Learning that you have obsessive-compulsive disorder (OCD) can bring a real sense of clarity. Suddenly, you have words for what you’re feeling, and you realize that you’re no longer alone. You can pursue evidence-based treatment like exposure and response prevention (ERP) therapy, gain tools to alleviate your symptoms, and explain your experience and needs to your loved ones.
But, as the adage goes, with knowledge comes responsibility. Once you understand the OCD cycle, you also become more aware of which actions can exacerbate it—and how people in your life may be unknowingly contributing. As you consider the ways you interact with loved ones, and how you ask them to interact with you, you may find yourself wondering, Am I setting healthy boundaries, or am I asking my family members and loved ones to accommodate my OCD in ways that will ultimately just enable my compulsions and intensify the cycle?
You’ve probably heard a lot about the importance of setting boundaries with your family and friends. It’s an especially popular topic on social media, where people discuss asking family members not to comment on their appearance, or letting their coworkers know that they won’t be responding to work-related messages after hours. These can be helpful and healthy steps to take. But when you have OCD, it can be hard to tell the difference between boundary-setting and OCD accommodation.
You deserve to feel cared for by the people in your life, and part of that care means not feeding into your OCD. It may be difficult, but with practice, patience, and compassion for yourself and your loved ones, you can learn to tell the difference between harmful accommodation and healthy boundaries.
What are harmful accommodations?
In general, loving someone means doing your best to accommodate their needs, and knowing they’ll do the same for you. This includes setting boundaries so that your relationship feels respectful. But OCD can make its demands feel like your needs—and when your OCD is accommodated, even if it creates immediate relief, it makes you feel worse in the long term. Compulsions reinforce obsessions.
Harmful accommodations are ways in which your family members or friends might, out of a desire to help you, facilitate your compulsions and feed into the cycle of your OCD.
Some of the forms accommodating behavior can take include:
- Modifying or changing routines to accommodate OCD. For example, if you have a routine of compulsions you perform every time you get ready for bed, your partner might modify their own bedtime activity to give you more space or time for your own compulsive rituals and guidelines.
- Participating (knowingly or unknowingly) in a ritual or compulsion. For example, if a child feels compelled to follow a specific, circuitous route to walk from home to school, parents or caregivers might agree to take this path without questioning whether it’s an OCD compulsion. Or, if your child asks you to wear gloves while touching things in the home, you might do it to appease the OCD in the short term, only for that behavior to exacerbate OCD in the long run.
- Enabling avoidance, or helping a loved one forgo anything that seems like it might be triggering. For example, if you experience sexual orientation OCD (SO-OCD), characterized by obsessive, irrational doubts about sexual orientation and identity, you might struggle to watch movies or television because you find yourself constantly monitoring your body for physical responses to gauge if you’re attracted to the actors. Your friends, knowing about your SO-OCD, might make an effort to structure your hangouts around non-film or TV-related activities.
- Providing reassurance, or offering constant and excessive validation to counter the anxieties and doubts raised by OCD. Reassurance seeking is an extremely common compulsion, and it’s very easy for the loved ones of someone with OCD to slip into because comforting the people we care about is often instinctual.
- Allowing, or justifying the necessity of OCD rituals and compulsions. Your loved ones, knowing how distressed it makes you if you’re not able to engage in compulsions, might tell themselves that accommodating OCD is actually a good thing, because it helps you cope with difficult emotions.
Family accommodation commonly happens amongst parents and children or siblings in a household. But it can also happen between romantic partners, or even friends. It describes when loved ones make adjustments to alleviate their child, sibling, partner, or friend’s distress and anxiety, or try to prevent perceived negative outcomes related to their OCD symptoms. It’s often able to flourish because family members frequently develop these behaviors over the course of a child’s early life out of a genuine desire to help and care for them, without knowing that the child has OCD. Even when the compulsions and rituals being accommodated cause distress for the child and family, it can be difficult to step back and realize these behaviors are perpetuating the OCD cycle.
The same kind of habituation can happen in long-term romantic and platonic relationships. But even people you’ve known for comparatively less time can fall into patterns of OCD accommodation without realizing it. Good partners and friends want to help you feel better and respect your boundaries—and they may end up inadvertently feeding your OCD along the way.
It’s important to note that creating awareness of accommodation is not meant to place blame on family members, friends, or others accommodating. It makes all of the sense in the world to want to help a loved one feel better. The fact that efforts, like offering reassurance to alleviate a loved one’s distress is counterproductive to OCD recovery, often seems counterintuitive.
Family accommodation is also typically not stopped cold turkey. OCD specialists may work with the family or bring your partner in for a session to discuss a gradual decrease in accommodating rituals.
The importance of healthy boundaries
In recent years, the way we talk about boundaries has gotten confusing. We’re having more mainstream conversations about mental health, and topics that were once reserved for therapeutic settings have become commonplace. In this landscape, it’s easy to stumble across online advice telling you to cut everyone out of your life who has ever upset you, or that “community” means tolerating treatment from others that feels unacceptable. What none of this advice can tell you is which boundaries are appropriate for you and your specific relationships.
While conversations about boundaries have gotten confusing, boundaries themselves are still important. A boundary is a rule, request, or limit that alerts other people to what we are comfortable with. For example, “If you email me after 7:00 PM, I will not respond until the morning.” Healthy boundaries help us define the shape and scope of our relationships, which helps us see them clearly and appreciate them all the more. At their best, healthy boundaries are flexible enough to evolve as we do while ensuring that we treat the people we care about with respect, and that we receive respect from them in return.
If you have OCD, however, it can be hard to tell the difference between a healthy boundary and a request for a harmful accommodation. For example, when you’re sharing a meal with siblings, you might want to ask your sister not to steal your fries—but you’re not sure if that’s because the fry-stealing feels like a greedy violation of your personal space, or because your contamination OCD makes you worried about her touching your plate. Your family may suggest a group trip that you want to excuse yourself from—but you can’t tell if that’s because you know it will likely devolve into fighting, or because you’re worried that a new environment will make it too difficult to carry out your compulsions.
How to tell the difference
Everyone deserves to be taken care of, and everyone deserves to be able to set boundaries. By learning to recognize the difference between a genuine preference or need and an urge to carry out a compulsion, you can learn to communicate with your loved ones about supporting you—without supporting your OCD in the process.
When you’re first learning about OCD, it can be very hard to tell the difference between asking the people who care about you to respect your needs and asking them to facilitate your compulsions. As you’re learning to distinguish between the two, you can try asking yourself questions like:
- Does the “need” I’m trying to meet through my request seem tied to an obsession and feared consequence? If so, would I be making this request if I didn’t have OCD? For example, a person who tells their partner that they will not be doing any diaper changes because they’re worried about POCD intrusions when they’d actually like to help change diapers if it weren’t for OCD. This can be a sign that you’re seeking accommodation for OCD rather than setting a healthy boundary.
- Do I actually want to do this, or does my OCD want me to do this? For example, someone with contamination OCD likely does not want to be sanitizing their hands seven times before every meal. They probably don’t truly want their parents to have to sanitize their hands excessively before they hug them, either. OCD wants this. OCD is likely demanding this.
- Does this boundary or request seem like it will disrupt the OCD cycle, or fuel it? For example, if you’re deciding whether to go on a family trip and you realize you’re reluctant because you know the stress of family conflict will worsen your OCD, declining can mean honoring your needs. But if you’re turning down the invitation because a new environment would disrupt the OCD rituals and compulsions you’re accustomed to, when you actually want to spend time with your family, this avoidance will likely fuel OCD.
You might be asking, but what if a boundary could also be considered a compulsion? Sometimes it can be both. Your OCD specialist will not have you violate your boundaries for the sake of OCD treatment. For example, if you’re starving and haven’t eaten in a while, you might request that a friend not take food from your plate. While this might also alleviate anxiety related to contamination obsessions, you genuinely don’t want them eating your food. It’s okay to set that boundary. There is ample opportunity for ERP elsewhere that does not constitute a violation of boundaries.
Of course, all of these questions can be difficult to answer accurately when OCD is stirring up your anxiety. ERP therapy, the most evidence-based treatment for OCD, can provide you with tools to differentiate between harmful accommodations and healthy boundaries. Your OCD specialist can work with you to help you recognize where your sense of need may be coming from so that you can ask for what you really need, not what OCD demands.
Through ERP, you’ll gradually face triggers while learning to resist compulsive rituals. Along the way, your OCD specialist can guide conversations about reducing accommodation from your family and loved ones and responding to symptoms in more supportive, effective ways. This approach helps both you and your loved ones build confidence in tolerating OCD symptoms and related distress, decreasing its overall impact on daily life.
At NOCD, our licensed therapists specialize in OCD and receive comprehensive training in treating OCD with ERP therapy. They’ll create a personalized treatment plan and help you incorporate ERP in a sustainable, practical way—including with the people you love.
