Watching someone you love struggle with obsessive-compulsive disorder can be heartbreaking and confusing. The disorder’s symptoms—intrusive thoughts, repetitive behaviors, intense anxiety—may seem inexplicable or irrational, creating helplessness in family members and friends who desperately want to help but aren’t sure how. Understanding how to effectively support someone with OCD while avoiding well-intentioned actions that inadvertently maintain or worsen symptoms is essential for being a positive force in their recovery journey.
Understanding Your Role
Before exploring specific do’s and don’ts, it’s important to understand what role loved ones can play:
You cannot cure their OCD: Professional treatment with evidence-based interventions is necessary for recovery. Your role is supportive, not therapeutic.
Your actions matter: Research demonstrates that family accommodation—when family members participate in rituals or modify their behavior to help the person avoid OCD triggers—predicts worse treatment outcomes. How you respond to OCD can help or hinder recovery.
Support looks different than you might think: Natural instincts to provide reassurance, help the person avoid distress, or participate in rituals often backfire. Effective support sometimes means tolerating the person’s temporary discomfort rather than rushing to relieve it.
You matter too: Supporting someone with OCD can be exhausting and stressful. Taking care of your own wellbeing isn’t selfish—it’s necessary for being able to provide sustainable support.
The Accommodation Trap
Family accommodation deserves special attention because it’s both common and counterproductive:
What Is Accommodation?
Accommodation occurs when family members modify their behavior to help someone with OCD avoid triggers or reduce anxiety. Examples include:
Participation in Rituals:
- Answering repeated reassurance questions
- Participating in checking or cleaning rituals
- Performing tasks the person fears doing
- Following special rules or restrictions in the home
Modification of Daily Routines:
- Adjusting family schedules around OCD symptoms
- Avoiding certain places or activities to prevent triggering obsessions
- Taking on the person’s responsibilities when OCD interferes
- Adhering to elaborate rules about what can be brought into the home
Enabling Avoidance:
- Making excuses for the person’s absence from activities
- Handling situations the person avoids due to OCD
- Protecting the person from anxiety-provoking situations
Why Accommodation Is Problematic
While accommodation feels helpful in the moment—it reduces the person’s anxiety temporarily—it maintains OCD by:
Reinforcing Compulsions: Accommodation functions as a compulsion performed by someone else, providing the same temporary relief that reinforces the OCD cycle.
Preventing Learning: When others prevent exposure to feared situations, the person never learns that anxiety decreases naturally without rituals or that feared outcomes don’t occur.
Increasing Dependence: Over time, the person may become increasingly reliant on accommodation, with symptom management requiring ever-more family involvement.
Predicting Worse Outcomes: Research shows that high levels of family accommodation predict worse treatment outcomes, particularly in children and adolescents with OCD.
Affecting Family Functioning: Accommodation can consume family time and energy, restrict family activities, and create resentment, damaging relationships and family cohesion.
The Challenge of Reducing Accommodation
Reducing accommodation is difficult because:
- It temporarily increases the person’s anxiety
- It may trigger anger or distress directed at family members
- The person may explicitly request accommodation
- Refusing accommodation can feel cruel or unsupportive
However, reducing accommodation is an act of genuine support that facilitates recovery, even if it doesn’t feel that way initially.
The Do’s: How to Effectively Support Someone with OCD
DO: Educate Yourself About OCD
Learn about the condition: Understanding OCD’s nature, how it works, and what evidence-based treatments exist helps you respond appropriately.
Recognize OCD patterns: Learn to identify obsessions, compulsions, and accommodation requests so you can respond strategically rather than reflexively.
Understand treatment: Knowing how exposure and response prevention (ERP) works helps you support treatment principles at home.
Resources: Books, reputable websites (like the International OCD Foundation), and support groups for families provide valuable education.
DO: Encourage Professional Treatment
Suggest evaluation: Gently encourage seeking assessment from a mental health professional experienced in treating OCD.
Support treatment engagement: Help with practical aspects like finding providers, scheduling appointments, or arranging transportation.
Respect treatment goals: If the person is in treatment, coordinate with their therapist about how the family can support (with the person’s permission).
Be patient: Recovery takes time. Maintain encouragement even when progress feels slow.
DO: Communicate Clearly and Calmly
Separate the person from OCD: Use language that distinguishes your loved one from their symptoms—”OCD is telling you this” rather than “you always do this.”
Express care: Regularly communicate love and support separate from OCD-related interactions.
Discuss accommodation: When the person is calm (not during a crisis), discuss how you’ll handle accommodation requests going forward.
Set boundaries: Clearly communicate what you will and won’t do regarding participation in rituals or accommodation.
Be consistent: Once boundaries are set, maintain them consistently rather than sometimes accommodating and sometimes refusing.
DO: Encourage Independence
Allow natural consequences: Let the person experience the natural outcomes of their choices rather than constantly protecting them from discomfort.
Promote problem-solving: When challenges arise, encourage the person to develop solutions rather than immediately stepping in.
Support gradual challenges: Encourage taking on tasks that are anxiety-inducing but manageable, celebrating small victories.
Maintain expectations: Where possible, maintain age-appropriate or role-appropriate expectations rather than lowering all expectations due to OCD.
DO: Reinforce Non-OCD Behavior
Notice improvement: Comment positively when you observe the person resisting compulsions or confronting fears.
Praise effort: Acknowledge attempts to resist OCD even when not fully successful.
Focus on functioning: Notice and appreciate when the person engages in normal activities, fulfills responsibilities, or participates in family life.
Avoid excessive attention to symptoms: While supporting the person, don’t let OCD become the constant focus of family attention.
DO: Practice Self-Care
Recognize your limits: You cannot fix this condition, and taking responsibility for another person’s OCD is unsustainable.
Seek support: Consider support groups for families, therapy for yourself if needed, or confiding in trusted friends.
Maintain your own life: Continue your activities, friendships, and interests rather than allowing OCD to consume the entire family’s functioning.
Set emotional boundaries: Recognize that you can care about the person’s suffering without being responsible for eliminating it.
Take breaks: It’s okay to need time away from caregiving responsibilities.
DO: Maintain Hope and Perspective
Remember treatability: OCD is highly treatable with evidence-based interventions. Recovery is realistic and achievable.
Recognize progress: Note improvements even when symptoms remain.
Maintain long-term view: Short-term discomfort (from exposure work or reduced accommodation) serves long-term recovery.
Celebrate successes: Acknowledge milestones in the recovery journey.
The Don’ts: What to Avoid
DON’T: Provide Excessive Reassurance
The reassurance trap: Answering repeated questions about whether something is safe, clean, or acceptable provides temporary relief but reinforces OCD. The relief is brief, and questions return, often escalating in frequency.
What to do instead:
- “I’m not going to answer that because I know it’s OCD asking, not you”
- “You know my answer—I’m not going to repeat it because that feeds OCD”
- “Let’s talk about something else”
Why this helps: Refusing reassurance initially increases anxiety but teaches that uncertainty is tolerable and that compulsive reassurance-seeking isn’t necessary.
DON’T: Participate in Rituals
The ritual trap: Helping perform checking, cleaning, or other compulsions, or following elaborate rules the person has created, functions as accommodation that maintains OCD.
What to do instead:
- Clearly state you won’t participate in specific rituals
- Remain calm and matter-of-fact in refusing
- Offer to engage in a different, non-OCD activity instead
- Remain consistent even when the person becomes distressed
Why this helps: Refusing to participate in rituals is an act of support that promotes independence and prevents symptom maintenance.
DON’T: Criticize or Express Frustration During Episodes
The criticism trap: While frustration is understandable, expressing anger, criticism, or exasperation when someone is anxious and struggling worsens the situation without helping.
What to do instead:
- Take a break if you’re becoming frustrated
- Express feelings at calm times, not during crises
- Use “I” statements about your experience rather than accusations
- Separate feelings about OCD’s impact from feelings about the person
Why this helps: Criticism increases anxiety and shame without addressing the underlying OCD, making symptoms worse rather than better.
DON’T: Make the Person Feel Ashamed
The shame trap: Implying that the person should be able to “just stop” or that their struggles reflect weakness or character flaws increases shame without helping.
What to do instead:
- Remember OCD is a medical condition, not a choice
- Acknowledge the difficulty of what they’re experiencing
- Recognize that recovery requires courage and effort
- Maintain respect for the person separate from their symptoms
Why this helps: Shame interferes with help-seeking and treatment engagement. Compassion without accommodation is the goal.
DON’T: Enable Avoidance
The avoidance trap: Making excuses for absences, handling all situations the person avoids, or restructuring family life around what triggers anxiety enables avoidance that maintains OCD.
What to do instead:
- Encourage gradual confrontation of avoided situations
- Allow natural consequences of avoidance
- Offer to support (not rescue) during challenging situations
- Maintain family activities even if the person can’t always participate
Why this helps: Recovery requires confronting fears. Enabling avoidance prevents this necessary exposure.
DON’T: Take Responsibility for Their OCD Management
The responsibility trap: Taking complete responsibility for ensuring the person follows treatment, performs exposures, or manages symptoms creates dependence and removes the person’s agency.
What to do instead:
- Offer support while maintaining appropriate boundaries
- Encourage the person’s ownership of their recovery
- Let them experience natural consequences of treatment decisions
- Provide support without removing responsibility
Why this helps: Recovery requires the person to develop skills and self-efficacy. Taking over this responsibility prevents growth.
DON’T: Compare Them to Others
The comparison trap: Statements like “why can’t you just do this like everyone else?” or comparisons to siblings, friends, or the person’s pre-OCD functioning increase shame without helping.
What to do instead:
- Recognize that OCD creates genuine challenges
- Compare current functioning to past functioning to note progress
- Avoid comparisons to others whose circumstances differ
- Focus on individual growth rather than external standards
Why this helps: Comparisons create shame and demoralization rather than motivation.
DON’T: Research Excessively with Them
The research trap: Some individuals with OCD compulsively research their symptoms, treatments, or feared outcomes. Participating in this research functions as accommodation.
What to do instead:
- Learn about OCD independently from reputable sources
- Encourage limited, focused research from good sources
- Refuse to repeatedly discuss research findings
- Redirect to treatment providers for medical questions
Why this helps: Excessive research becomes a compulsion that maintains anxiety rather than providing genuine help.
Special Considerations for Different Relationships
Supporting a Partner/Spouse
Romantic relationships face unique challenges:
- Physical intimacy may be affected by contamination fears or other obsessions
- Accommodation requests may be framed as demonstrations of love
- Relationship OCD may involve you directly as the target of obsessions
- Financial decisions about treatment costs require collaboration
Key principles:
- Maintain couple identity separate from OCD
- Preserve intimacy in areas OCD doesn’t affect
- Consider couples therapy in addition to OCD treatment
- Set boundaries that protect the relationship while supporting recovery
Supporting a Child
Parenting a child with OCD involves balancing support with promoting independence:
- Developmental stage affects how accommodation manifests
- Schools may need to be involved
- Family accommodation is particularly predictive of outcomes in pediatric OCD
- Age-appropriate expectations must be maintained
Key principles:
- Collaborate with the child’s treatment team
- Maintain structure and routines
- Don’t let OCD excuse all misbehavior—some behavioral issues are separate
- Prepare siblings to understand and respond appropriately
Supporting a Parent
Adult children supporting parents with OCD face unique dynamics:
- Role reversal feels uncomfortable
- Parents may resist “taking advice” from children
- Long-standing accommodation patterns may be deeply entrenched
- Other family members may not support reducing accommodation
Key principles:
- Approach with respect for the parent-child relationship
- Focus on concern and care rather than criticism
- Offer to help find resources rather than taking over
- Accept that you have limited control over an adult parent’s choices
Supporting a Friend
Friendship relationships have different boundaries:
- Less obligation to accommodate
- May have less awareness of the full extent of symptoms
- Limited ability to influence treatment decisions
- Important source of normal social connection
Key principles:
- Maintain the friendship’s positive aspects
- Include your friend in normal activities
- Gently refuse accommodation requests when they arise
- Respect privacy while offering support
- Don’t let OCD become the sole focus of the friendship
When to Seek Help for Yourself
Supporting someone with OCD can be exhausting. Seek help when:
- You feel overwhelmed or unable to cope
- You’re experiencing depression, anxiety, or stress-related symptoms
- Family relationships are significantly strained
- You’re unsure how to handle specific situations
- You need help setting or maintaining boundaries
- Your own life is consumed by their OCD
Resources for families:
- Family therapy or coaching focused on OCD
- Support groups for families (in-person or online)
- Individual therapy to process your experiences
- Educational programs about OCD and family response
Conclusion
Supporting someone with OCD requires balancing compassion with firmness, understanding with boundaries, and short-term discomfort with long-term recovery goals. The natural instinct to relieve a loved one’s distress by providing reassurance or accommodating symptoms often backfires, maintaining the OCD cycle rather than disrupting it. Effective support involves educating yourself about OCD, encouraging professional treatment, gradually reducing accommodation, reinforcing non-OCD behavior, and taking care of your own wellbeing.
This approach isn’t easy—it can feel counterintuitive or even cruel to refuse reassurance or participation in rituals when someone you love is distressed. However, these boundaries represent genuine support that facilitates recovery rather than an obstacle to it. By responding strategically rather than reflexively, maintaining consistency, and remembering that OCD is treatable with appropriate intervention, family members and friends can be powerful allies in their loved one’s recovery journey while protecting their own wellbeing and the health of the relationship.