Why Reassurance Makes OCD Worse (And What Actually Helps)
When someone you love is struggling with OCD, it's natural to want to help. So you answer their questions. You tell them everything is going to be okay. It feels like the kind thing to do. But here's the problem — reassurance actually makes OCD worse. Not because you did anything wrong. Because that's just how OCD works. In this post, I'll explain why reassurance backfires and what actually helps instead.
What is OCD?
Obsessive-Compulsive Disorder (OCD) is a mental health disorder that includes intrusive/obsessive thoughts followed by the strong desire to engage in a compulsive behavior(s) or mental ritual(s) meant to neutralize/take away the anxiety. The type of fears rooted in OCD symptoms can vary widely. For example, some people with OCD worry about being contaminated by germs. Others have a fear of harming themselves or others. Yet others worry constantly about making a mistake, or even a fear of appearing foolish in front of others. These all show up differently, but they are all OCD.
A common theme of all these different versions of OCD? The symptoms (the worrying, the checking, etc) tend to be very time consuming. In fact, they are usually taking up at least one hour of time a day. This is time spent being bombarded by unwanted thoughts, followed by time spent trying to stop these thoughts, to lower the anxiety/distress level.
Why do People with OCD Seek Reassurance so Often?
Reassurance seeking is considered a compulsive behavior or mental ritual. Reassurance seeking can include both giving yourself reassurance, or getting reassurance from others.
Self-reassurance might sound like, “I’m going to be okay;” “I won’t get sick.” Getting reassurance from others might sound like, “Are you okay?” “Did I do the right thing?” “Is something bad going to happen?”
Reassurance seeking might reduce anxiety/distress for a short while, but because compulsive behaviors and mental rituals only work for a short time, if at all, persons with OCD have to repeat the compulsive behaviors or mental rituals again and again, to try to reduce the anxiety.
What Should You Say Instead of Giving Reassurance to Someone with OCD?
In order to help not feed into someone’s OCD symptoms, it can be helpful to not engage in giving reassurance when someone asks. But you might be wondering, what to say instead? It is okay to validate the person’s anxiety/distress, but not okay to engage in their fear. For instance, “I can see this is making you very anxious, but I’m not going to answer that question.” Even helping the person lean into the uncertainty or lean into the fear, and then sitting with them while the anxiety/distress goes down. For instance, “That (fear) might happen; I believe you can sit with this uncertainty.”
What is the Difference Between Support and Reassurance?
Support fosters encouragement in the fight against OCD whereas giving reassurance feeds into the OCD cycle. Providing words of encouragement or even a physical presence as the person sits with the anxiety/distress is considered support, but providing reassurance/answers/comfort about the fear, would be considered giving reassurance.
Think of it this way: support says "I'm here with you." Reassurance says "here's the answer to make the fear go away." One builds strength. The other keeps the cycle going.
How Does ERP Therapy Break the Reassurance Cycle?
Exposure and Response/Ritual Prevention (ERP) Therapy is considered the Gold Standard treatment for OCD. ERP incorporates education about OCD. It also involves engaging in In-vivo and Imaginal Exposures. These help people expose themselves to their feared situations and outcomes — in a gradual way — while reducing or stopping compulsive behaviors and mental rituals.
It's hard work. But it works.
Over time, this results in anxiety and distress going down. There is also an eventual reduction in intrusive thoughts and urges to engage in compulsions. ERP can also help build tolerance to uncertainty.
Since reassurance is a form of compulsion, it keeps the OCD cycle going. By not engaging in reassurance seeking, the person is able to break that connection. They learn that they don't need reassurance to get relief — and that they can handle the uncertainty on their own.
Begin OCD Treatment in Missouri
You don't have to keep living in the OCD cycle. Help is available.
At Aspire Counseling, we have multiple therapists trained in ERP — the gold standard treatment for OCD. Katherine works with clients in person in Columbia, MO and online across Missouri. Both of our office locations now have ERP-trained therapists available for in-person and online appointments.
Not sure which ERP therapist would be the best fit? That's okay. Our client care team can help with that. You can schedule a free call to talk through what you're looking for. They'll match you with the right therapist based on your needs, location, and schedule.
You've spent a long time trying to make the anxiety go away. ERP can help you learn to face it — and find out you can handle it. Reach out today to get started.
About the Author
Katherine Ottofy, MSW, LCSW is a Licensed Clinical Social Worker with over 15 years of experience supporting clients in Columbia, MO. She specializes in OCD treatment, and uses evidence-based treatment like Exposure and Response/Ritual Prevention Therapy to help clients with OCD.
At Aspire Counseling, she is committed to providing compassionate, expert care both in-person and through secure online therapy for clients across Missouri.
