My fiancé and I both have obsessive-compulsive disorder (OCD). Because I was well-educated on the disorder by the time we started dating, we talked extensively about our respective themes so that we knew when not to provide reassurance—a common compulsion that keeps one stuck in the OCD cycle.
Though we are well aware of our own mental health and one another’s, it can still be challenging to not provide that reassurance. April Kilduff, MA, LCPC, LMHC, notes that “it’s a natural human instinct to want to ‘rescue’ a loved one in distress.” It’s uncomfortable to see the people we love suffer. And yet, by acting in a way that provides immediate relief to their distress or worry, we may actually be making their mental health problems worse.
Of course, this is not to say that you are to blame for their mental health—their condition isn’t your fault, nor is it theirs. However, you can both be a part of getting help and developing better coping skills by learning more about their condition and their best options for recovery.
If you’re becoming worried that you’re accommodating someone’s mental health problem, and found your way to this article, you’ve made a powerful first step. Keep reading to learn how you can identify when you’re enabling someone’s problem, and how to stop.
What does it look like to accommodate a mental health issue?
I mentioned how my partner and I have to be conscious of reassurance-seeking. Kilduff cites this, too, as a common example of how someone may accommodate a loved one’s behavior as it relates to mental illness. In the case of OCD, for example, the sufferer seeks reassurance from others that their fears and anxieties are not true. Because it’s a compulsion—and the nature of compulsions means that they never provide lasting relief—it just feeds the cycle of OCD. Reassurance-seeking is repetitive and frequent. It could sound like: “Are we going to break up?” “Feel my armpit, do you think that’s a tumor?” “I ate something in the fridge past its expiration date, am I going to get sick?” “Do you think I’m a bad person?” “Watch my eyes, do you think I’m blinking weird?” among a million other possibilities. The root of it is always the same: they want you to help them confirm that everything is “normal” or “okay.” Unfortunately, no matter what you say or how many times you say it, their worries and doubts always return later, often with even greater intensity.
Giving reassurance could show up in other disorders, too. You may have the desire to reassure someone without them asking for it out of that same desire to “rescue” them. For example, if your loved one routinely has tumultuous relationships full of conflict and anger, and you are always there to tell them that they’re not in the wrong, that’s a form of reassurance, too. Let’s say your loved one said something rude to a friend and that friend got upset about it. If you say, “She’s being dramatic. You had a long, exhausting day, and she was being too loud,” that dismisses the need to reflect on how their actions affect others. They have now been enabled to continue behaving in such a way, knowing that you will stick by their side no matter what. In reality, you can “stick by someone,” if you value them and your relationship, without enabling them. Though it will feel uncomfortable for both parties at first, and the person with the condition may feel betrayed or angry about being held accountable, it is for their benefit in the long run—and yours.
Another common way people enable mental health problems is by assisting their loved ones in avoiding people, places, or activities that trigger them, Kilduff says. For example, if someone has contamination OCD that has caused them to avoid public places or social settings, and you show full support of this without encouraging them to live by their values and intentions—rather than their fears—you’re actually helping them stay stuck in their phobia. Let’s say you only plan date nights with your partner, who has contamination OCD, that take place at home. You plan movie nights, backyard picnics, and living room dance parties. Their behavior becomes normalized and stops becoming a problem because they have you to cater to it. Instead, you can learn to validate their feelings while still encouraging them to do things that are hard so that they can engage in new activities they’re interested in. If this sounds especially difficult, you might consider enlisting the help of a mental health professional to work with you together.
Someone with a personality disorder, such as borderline or narcissistic, might have the tendency to try to enact control over you. They may want to limit your world to keep you closer to them. For example, let’s say you’re supposed to be going to a family member’s birthday party. Your friend, who has borderline personality disorder, feels like you’re abandoning them when you walk out the door. Because you don’t want to hurt them, you stay with them and skip the birthday party. By allowing this to happen, and catering to their wishes, you reinforce their belief that they can control you and have you “to themselves”—and they feel as if this control is keeping them safe, reinforcing their fear of abandonment. Instead of staying with them, you can say something like, “I really value our friendship, and I also really value participating in family events. I would love to hang out later.” This both expresses your love for them and denies them the ability to make decisions for you.
Those struggling with substance use disorders and other addictions often have people in their lives who enable them. Again, like Kilduff says, this is a normal human instinct. Of course you don’t want this person to suffer. If you could take their addiction away by now, you would have—same goes for any mental health condition. If someone in your life is struggling with addiction, and you continue to give them money or try to “fix” the consequences of their actions, for example, that shows them that they can make their addiction work because they have people who will help them no matter what. To be clear, there are people who can help them—but it’s not the same kind of help. Instead of trying to fix things for them, you can offer to help them find a trained professional who has experience with their condition. In the next section, we’ll go over tips for encouraging someone to go to therapy.
Remember: recognizing behavior that enables someone’s mental health problems is not about blame, shame, or guilt. Rather, it’s about acknowledging and resisting harmful behaviors in order to partake in their treatment, rather than their illness. There are also resources for your own mental health if being a support person has taken a toll on you.
What to do if you think you’re accommodating someone’s mental health problems
Chances are that if you’re suspecting that you’re accommodating someone, you’ve learned some things about their mental health condition. That’s great—keep learning. There are tons of online educational resources, but make sure you’re using reputable, evidence-based sources. You can also share these resources with your loved one, depending on how much research they’ve done themselves. If they have done research and are well-educated on their condition, you can also ask them to send you information that resonates with them, so you can best understand their experience rather than just the condition in general. Beyond educating yourself, Kilduff recommends joining your loved one in a therapy session so that you can learn more about their treatment and get recommendations from the therapist about “dos and don’ts.” The therapist can help you recognize ways you accommodate the person’s behavior, even in ways you might not have identified yet.
If your loved one is not in therapy, there are strategies you can use to effectively encourage them to do so. The National Alliance of Mental Illness (NAMI) recommends the following:
- Convey that you want them to get help because you love them and value your relationship. Stress the ways your relationship would benefit if they went to therapy. Avoid giving an ultimatum, as this might cause distress that hinders them from being receptive to your suggestion.
- Point out the things you admire about them. Make sure they know that you think they have plenty of positive qualities. Knowing that you’re not saying they’re all “bad” will help them be more open to the conversation.
- Be specific. If they have not recognized their own problems yet, their first response may be denial. They may not think they have a problem at all. By offering specific examples—still in a loving, non-judgemental way—you can navigate around their tendency to argue.
- Depending on how much emotional, mental, and time capacity you have, offer help how you can. Perhaps you can help them find the right therapist, learn about their condition and recovery options together, or even take them to their first session and wait with them in the waiting room.
If you’re not sure if your loved one needs help, the fact that you’re reading this article is a sign that you and your relationship has been affected by the condition, and therefore, help is likely to be beneficial.
You can also seek a therapist yourself. You’re not betraying this person by needing help for emotions or experiences that have occurred because of their condition. In fact, by dealing with those emotions and experiences, you are being proactive about preserving your relationship. You don’t want to get to the point where resentment builds. There’s a common metaphor that compares the situation to airplane safety: before an airplane takes off, the flight attendants tell you, in their safety speech, to put on your oxygen mask before you help someone else with theirs in the case of an accident. That’s because you won’t be able to help anyone or save yourself if you lose consciousness. This metaphor seems fitting for seeking help for the ways someone’s condition has affected you. You have to take care of yourself in order to continue caring for your loved ones and fostering your relationships.
Moreover, you can find online support groups for loved ones of people with various mental health conditions. We have one here at NOCD for the loved ones of people who are in treatment with us for OCD, anxiety, depression, and related conditions like hoarding and BFRBs.
I would also recommend checking social media sites like Facebook for private support groups. Of course, there are also support groups for people with various conditions that your loved one can look into if they’re wanting support outside of one-on-one therapy.
No matter your loved one’s condition, neither of you is alone in your experience. There are people who would see themselves in your story. There are trained professionals willing and ready to help you and your loved one. It’s never too late to stop enabling their illness and start supporting their treatment.
If you think a loved one may be struggling with OCD, anxiety, depression, PTSD, hoarding, or related conditions, please read more about NOCD’s evidence-based, specialized approach to treatment. Our therapists regularly involve members’ loved ones in order to strengthen the treatment journey.