Supporting families with OCD is an important part of a loved ones OCD recovery. Family Accommodation is the term used to describe a relationship between the OCD sufferer and their loved ones that help soothe the pains, fears, and intrusions of OCD. Family accommodation often looks like being nice and gentle but also, a lot of family accommodation is responding to OCD’s demands directly or diverting the therapeutic focus. Because we have started this IOP in support of your loved one’s recovery from OCD. We wanted to prepare you for the changes they need from you as well.
When someone you care about has Obsessive-Compulsive Disorder (OCD), it’s natural to want to help them feel better, especially when they’re experiencing distress. Often, this leads family members to engage in “family accommodation,” which includes actions like reassuring the person repeatedly, participating in their rituals, or modifying daily routines to prevent their anxiety. While these actions come from a place of love and compassion, they can inadvertently reinforce OCD symptoms, making it harder for your loved one to manage their condition in the long term.
What is Family Accommodation?
Family accommodation happens when family members alter their behavior to reduce the person’s anxiety or prevent OCD-related distress. Examples include:
- Participating in rituals: Helping with or engaging in compulsive behaviors at the request of the person with OCD.
- Providing reassurance: Constantly assuring them that everything is “okay” or that their fear is unfounded.
- Avoiding certain situations: Changing routines to avoid triggering their anxiety.
- Making special arrangements: Allowing OCD-related demands to dictate family activities or schedules.
Why Reducing Accommodation is Important
While accommodation may provide temporary relief, it ultimately reinforces the OCD cycle by validating the person’s fears and avoiding opportunities for them to confront and manage their anxiety. Recovery-focused support means learning how to balance compassion with boundaries that encourage independence and resilience. Reducing accommodation can help your loved one:
- Build confidence in their ability to tolerate distress.
- Engage more fully in Exposure and Response Prevention (ERP), a key therapy for OCD that involves gradually facing fears and reducing reliance on compulsions.
- Values Oriented in their chosen believe system in life. Sometimes the way we get to those may not be a “traditional” route. This helps the person have the will to face the fears and intrusions.
Our Clinical Program Director Lori Johnson speaking on Family Support and Boundaries with OCD
Does answering this question or taking this action prevent them from feeling anxious or distressed?
If yes, it might be accommodation as it reinforces the avoidance of anxiety.
Is this something they’ve asked before, or are they seeking reassurance about the same topic repeatedly?
Repetitive questions for reassurance often indicate accommodation rather than a genuine need for new information.
Would not answering this question or not engaging in this action lead them to feel uncomfortable or try to avoid the situation?
If yes, it may be a compulsion being accommodated, rather than a genuine question.
Does this request interrupt their treatment goals, such as exposure or resisting compulsions?
If it interferes with treatment, it is likely an accommodation rather than a necessary question.
Am I trying to control the way they feel?
Often family wants a person to be who and how they were before this hit their family. Be mindful to try and not make them be or present in a certain way. Its similar to wanting the weather to be different than the season presents in the moment or geographic region.
How Families Can Support Recovery
Learn About ERP: Understanding the principles of ERP will help you support your loved one’s progress. ERP involves exposing the person to anxiety-provoking situations without engaging in compulsions. By understanding this process, you can better support them in facing fears rather than avoiding them.
Set Boundaries on Accommodation: Work with your loved one’s therapist to gradually reduce accommodations. For example, if they ask for reassurance, practice responding with supportive phrases like, “I believe in your ability to handle this,” instead of directly answering the question. Setting small boundaries can help reduce dependence on compulsions.
Encourage Self-Help Strategies: Gently encourage your loved one to use coping strategies they learn in treatment. Support them in practicing distress tolerance skills rather than participating in compulsions.
Acknowledge Progress: OCD recovery takes time, and every small step forward is an accomplishment. Recognize and celebrate their efforts and courage in facing fears.
A wonderful book of navigating life with OCD to help families understand the nuances of how reassurances sneaks it was into families, relationships and households right under your nose.
Lori Johnson, M.A., LPC-S, LAC, ACS is the Founder and Clinical Director of IFC. she is passionate about increasing awareness for the diagnosis of OCD, especially for those who struggle with co-occuring addiction. She is a clinical supervisor and trainer, speaker and advocate on the topics of Substance Use Disorder, Addiction, and OCD at the IOCDF Conference and Denver treatment centers. Featured on Podcasts, The OCD Stories, Chrissie Hodges Pure OCD Author’s podcast, and is proud to be part of the OCD Gamechangers.