Obsessive Compulsive Disorder (OCD) is a symptom of anxiety, so strategies for helping people with anxiety also apply to OCD.

There is a part of the brain called the hippocampus which is responsible for habits and behavioural patterns.  When someone’s anxiety levels go up, they trigger behaviours which the brain has locked onto thinking will help with crisis, emergency or danger.  Rationally we know that washing your hands isn’t necessarily going to help with a disaster, emergency or crisis, but behaviours logged in the hippocampus are not necessarily rational, they have no logic to them and usually no relation to helping to with a crisis.  However, someone with OCD is activating the amgydala, responsible for flight or fight, through their anxiety caused by negative thinking which works closely with the hippocampus responsible for habits and has linked a particular behaviour as an appropriate way to deal with anxiety levels and therefore keeps repeating those patterns. 

It is the increased anxiety levels that are triggering the behaviours, but unfortunately we (and the person with OCD) end up focusing on the behaviours, the OCD, rather than deal with the anxiety.  This is not going to help!  As long as the levels of anxiety are high, these triggers and behaviour patterns will keep repeating themselves. 

Particularly unhelpful is trying to get someone to stop their patterns of behaviour because you are causing their anxiety to go sky high and rather than helping you are going to create more of a problem and worsen the behaviour.  Don’t forget that in this person’s primitive brain, they believe the behaviours are helping with a disaster, crisis or emergency, so if you stop these things, they will inwardly panic. 

But there are things you can do.

I’m not saying you have to tolerate it, although in the video of how to help someone with anxiety I did emphasis that someone can only receive help when they are ready, you cannot force help on someone.  So forcing help on somebody to stop their OCD habits is actually going to have the countereffect and increase the anxiety and worsen the OCD habit, they have to get to that point on their own – and they will if you follow some simple tips.

  1. Ignore it as much as you can, do not bring attention and focus to the OCD habit that they have, because every time they focus on it videos replay in their mind and reinforce the behaviour.
  2. Point out when it is better, ie when they are not doing their habit. For example, say someone has a particular ritual around germs or infection, and you’ve noticed that they weren’t as bad as they normally would have been at a particular time, point it out to them.  You might explain, you noticed they weren’t washing your hands as much to day, why was that? Encourage them to think about why it was better.  They might say ‘I don’t know’.  Then you can reply ‘what were you doing today that you haven’t done other days?’  It will encourage the connection in their brain between when it is better and what they were doing.  There will be something they were doing differently on those days it is better and it will fall into one of three categories

Positive interaction – they would have been with other people more than usual or different people.

Positive activity – they were doing something which was really good for them, they might have been involved in a hobby or sport and during that time they are not able to do their OCD because their mind was focused on something fun and were doing something positive.

Positive thinking – when they were focused on something positive in their life or thinking about the future in a positive way – or were just in the moment for a change. 

  1. If you want to go a step further, observe and try and make those connections yourself to help the sufferer who might be struggling with that connections themselves. For example, ‘I’ve noticed that when you’ve been running or when you’ve been to the cinema, or when you’ve spent time with Jane etc, you wash your hands less – have you noticed that?’.

In summary, helping someone with OCD is about helping the person make the connections of when it is better, because when you can focus on when things are better, you can do it again.  You can work out why it was better and then you can emulate that and encourage other similar activities.  If it’s better when you’re with people, spend more time with people.  If it’s better when you exercise, find more fun exercises to do etc.

Unless they want to engage in a positive conversation about how they can help themselves (by this time you will be armed with lots of positive information of the moments when it is less severe), do not focus them on the subject, their anxiety or try to stop the OCD through force, impatience or making them feel bad, but equally, don’t enable it by helping them, buying antibacterial products (if that’s the OCD) or joining them in their rituals.  OCD is about control and if you let it, it will spread out to controlling not only the afflicted’s life but also everyone around it.  Encourage the fun things in life instead.

HPD, DHP, MNCH(Reg), AfSFH

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