Obsessive compulsive disorder - OCD treatment and therapy from NOCD

Reassurance is Actually Making You Less Assured

7 min read
Stacy Quick, LPC

Imagine you’re a college student who has to turn in your mid-term paper, but you recently started feeling under the weather. Your illness causes you to get behind on your schoolwork, and since your paper is due in a couple of days, you’ll need to ask for an extension from your professor. Many students do this, so you’re aware that it’s not an unusual request, but you just can’t seem to send the email. Maybe you even typed it as soon as you knew you’d fall behind, so it’s been ready for a while—but instead of hitting “send,” you keep rereading it over and over, trying to make sure it’s just right. 

You decide to ask your roommate to look it over, asking “Does this sound ok?” “But could my professor interpret this wrong?” and “Are you sure there are no errors in here?” Only after your roommate has repeatedly assured you that they approve do you finally send out the email. Eventually, it doesn’t take long for this to become a regular occurrence: you need to ask your roommate to check every email you put together, so they can assure you that there are no mistakes and that you haven’t unintentionally worded something poorly. Soon you notice your roommate seems to be less available, and you begin to feel anxious without their review.

This scenario demonstrates what is known as reassurance-seeking: repeatedly asking the same thing over and over, sometimes in a roundabout way, to relieve the anxiety or fear that comes from obsessions. For someone who has OCD, reassurance-seeking often becomes a compulsion—something that is done either internally or externally to neutralize an intrusive fear or thought.

The natural response from loved ones and friends who care about a person with OCD is to provide a comforting response when asked for reassurance. They want to answer the person in a manner that minimizes distress and alleviates their anxiety. It can be painful to watch a loved one experience anxiety and feel helpless, so the temptation to reassure them can feel daunting. 

Unfortunately, despite the best intentions, this can inadvertently strengthen the endless cycle of reassurance-seeking: the more they give their loved ones reassurance, the more their loved ones feel that they need it. That’s because the more they are given it, the less they trust their own ability to answer for themselves. 

Reassurance-seeking can also change and become less obvious over time, as the person with OCD learns ways to seek reassurance without asking for it outright, which may cause them additional embarrassment and shame.

Examples of reassurance seeking

There are many ways in which reassurance-seeking may play out, and sometimes they can be difficult to identify. Imagine a scenario in which a 10-year-old child constantly asks his parents whether or not they love him. What if something bad happened to them or to him and they hadn’t said it? He feels that he needs them to answer it constantly so that his anxiety will go away. The parents naturally want him to know that they love him, and they quickly answer affirmatively every time he asks. He feels good for a while, only to have that same feeling arise again and again. He notices the exhausted looks on his parents’ faces when he asks for the fifteenth time in a day, and yet he feels compelled to continue whenever he feels unsure. 

Or we can imagine a newly married couple who are out to dinner when the wife asks her husband to inspect her water glass. It looks like there is something on it, but she cannot be sure. He obliges by taking a good look and tells her there doesn’t seem to be anything on the glass, so she is able to relax and drink from it. But soon enough, this becomes a regular occurrence. She continually asks him whether he sees anything on plates, forks, cookware, and anything she touches. She sometimes asks fifty times a day. He is growing weary of her requests and becomes annoyed. He doesn’t understand why she needs him to inspect everything. 

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It’s as if the loving reassurance that these parents or this husband gave to their loved ones has only increased their anxiety. They begin asking more and more, even spreading into other areas of their lives until it consumes the relationship. Eventually, the person with OCD may start demanding reassurance. 

Reassurance seeking can lead to avoidance and doubt

Another unfortunate thing that might begin to happen with constant reassurance-seeking is that the person struggling with OCD begins to believe that they really need reassurance and that they cannot actually tolerate the distress and uncertainty that their thoughts bring. This can lead to further avoidance, making them believe that their fears are rooted in reality. 

OCD is known as the “doubting disorder” because breeding doubt is what it does best. It inserts doubt into any situation, any thought, and any feeling. When someone who has this disorder seeks reassurance from someone else, they feel more and more that they cannot trust themselves. They feel as though they cannot rely on their own judgment, their own memory, or their own beliefs. This is why they seek it from others—they believe that others know more or are better equipped than themselves. Sometimes they simply seek to alleviate feelings of anxiety, while other times they may act based on a deep mistrust or doubt of who they are. 

How can I help my loved one?

Are you looking to provide immediate relief from any form of distress that your loved one is feeling? Or are you looking to help your loved one learn that they can trust themselves and that they can tolerate uncertainty? The former frame of mind only reinforces compulsive reassurance-seeking, while the latter can help your loved one manage OCD long-term. 

First, start off by letting the person know that you have noticed their pattern of behavior. I recommend that you do this in a loving way that shows compassion and concern. Let them know that you understand the reason they are asking for reassurance. Let them know that you want to help them and that you recognize that helping them may not work right away. The results may take a while to notice. 

Help them understand that your goal is simple: you want them to learn to rely on their own opinions and decisions and to know that they can be uncertain and uncomfortable and still move through these feelings. They don’t need to do anything to fix this, including asking for reassurance. Let the person know that this is not a punishment and that you are not trying to hurt them or be insensitive to what they think that they need. Instead, you are going to focus on helping them recognize that they are strong enough and capable enough to manage without your reassurance. 

Because this can be a difficult situation to maneuver, and because you may have been providing reassurance for a very long time, I advise that you work through this process with a professional who is specialty-trained in OCD. This will also allow you and your loved one with OCD to feel supported together. Focusing on long-term goals for your loved one can help you through the hard times in the beginning. This will be a challenge, and you may see your loved one struggle initially, but the rewards will be well worth it.

Making ERP a priority

Whether you’re struggling with OCD or want to help someone else stop relying on reassurance, I strongly suggest you look into exposure and response prevention (ERP) therapy. When conducted by a licensed OCD therapist, ERP is the best way to recover from OCD and unlearn reassurance-seeking behaviors. This unique therapy is specifically designed to help people face their obsessions and resist compulsions in healthy and productive ways.

A therapist who has received specialized training in OCD treatment will know what to anticipate when you describe your thoughts and behaviors, and how to build your personalized treatment program. Their expertise is in teaching you how to manage your OCD so you don’t feel stuck trying to “get rid of” the unpleasant feelings caused by disturbing thoughts.

ERP is considered the gold standard for OCD treatment and has been found to be effective for 80% of people with OCD. The majority of patients experience results within 12-25 sessions. As part of ERP therapy, you will track your obsessions and compulsions and make a list of how distressing each thought is. You’ll work with your therapist slowly to put yourself into situations that trigger your obsessions. This has to be carefully planned to ensure that it’s effective and that you’re gradually building toward your goal rather than becoming overwhelmed. 

The basis of ERP therapy is that direct exposure to these feelings is the most effective way to treat OCD. When you continually rely on compulsions like reassurance-seeking, it only strengthens your need to engage with them. On the other hand, when you prevent yourself from engaging in your compulsions, you teach yourself a new way to respond and will very likely experience a noticeable reduction in your anxiety. 

Find a therapist who can help you manage your OCD

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At NOCD, all of our therapists specialize in OCD and receive ERP-specific training and ongoing guidance from our clinical leadership team. Many of them have dealt with OCD themselves and understand how crucial ERP therapy is. NOCD offers live face-to-face video therapy sessions with licensed OCD specialists, in addition to ongoing, always-on support on the NOCD telehealth app, so that you’re fully supported during the course of your treatment. 

To learn more about how working with a licensed NOCD therapist can help you get better, schedule a free call with our team today.

NOCD Therapists specialize in treating OCD

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Taylor Newendorp

Taylor Newendorp

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.

Madina Alam

Madina Alam

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.

Tamara Harrison

Tamara Harrison

Licensed Therapist, MA

I have personally struggled with OCD and know what it's like to feel controlled by intrusive thoughts and compulsions, and to also overcome it using the proper therapy. I’ve been a licensed therapist since 2017. I have an M.A. in Clinical Mental Health Counseling, and practice Exposure and Response Prevention (ERP) therapy. I know by experience how effective ERP is in treating OCD symptoms.

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