The worst and best things to say to someone with OCD

It takes average From 14 to 17 years People are diagnosed with obsessive-compulsive disorder (OCD) after symptoms appear. One reason so many “suffer in silence” is the shame that clouds their days, says Alexandra McNulty, a psychotherapist in Baltimore who specializes in the condition.

“The challenge is that OCD is often filled with very distressing thoughts that conflict with a person’s values ​​and morals,” she says. This may mean recurring thoughts about harming themselves by jumping in front of traffic, committing a violent act such as murder, or engaging in illicit sexual acts. “Because of this shame, people often don’t feel comfortable explaining to people, including their providers, what they’re experiencing.”

When they do open up—and finally share their inner dialogue with loved ones—it’s not unusual for them to be bombarded with well-intentioned but harmful comments that only fuel the embarrassment they feel about the thoughts, images, and urges running through their brains. This can exacerbate the cycle of obsessions and compulsions, which is why, if you’re on the receiving end, it’s very important to think about how you respond. We asked experts to share the worst things to say to someone with OCD, and which words are really helpful.

“Don’t worry, everything will be fine.”

If someone you love is struggling with disturbing thoughts, it’s natural to want to reassure them. But this is the worst thing you can do. Telling them everything will be okay “may provide temporary relief, but the problem is that the only thing that’s really certain in this world is that there will always be uncertainty,” says Alyssa Giroud, a clinical assistant professor of psychiatry at the University of Pennsylvania. “When someone offers that certainty, it might work for a moment, but then the brain will come back and say, ‘Wait, what if they’re wrong?’ Or ‘What if it’s okay this time, but next time it’s not?’

This leads to a yo-yo effect: your loved one will feel anxious, then relieved, then anxious and desperate for reassurance again. It’s a vicious cycle that you must resist feeding into.

Instead say, “I know this is hard for you, and I know you can do hard things.”

Jerrod’s clients often tell her that resisting OCD demands is painful, difficult, and anxiety-inducing. That’s why it’s important to remind your loved ones that they are capable of doing difficult things, and celebrate their efforts. “Living with OCD is hard, and it can be helpful to acknowledge that and know that others believe in you,” she says.

“Do you have thoughts like that? That’s disgusting.”

People with OCD can have debilitating intrusive thoughts that seem forbidden, such as sexual violence or harming themselves or others. This is not a reflection of their true selves. If someone you love tells you what they’re going through, don’t respond with shock or horror. “The worst thing you can do is reinforce the shame, guilt, and disgust they already feel,” Hardis says.

Instead say: “Our brain comes up with a lot of ideas.”

It’s best to respond in a way that makes it okay to have strange and sometimes distressing thoughts. Hardis recommends using a neutral tone. If your child has just told you about an upsetting thought he’s having, for example, explain that the brain distributes thousands of thoughts every day, and that they don’t mean anything. She suggests adding: “I can appreciate how scary this feels for you.”

“I have OCD too!”

OCD – like any other mental health condition – should never be used as an adjective. However, people have latched on to the term as a way to express that they are too organized or concerned about germs. On the other hand, some people shout that they… He wishes They were obsessive-compulsive, because they could be more masterful.

Read more: Stop saying these five things to people with social anxiety

“It ignores the enormous suffering that someone might be experiencing,” says Joanna Hardis, a therapist in Cleveland Heights, Ohio, who specializes in treating obsessive-compulsive disorder and anxiety disorders. “You may see someone washing their hands, but what you don’t see are the cruel and intrusive thoughts that may be driving it. You have absolutely no idea how torturous the thought behind this behavior is.”

Instead say: “If you would like me to help you find a therapist who offers highly effective, evidence-based treatment for OCD, I would be happy to do so.”

“This is quite possibly the most helpful thing you can say to someone with OCD,” says Giroud. Exposure and response prevention (ERP) therapy is a treatment Gold standard processing for OCD, but it’s not always easy to find a provider (especially one that’s available and affordable). Offering to do some legwork to track down the doctor can go a long way.

“Sometimes, people don’t realize they have OCD. They just think this is the way they do things. This is the way they live in the world,” Girod says. “Letting them know that you’re happy to look into it for them if it helps, suggests that there may be an alternative path — maybe they don’t always have to struggle that way.” She adds that this can provide a much-needed sense of hope.

“You’re overreacting.”

Telling someone there’s no reason to worry is “incredibly dismissive,” McNulty says. She likens it to saying, “I don’t see any problems, so your reaction doesn’t make any sense.”

“People with OCD have a horror movie of worst-case scenarios running through their minds all the time,” she says. “Their mind cannot distinguish between what is happening and what is happening He could It is happening. To say they are overreacting, well, no, their feelings and anxiety are actually justified given the story their mind is telling them.

Instead say: “Your anxiety is real, but the story your mind is telling you may not be. You can trust what your senses are telling you.”

McNulty sometimes explains OCD as follows: Suppose you dreamed that your husband was cheating on you, and when you woke up, you were angry with him, even though you knew your feelings were not based in reality. “The feelings are real, but the story is not real,” she says. “This is what people with OCD experience while they are awake.”

Read more: The worst thing you can say to someone with depression

Of course, being able to talk to someone with OCD about the way their brain works requires an accurate understanding of what they’re going through. That’s why she recommends attending a therapy session with your loved one, so you can learn all about OCD and how to support the person you care about. There are also lots of support groups that family members can join, which can provide valuable tips on communication.

“If I do that again, there will be no screens for a week!”

Punitive statements are rarely, if ever, appropriate, and this includes when you are talking to someone with OCD. “Would you punish a child with diabetes because their blood sugar is low?” Jerrod asks. “We don’t know exactly what causes OCD, but there are definitely biological components. Why would we punish someone when that’s how their brain is wired to work?”

Instead say: “That was really brave of you. Well done!”

People with OCD tend to give themselves a hard time. When they get stuck in an obsession, they reach a critical choice point, Giraud says: They can either give in to their desires, or try to reduce their anxiety in some way, which seems risky and difficult. “Every time they do it, they get a little stronger, and their OCD gets a little weaker,” she says. “When we leverage those small wins, it can help empower them to keep going.”

“Just stop.”

If your loved one has to tap their body four times in a row before moving on to a new task, or insists on rewriting an email until it’s okay, you might be tempted to tell them to stop. They can control their behavior, right? Not exactly. “OCD is not about a lack of willpower,” says McNulty. “In fact, it takes a lot of willpower – my clients often end up failing in life so that they can do the things they enjoy despite their obsessions and compulsions.”

Instead say: “I realize this is difficult right now. How can I, as your support person, help you at this moment?”

The same techniques won’t help everyone with OCD quiet their minds, but basic practices that focus on engaging your senses in the present moment are often valuable. You can offer to go for a walk with your loved one, for example, or listen to your favorite album together. If you’re not sure what might be most helpful, McNulty suggests asking: “What can we do right now to help get you out of these really scary stories your mind is telling you?”

Read more: What it really means to have intrusive thoughts

It’s also a good idea to spend some time educating yourself about what OCD feels like, and asking your loved ones questions about their experience. Instead of making assumptions, be curious: “What is your mind telling you right now?” “If you don’t understand, ask,” she says. “Give someone space to share their life experience, and listen to them in a non-judgmental way.”