A frequent problem among those with obsessive-compulsive disorders is one involving the attitudes and behaviors of the significant others in their lives, i.e., husbands, wives, boyfriends, or girlfriends. You significant others can be of great help and support to the recovery process, or you can create many types of obstacles. Trying to recover from OCD is difficult enough in itself, and when relationship problems are added, it just makes things that much tougher.
Let us first examine some of the ways in which significant others can be a source of difficulty. Then, we will look at ways in which you can help, instead.
Probably the single greatest source of problems in any relationship is when one partner sets out to change the other. The most successful relationships are based upon unconditional acceptance. This is necessary because all human beings are naturally imperfect, so each partner must accept the other as they are, with all their strengths and weaknesses, if they are to get along. Please understand that unconditionally accepting one’s partner does not mean liking every single thing about them. It just means acknowledging that they are the way they are. Certainly we all have things we would like to change about our partners, but we learn to live with them because: 1) it is not within our power to make such changes in them; and 2) we hope that they will accept our own problems, weaknesses and deficiencies.
Truly loving someone doesn’t mean being merely in love with the image of the perfect partner you would like them to be. That ideal person doesn’t, and never will exist. Your partner is an ordinary fallible, mistake-making human being, just as you are. To set yourself up to judge them as if you, yourself, were some kind of superior being is to egotistically imagine you are god-like, and totally free of all faults. It is as if you sat there on your throne, and looking down, commanded “You should not be the way you are! You should be the way I say you must be!” All important undertakings in life are risky, and if you decide to enter into a relationship, you have to accept that you are in it for the whole package. You cannot simply filter out the parts you don’t like.
Throw away your blueprint! You may command that your partner not have OCD, however, whether you like it or not, it is a part of their life. They own it. It is chronic, and it is something they carry with them. It will not simply go away because you don’t like it. Many things that we do not like exist in life. In order to have a relationship with this person, you must accept that their disorder is a part of that total package. Your partner may attempt to change this behavior, or they may not. In the end, it is totally up to them. The only one who can change them, is them. In any case, you cannot change them. Period.
Please don’t misunderstand. Everyone with OCD would like to get rid of this problem, but not everyone is ready or able to do so at a particular time, for a wide variety of reasons. For example, proper help may simply not be available where they live. Don’t criticize them in their entirety as human beings. Those with OCD feel badly enough about themselves already without that. OCD is only one facet of who they are. It is not all there is to them. I have heard many sufferers describe themselves as “weirdos” and “freaks.” Imagine having to explain to the people in your life about the unusual thoughts you are having, or the strange behaviors you feel compelled to perform, despite being an intelligent person. Also, it is important to understand that the purpose compulsions serve is to relieve the anxiety and stress caused by obsessions. If you insult, threaten, or criticize, the stress you will be creating will only result in more obsessions, and thus more compulsions.
Look at it this way: this is the person you love and have joined your life to. As far as we know, the problem is biological in origin and probably genetic. It is not simply a bad habit or a vice. Don’t confuse yourself by believing the notion that having OCD was a deliberate act on their part. They didn’t ask for it, and are not to be blamed for having it in any way. On the other hand, it’s true that they are responsible for helping themselves, but even if they are not doing that at the moment, how can you justify making them feel badly about it, and what purpose do you think it will serve? What if they were afflicted by some other chronic illness such as lupus or diabetes. Would you still be as angry and upset with them?
It might help to examine the source of the difficulties you are having with your partner’s problem and look into yourself. Ask yourself these questions: could it be that rather than empathizing with your partner and feeling sympathy for what they are going through, you are only concerned in a self-centered way with what others will think of you, when you are with this person? Do you worry that you will be seen as responsible in some way, or that you will be considered abnormal by association? Do you feel that this kind of thinking or behavior has somehow magically made this person you may have spent years with, into someone that you suddenly don’t know and can’t tolerate being with any more? Is this person’s illness now all there is to them in your eyes?
Even if you are over the hurdle of acceptance, and can accept the disorder, there are still a number of difficulties you may encounter. First, if your partner is actively working on improving their self-control, openly expressing impatience with their rate of improvement will prove extremely destructive to their morale. Recovering from OCD takes a lot of work and effort, and can be a difficult task. It is a very stubborn set of habits. Unless you want to make a difficult job even more difficult, avoid pressure tactics, such as constant nagging. Simplistic statements such as “Why don’t you just stop,” or “Get a grip” are useless and meaningless for these disorders. Don’t try to punish them with your anger, silence, or absence at times when they have slips or setbacks. Don’t try to use guilt, with such statements as “Our relationship would be great if it weren’t for your OCD,” or, “I’m ashamed to be seen with you in public,” or, “You must really want to ruin our lives,” or, “If you really loved me, you’d stop.” As one of my patients told their impatient partner, “Do you actually think that I like doing these things, or thinking these miserable repetitive thoughts?”
No matter what the problem is, avoid the rather childish use of sarcasm and name-calling. It is an inappropriate and disrespectful way for one adult to treat another adult, and as a way to get someone to improve, it’s crude and simply won’t work. Finally, don’t continually threaten to leave them because they aren’t getting well quickly enough to suit you. If you really feel you absolutely can’t understand or accept it, and can’t control your frustration with them, then leave. It is probably kinder in the long run.
A second type of difficulty commonly seen is a situation in which the unafflicted partner is totally enmeshed in helping their ill companion by doing compulsions with them or for them. They may do this to keep the peace by avoiding angry scenes, or to spare their loved one upset, anxiety, or exhaustion from another bout of compulsions. They may actually believe that they are showing they care by doing these things. Understand that there are some types of help that simply don’t help. Washing or cleaning things for your partner, changing your clothes at their command, checking things for them, reassuring them, or doing tasks for them that their illness makes difficult to do does not truly represent caring. It only looks like it. These behaviors are short-term fixes designed to get you by for the moment. In the long-run, however, this so-called help is really helping to lock your partner more strongly into their illness, and you along with them. It may even help them to function just enough to feel that they really don’t have to change or get help at all. As you become more and more responsible for helping to get them through their day and meeting their needs, you gradually find that you are not really living your own life anymore, and that you are pursuing your own goals less and less. This can then only lead to increasing frustration, depression, and a sense of helplessness on your part.
A third major source of difficulty in these relationships is when one member is supportive of an ill partner in their treatment, but somehow becomes directly responsible for that other person’s recovery. You can’t want them to improve more than they do. If they can’t do it themselves, it is simply no good. They won’t learn if you try to do it for them. Even if you could get them to stop doing compulsions every time you caught them at it, what would happen when you weren’t around? You cannot stand guard over them twenty-four hours a day. Also, if you were to somehow take total responsibility for their problem, it would relieve them of ever having to take responsibility for it themselves, so they wouldn’t. If your partner actually prefers that you take control of their behavior because they imagine that they are too weak to learn to control themselves, resist the temptation. Otherwise, they will soon come to believe they are powerless. You’ll be doing them a big favor by allowing them to be fully responsible for themselves. Try to not get into the bad habit of calling their attention to their compulsive behaviors. Don’t waste your time whistling, snapping your fingers, waving, or otherwise signaling whenever you see them about to check, wash, or ritualize. Resist the urge to physically restrain them. Suppress your impulse to yell or call out. Developing self-awareness and control takes a lot of work, even when you’re motivated. If your partner isn’t motivated, rest assured that nothing you can do will make the slightest bit of difference.
So having said all this, how can you truly be of help? First, accept that the problem exists, and that it is not their fault that they have it. Read up on it, and educate yourself about it. Visit a support group meeting, if that is possible. Second, stay out of any involvement in their symptoms. If you are not yet very involved, keep it that way. If you have already fallen into the trap of participating in numerous compulsions, you will need to gradually withdraw. In many cases, this may require the help of a trained therapist who will explain to your ill partner why this is necessary for their recovery, and outline some gradual steps by which this can be accomplished. As they say, “don’t try this at home.” Third, understand that it is not your responsibility to get them recovered - it is entirely in their hands. It is completely up to them to change their behavior. Stay out of it and give them space to do what they need to do. Keeping their stress down will enable them to do a much better job. What you can do, is give unconditional support for their efforts to help themselves, and always be aware of how difficult it must be for them to live with this problem and fight it every day. Try to appreciate the courage it takes for them to face their worst fears, and to break years of solid habit. Accept their lapses, bad days, and slip-ups. There may be disappointing times when weeks of progress suddenly seem to vanish. This is not unusual, and must be viewed as one of the potholes in the road to recovery. No one learns a new skill without making mistakes. They may feel really discouraged at times, and believe that they cannot do it. Your belief in them can go a long way. If a pep talk is appropriate to the person and the situation, give one, by all means. Just be careful not to overdo it.
Couples encounter many obstacles in their lives together. This will just be another. Whether we like them or not, we are forced to accept such obstacles. Life is not like a card game where you can always throw down your cards and simply ask to be dealt a new hand. Remember that to get through this, or any difficulty, it must be the both of you combining your efforts against the problem, rather than each other.
Dr. Fred Penzel is a licensed psychologist, and executive director of Western Suffolk Psychological Services, located in Huntington, New York (631-351-1729). He has been involved in the treatment of obsessive compulsive disorders since 1982, and is a frequent contributor to the IOCDF newsletter. Dr. Penzel sits on the science advisory boards of both the IOCDF and the Trichotillomania Learning Center.