges! Accept them.
ERP and HRT are hard treatments to do. Your loved one may get frustrated and want to give up. Their OCD, BFRBs, or tics can get more active at times depending on stressors and treatment progress. Remind them that recovery isn’t linear and you can’t expect perfection. Try being a pillar of support for them in between sessions.
Maybe they can watch videos with you to stay motivated, like Kicking Childhood OCD to the Curb or AT Parenting Survival School. Help them build positive coping skills that bring them joy and connect them to their values—perhaps you can volunteer with them, make something with them, or go on walks and exercise with them. Stay firm and consistent with rules and reminders. If they slip up, remain supportive, but don’t give into compulsions. Make them do exposures, and reward them for challenging themselves.
5. Be compassionate with them—and yourself
You may get frustrated when you don’t see progress in your loved one. They may sometimes get angry with you and themselves. Allow the anger to be there, but also be kind to yourself. OCD, BFRBs, and tics don’t just go away. They are not easy to manage. Realize when you and your loved one are doing the best you can, and recognize when you can do better.
Sources of support are key to recovery
Whether your loved one is suffering from OCD, BFRBs, or a tic disorder, recovery from these conditions can be difficult to accomplish alone. But with the help of loved ones who understand effective ways to provide understanding and motivation, people can learn to manage their symptoms and get back to living the life they want to live.
Effective, specialized OCD therapy is hereLearn more
If you or a loved one may be suffering from OCD or a related condition, NOCD can help. Our licensed, specialty-trained therapists use exposure and response prevention (ERP) therapy to treat all subtypes of OCD, and many NOCD Therapists have also received specialty training in treating BFRBs and tic disorders. You can book a free 15-minute call with our Care team to learn more about working with a NOCD Therapist. We also offer NOCD 411 sessions, specifically designed to support and guide the loved ones of people suffering from OCD and related conditions.
NOCD Therapists specialize in treating OCDView all therapists
Licensed Therapist, MA
I started as a therapist over 14 years ago, working in different mental health environments. Many people with OCD that weren't being treated for it crossed my path and weren't getting better. I decided that I wanted to help people with OCD, so I became an OCD therapist, and eventually, a clinical supervisor. I treated people using Exposure and Response Prevention (ERP) and saw people get better day in and day out. I continue to use ERP because nothing is more effective in treating OCD.
Licensed Therapist, LCMHC
When I started treating OCD, I quickly realized how much this type of work means to me because I had to learn how to be okay with discomfort and uncertainty myself. I’ve been practicing as a licensed therapist since 2016. My graduate work is in mental health counseling, and I use Exposure and Response Prevention (ERP) therapy because it’s the gold standard of OCD treatment.
Licensed Therapy, LMHC
I've been a licensed counselor since 2013, having run my private practice with a steady influx of OCD cases for several years. Out of all the approaches to OCD treatment that I've used, I find Exposure and Response Prevention (ERP) therapy to be the most effective. ERP goes beyond other methods and tackles the problem head-on. By using ERP in our sessions, you can look forward to better days ahead.