family involvement in treatment – katie d’ath ocd presentation-katie-d ath

Supporting your loved one not their OCD

Family Involvement in OCDOCD Action Conference

February 2010

Katie d’Ath

www.katiedath.com

Can I fix it?(Can I be fixed?)

No. But you can help.

The OCD sufferer plays the most important role in their recovery but they need your support, encouragement and understanding

Katie d’Ath Feb 2010

Supporting your loved on not their OCD

• Effects of OCD on family members• Understanding how we often respond to OCD• Finding better ways of responding to OCD• Building resilience: agreeing goals and moving

forward• Shifting the focus from OCD• Questions and Answers


Depression SadnessShame Hurt

AngerGuiltConcern

Anxiety

Resentment

Frustration

Exhaustion Katie d’Ath Feb 2010

How does OCD affect you?

Introducing the OCD snake


QuickTime™ and a decompressor

are needed to see this picture.

CBT: Exposure & Response Prevention

- Deliberate exposures to the feared event or stimuli

- then NOT engaging in the ritual (including reassurance seeking!)This promotes HABITUATION


WHAT WOULD YOU DO IF THERE WAS A SNAKE IN YOUR HOUSE?


Why do we accommodate the OCD?

• Counter-Intuitive: it’s normal to reassure someone or help them when they feel bad

• Quicker: Short term gain (long term pain)• Easier: Short term gain (long term pain)• Less distressing: In the short term


HOW DO WE ACCOMMODATE THE OCD SNAKE?


Accommodation Traps

• REASSURANCE – “everything will be ok”• AVOIDANCE – avoiding doing things for fear of triggering OCD• RITUALS – participating in OCD rituals• ASSISTANCE WITH DECISIONS AND SIMPLE TASKS• MODIFYING WORK, FAMILY OR SOCIAL ROUTINES• ASSUMING LOVED ONES RESPONSIBILITIES• TOLERATING ABNORMAL BEHAVIOURS OR CONDITIONS


Why doesn’t accommodation work?

• Inadvertently sends message it’s okay or necessary to respond to OCD in this way

• Gives OCD respect it doesn’t merit

• By stepping in you are modeling belief that they can’t cope and need to be protected

• Unwittingly Sending the message that they are weak/vulnerable

• ALL OF THESE THINGS HELP MAINTAIN THE OCD


Aims of standing up to the OCD Snake

1.To promote HABITUATION – i.e allow sufferer to feel the fear and not do anything to make it better

2.To encourage RISK TAKING – fighting against the need for certainty

3.To STARVE the OCD Snake of attention


OCD demands:

Overcoming OCD:


Resisting the OCD




Standing up to the OCD Snake


• Manage expectations (change rarely happens overnight, but persistence pays off)

• Reward your loved one for sticking with it

• Alert to OCD’s cunning

• Help by being consistently unaccommodating

• Contract: agree what you’re working on

Obstacles to Standing up to the OCD Snake


How do I know if it’s the OCD or a different concern?

• 99% of anxiety experienced by the sufferer is a result of their OCD.

• Magic question: Ask if they’d feel anxious if you didn’t help them. If yes: it’s an OCD thing and needs to be treated

as suchIf no: suggest experimenting to test this out

You’ll soon learn to play the OCD snake at it’s own game.


RULE OF THUMB

If, in the short term, the actions:

• help the sufferer to feel better • relieve anxiety• provide comfort

WORK TOWARDS NOT DOING ITIt’s food for the OCD Snake!


What can you do when it’s not working?

TROUBLESHOOT - did you negotiate the contractaccording to the rules? If not renegotiate.

DON’T TAKE IT PERSONALLY - it’s not your fault!

DON’T JUDGE - they are trying their best.

ACCEPT - if your loved one is not ready to change youcan’t force them to but you can change how you respond to the OCD’s demands.STICK to the contract even if your loved one is not fulfillingtheir part - it’s not IF you’ll stop feeding the OCD it’s WHEN

WHY DON’T YOU?




More accommodation leads to:

-More severe OCD-Greater level of family dysfunction-More negative attitude towards sufferer

Reduction in accommodation leads to:

-OCD sufferer does better in treatment-More functional family life-Better family relationships

“Life shrinks or expands in accordance with one’s courage”

- Anais Nin

www.katiedath.com

family involvement in treatment – katie d’ath ocd presentation-katie-d ath

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