Episode #42: My Top Tips for Helping a Loved One Manage OCD

Hello, Friend. It’s been about a decade since OCD entered our family’s life.

 

Today I would like to tell you my number one lesson that’s made the biggest difference to my son learning to manage his OCD, to my family and to me.

 

It’s the one thing that may make the biggest difference in your life, no matter how long you’ve been on this OCD path.

 

Welcome to the Free Me From OCD Podcast. We’re here to offer educational resources, coaching and community support to help you say YES to your life by saying NO to OCD. I’m Dr. Vicki Rackner your podcast host and OCD coach. I call on my experience as a mother of a son diagnosed with OCD when he was in college, surgeon and certified life coach to help you get in the driver’s seat of your life. My vision is to help you move towards a future in which OCD is nothing more than the background noise of your full life. This information is intended as an adjunct—not a substitute— for therapy.

 

So let’s dive in.

 

It’s been about a decade since my son’s life was invaded by OCD.

 

If you’ve listened to this podcast, you know that this has not been an easy path for my family.

 

I tried many things in the intention of making things better only to make things worse. I’ve made many mistakes. The goal of this podcast, in fact, is to help you learn from my mistakes so you can take the fastest and most direct path to being freed from OCD.

 

I can only imaging how much different it would have been if I knew a decade ago what I know now. 

 

So, Friend, let’s sit down on the preverbal kitchen table and I will share with you the ideas that have made the biggest difference for me.

 

I’ll begin by setting the stage for my number one lesson. I’ll paint the big picture of the challenges built into managing OCD, and then offer you a way of understanding OCD.

 

Then I’ll share my best ideas about how to help a loved one with OCD in the most helpful way. 

 

So, here we go.

 

If you’re at the beginning of your OCD journey, fasten your seatbelts, because OCD is a bumpy ride. It’s unlike anything you’ve faced. The stakes are high, and the consequences can be profound.

 

Plus, OCD is filled with paradoxes.

 

Your intuition about parenting or supporting someone in pain will often lead you in directions that make OCD worse rather than better.

 

Sometimes the counter-intuitive ideas offer the biggest breakthroughs. I spent many days wondering, “Which way is up?”

 

Here’s a way of understanding what it means to have OCD.

 

I once had a patient who had what was called at the time Multiple Personality Disorder or MPD. I met several of the alters who inhabited her body. I once asked, “What’s it like living with MPD?”

She said, “Sometimes I think of my body as a school bus. The Alters are like the children and the adults riding on the bus. Some are better behaved than others. Sometimes they fight. But the rule is that everyone needs to stay on the bus. No one can get kicked off, even when we all agree we want to vote them off the island.

 

She said that at any time, one of the Alters is driving the bus. Different Alters have different skills at driving and want to get to different destinations.

 

As she spoke, I could relate. I had different parts of me, too. At the time, fitness was a high priority. Part of me made a commitment to regular exercise, and another part of me reminded me it was raining and suggested I stay dry by lying on the couch reading a book. Part off me wanted to avoid sugar and another part of me wanted to eat ice cream. The stronger part of me in the moment got in the driver’s seat and determined the choice.

 

Imagine each one of us has our own school bus.

 

One day your loved one’s bus stops. The door opens and a new passenger we’ll call OCD gets on the bus. We don’t really know how or why OCD gets on the bus, but it does.

 

Sometimes it enters during early childhood. My son was nearing adulthood when OCD got on his bus.

 

What’s important to understand is that it’s nobody’s fault that OCD got on the bus. Nobody did anything wrong. The bus is not broken. It simply has a new passenger.

 

OCD is not just any old passenger. Plus it’s no shrinking violet passenger. OCD makes lots of noise and creates lots of drama on the bus. Without proper management, OCD can keep this bus from getting to where the bus driver wants it to go. It can bring the bus to a halt.

 

OCD has a single job it takes very seriously: looking for danger.i And OCD sees life-threatening danger everywhere. The themes of OCD are the classes of dangers that threaten life:  contamination or harm or disordered and potentially dangerous spaces. There’s the risk of being ejected from the tribe through violations of moral, sexual or religious principals. During most of the course of human history, being alone meant certain death.

 

OCD’s thoughts about danger are the obsessions. These are not fleeting thoughts; they are  pervasive thoughts and images with a deeply disturbing message. Often the thing that a person most values are obsession topics.

 

 

There’s a part of this person like my son that is aware that these obsessions are nothing more than crazy ideas that should be dismissed.

 

However, the OCD passenger has tricks, It poses the question, “Can you really trust yourself?What it you’re wrong this time?”

 

 

Imagine going to a salon to get your hair colored. You’re delighted that your stylist created the perfect blond highlights. A stranger on the street outside of the salon says,” Your green hair looks awful!”

 

You might know that’s not true. You just saw your hair color with your own eyes, You might wonder, “What’s wrong with this crazy person.”

 

Maybe you’re not so certain. Maybe in the sunlight there is a green tint. You might be worried or angry and  march yourself back into the salon. 

 

The thought you believe triggers feelings and actions.

 

 

When the obsessions are treated as valid thoughts, they trigger high levels of unpleasant feelings—usually anxiety, worry or disgust.

 

People with OCD say that these feeling are more than they can bare.

 

OCD offers a way out. “Just do this thing, and you or your family or the world will be safe.” These things that the OCD demands are the compulsions.

 

The compulsions offer a temporary reprieve from the anxiety.

 

This OCD cycle is repeated over and over. While the specific obsession or even obsession theme can shift, the elements of the OCD cycles are the same. OCD offers an obsessive thought or image . That obsessions leads to high levels of unpleasant feelings. Then the person performs compulsions to get temporary relief from the unpleasant feelings.

 

The more times the cycles are repeated, the louder and more demanding OCD becomes. When the cycles are interrupted, OCD gets quieter.

 

Think of a person’s thoughts and feelings as the conversations on the bus. From the outside you don’t know exactly what’s going on. OCD wants it to be a secret. So the person with OCD tries to hide the drama on the bus. They try to perform the compulsions in private.

 

If the person you love has OCD on board, you might notice that their driving is slightly off. You might notice that it takes longer to get tasks done. Or they are not doing things that used to bring them joy, like getting together with friends or participating in a sport.

 

You might be confused about what you are seeing. You might make up stories about what is happening.

 

Over time, you will notice more changes. Their school bus—if you will-drives more erratically.

 

Now you share the road with an erratic driver. This impacts you, too.

 

You often change your driving to avoid collisions. Unbeknownst to you, you might be helping OCD grow stronger.

 

Sometimes it takes years before a health care professional finally says, “The problem is OCD . It creates chaos when it’s unmanaged. However, when it’s actively managed it becomes an annoyance, like a mosquito buzzing around your ears.

 

Sometimes therapists say, “I can help you manage OCD.” However, they don’t really understand how OCD operates, and their efforts actually make OCD worse.

 

Different parts of you may react very differently to the OCD diagnosis.

 

Once my son got the diagnosis of OCD the part of me I call the Fixer went into full Mother Bear mode. I wanted to barge on his bus and restrain the unruly OCD passenger.

 

When you have young children, you have permission to get on their busses.  But trying to board an adult’s bus is like “relationship breaking and entering.”

 

My son was an adult when he was diagnosed with OCD.

 

Still I had constructed reasons I was in a better position to manage my son’s OCD than he was.

 

 

I had 40 more years of life experiences than my son.

My own prefrontal cortex was completely developed; my son still had a few years before his prefrontal cortex was completely built.

I’m a physician with experience making sense of medical studies

I have years of experience managing complex medical conditions.

 

Good arguments, right?

 

I also knew on some level that this was wrong.

 

Physicians gave up medical paternalism—doctors making patients’ choices over 50 years ago.

 

And here I was trying to implement medical maternalism. This was disrespectful. I was telling my son, “I don’t trust you to make good choices.”

 

Any efforts to manage other peoples’ busses will usually end badly.

 

You may have a part of you that wants to fix things, too. It’s easy to focus on stopping the compulsions, not really understanding that the compulsions are a symptom.

 

Another part of you might want to comply with OCD’s demands to make your loved one’s life easier and more comfortable.

 

You might notice a part of you judging and blaming yourself. Certainly there’s something you did to open that bus door to the OCD passenger. You must be a bad parent.

 

A part of you may worry about what the future holds.

 

A part of you may be mourning the loss of the times before OCD.

 

Here’s what you need to understand.  All of these are perfectly normal human reactions when a loved on has OCD on board.

 

And, I have learned from painful experience that none of these parts of you will help you get to where you want to go: to help your love one manage their OCD.

 

Here is the number one lesson my decade with OCD has taught me. If your goal is to help in the most helpful way, manage your own bus.

 

You will want to manage your loved one’s bus. It’s completely understandable you would do this.

 

If I came across even one person who successfully persuaded or cajoled or shamed their loved one into managing OCD, I would share their secret.

 

I’ve never met such a person.

 

Paradoxically. the best way to help a loved one with OCD is to give up the idea of persuading them to change.

 

Instead, manage your own bus. Manage the many parts of you that respond to your loved one so you show up in the most helpful way.

 

And here’s the most important self-management task: learn conduct yourself as an empathic witness.

 

What does that mean? You commit to being present, and saying with your words and actions, “I see your pain. I’m here no matter what. You are not alone. And I believe in your ability to manage OCD or rise to any challenge you face.

 

Isn’t this exactly what you would want when you are in pain?

 

I recently heard Terri Gross interview Salmon Rushdie about his new memoir., "Knife: Meditations After An Attempted Murder."

 

As you recall, years ago Iran's Ayatollah Khomeini ruled that Rushdie’s 1988 novel The Satanic Verses was blasphemy and  issued fatwa calling for Rushdie's death.

 

Then in 2022, while Rushdie was at a reading at a New York event, a 24-year-old man stormed the stage and stabbed Rushdie.

 

In his new memoir, he writes about the attack and its consequences.

 

The conversation turned to Rushdie’s wife. He recognized that his wife shouldered all the burdens of their day-today lives. He also noted that she did somethings else truly extraordinary. She showed up with love and support. He never saw her sorrow or grief or fear. He knew they was there, and he could only imagine how hard it was for her. She managed them when he was not there.

 

Rushdie’s wife was an empathic witness.

 

RUSHDIE continues, “Trauma that doesn't just happen to the attacked person. It happens to everybody around you. And so it was very traumatic for her.”

 

In many ways, OCD is like Rushdie’ attacker. It effects everyone.

 

If you want to be a force for change and support your loved one’s efforts to be freed from OCD, show up as an empathic witness.

 

This seems so simple.

 

Why is it, then, that resisting the urge to fix things when someone is in pain seems like the hardest thing in the world to do?

 

Part of it is that we need to defy our own instincts and behaviors that contribute to our survival over tens of thousands of years. We evolved to keep our kids safe and protected from pain.

 

To step into the role of empathic witness, you need to learn and practice new skills and master new tools.

 

 

It begins with being an empathic witness to yourself.  It’s hard to be present if you’re thinking, “Where did I go wrong as a parent?” Or, “”What will my child’s future look like?”

 

Empathic witnesses are willing to rethink and retell their OCD story. This is a skill that can be developed.

 

Second, to be an empathic witness you are able to feel your feelings. When someone you love is in pain, you feel their pain as if it’s your own. Sometimes it’s even worse.

 

Many people will do just about anything to avoid feeling pain.

 

My son’s pain was the driving force behind my efforts to be the OCD Fixer. “I feel your pain. I know the pain is tied to your unmanaged OCD. If I can persuade you to do your OCD work, we’ll both have less pain.”

 

In fact, I lived most of my life from the neck up. I learned the skill of feeling my feelings.

 

Third, empathic witnesses are able to keep the calm. This is particularly important with OCD, and here’s why.

 

People with OCD spend much time experiencing the world as a dangerous place. When someone detects danger, the the nervous system leaves the balanced, regulated zone of safety. It becomes dysregulated to create the physiology that prepares the body to fight, flee or freeze.

 

Now put this person who thinks they are in danger in the same room as a compassionate person. What happens?

 

A sense of danger is contagious.  The compassionate person becomes dysregulated, too. This makes total sense through the lens of evolution. If someone around you is in danger, you can be in danger, too.

 

An empathic witness learns how to bring a dysregulated nervous system back into the zone of safety. This makes it easier for the person with OCD to catch your calm rather than you catching their chaos.

 

I could learn to resist the urge to board my son’s bus.

 

As an empathic witness, I would be there for me son no matter what was happening on his own bus. Whether or not the found a therapist. Whether or not he did his ERP homework. Whether he was having a great day or he was struggling.

 

He managed his own bus, and I managed mine.

 

Once I learned how to understand and manage my human brain, understand my parts and  and heal my own nervous system, I transformed my life, Then something crazy happened. My son now had a safe place to do his own OCD work.

 

And here’s the irony. To evolve into an empathic witness, you are doing the same work someone learning to manage OCD does. It’s a meta skill!

 

Think about what ERP is.

 

The person with OCD is willing to witness their thoughts that creates the anxiety that they're willing to lean into. Through repetition the brain learns that anxiety is not dangerous. The trigger is not dangerous. 

 

So, the single message I have for you is this: the best way for you to help a loved one manage OCD is to manage yourself.

 

You will have an urge to hop on the other person’s bus and make helpful suggestions. Resist the urge. It simply doesn’t work.

 

Instead, make peace with the reality that each person manages their own bus. People do the best job they can with the skills and tools that are available to them in the moment.

 

Focussing on my bus and trusting that my son was managing his bus to the best of his ability is the single thing that made the biggest difference in my family.

 

My one suggestions for you Show up as the empathic witness. Be there. Be able to say, :”I see your pain,” without making an effort to fix things. Be willing to feel your own pain. Learn to keep calm.

 

 

The best way for you to help a loved one manage OCD is to manage your own bus.

 

 

Here’s what managing your own bus means.

 

Get clarity about your own destination. For me it was doing everything in my power to free my son from OCD in the most effective way.

 

Set the rules for your bus. Did your school bus have a sign, “no spitting or hitting”? What are your bus rules?

 

For me it was “Replace judgement with compassion” It was, “People with OCD are not broken; they are having their version of a human experience. “

 

Write a job description for the bus driver. For me int includes taking responsibility for the things I can control—like the way I showed up and what I say and do—and letting go of the things I cannot control—like how my son is managing his OCD.

 

It means seeing the best parts of my son, even when he forgets.  I remind myself that OCD is just ONE passenger on his bus. I want to give my attention and support to the other parts of him I celebrate.

 

It means aligning my actions to unleash the amazing potential of both the brain and the body to heal.

 

It means reminding myself that I have gotten through every single challenge I have faced, whether it’s overwhelm or burnout or even trauma.  Whatever OCD dishes up, we’ll find the resources to manage it.

 

Invest in new skills and tools to show up as an empathic witness— to both your loved one learning to manage OCD and to yourself

.

 

Learn to witness and choose your thoughts.

 

Learn to lean into any feeling you have instead of avoiding or numbing them.

 

Learn to resist urges and change habits.

 

Learn to be the change you want to see in your loved one with OCD.

 

 

That’s a summary of my decade of OCD lessons. I call it the OCD Freedom Formula.

 

Once I cracked the code, my life transformed.

 

I’ve shared elements with others and their lives were transformed too.

 

This doesn’t happen by magic. It happens when you follow a recipe and a formula. It takes practice and real work!

 

For the first time, I will be offering the complete OCD Freedom Formula Bootcamp.

 

If you enroll, here’s what you get in the 28 day program:

 

Access to online video tutorial will deliver sound biologically based knowledge about how the human brain and nervous system work, what it means to have a neurodivergent brain and specifically what it mean to have OCD.

 

Second, you will be walked through exercises to understand yourself better. I will share the simple self-coaching tool I use every day.

 

I will also share exercises that help you regulate your nervous system,

 

You will get ideas about how to connect with others and reboot your relationship with your loved one managing OCD.

 

You will have access to a safe community to share your stories and insights and struggles. The community can serve as your empathic witness.

 

Last you will be invited to participate in four live coaching calls with me.  You can bring any question you wish, and I’ll help you understand what’s happening in your brain.

 

This is the first time I’m offering the OCD Freedom Formula Bootcamp. While my hope is that participants will have a perfect experience, I’ve delivered online courses long enough to know better. The first time is often like a dress rehearsal. Things get tweaked. There might be a typo in the worksheets. Sometimes the content gets reordered or edited.

 

My plan is to collaborate the participants who go through the inaugural Bootcamp so that I can add those final touches.

 

For that reason, I’m offering a promotional tuition for the Bootcamp that will be a fraction of  the investment I’ll ask future participants to make.

 

Please follow the link in the show notes to learn more about the Bootcamp, and decide whether it’s a good fit for you.

 

Thank you again for your listening ear and your commitment to yourself and to the people you love.

 

And if no one has told you yet today, I admire your courage. Managing OCD may be the hardest job I’ve taken on. Whether you’re an OCD Warrior or and OCD Champion, you’re not alone. There’s hope for a better tomorrow. You got this!

 

Follow the link below to learn more about the OCD Freedom Formula Bootcamp. I hope to see you there!

Click here to learn more about the OCD Freedom Formula Bootcamp that kicks off May 7, 2024. 

 

The Connection Prescription is part of the agenda.