Q&A: How should I deal with my spouse's obsessive-compulsive disorder?

Question: My spouse is obsessive-compulsive. I’m not using this term informally or unadvisedly. She’s anxious and worried all the time, and her life is dominated by aggravatingly senseless little rituals. She won’t go to bed without checking the front door at least ten times. I earn a good salary, but she’s constantly voicing her fears that we won’t be able to pay our mortgage. It’s starting to drive me crazy! Any thoughts or suggestions?

Answer: 

You’ve taken an important step in the right direction by recognizing that there’s a problem with your spouse’s behaviour and that it needs to be addressed. In many cases the family members of people who suffer with obsessive compulsive disorder simply deny that the condition exists. Others give in and cater to the obsession, allowing it to define their loved one’s personality and shape the entire household’s way of life. Both of these extremes should be avoided.

What is OCD? 

Obsessive compulsive disorder is a disorder of the brain characterized by intrusive, anxiety-producing thoughts which express themselves in repetitive or ritualistic behaviours aimed at reducing the anxiety. When an individual has OCD, it’s as if her mind gets stuck on a certain idea or image. The brain insists that danger is present and that some kind of evasive action is required even when it is obvious that this is not the case. Excessive hand washing is one of the most common and best known examples of obsessive-compulsive behaviour. Your wife’s all-consuming concern with locking the doors is another fairly typical manifestation of the disorder.

The origins of OCD are complex and differ from individual to individual. In some cases they may be regarded as almost purely genetic in nature. In others, it is likely that environmental factors have also played an important role. OCD may arise in children who have been obliged by circumstances to take on a greater degree of responsibility than is appropriate to their age and stage in life.

Develop empathy

It’s crucial to understand that an obsessive-compulsive person sees things differently than the rest of us do. The "filters" through which her brain perceives the world are askew. In an important sense, she inhabits another reality.

You can help break the pattern by questioning that reality and challenging those false perceptions. At every opportunity, do what you can to help your spouse reframe her perceptions and re-evaluate her thoughts. When she’s on her way to check the door for the fifth time, lay a hand on her shoulder and say, "You don’t need to do that again, honey. We already know that the door is locked." Don’t get angry if she contradicts you. Instead, gently hold your ground, but show compassion by empathizing with her emotions: "You may feel as if it’s still unlocked, and I understand that those feelings make you anxious. But there’s really no reason to be afraid." Then prove your point by taking her to the door and trying the handle yourself.

If she comes back again, repeat the process. If you think it’s appropriate, you could try making light of the issue by turning it into a joke; for example, "Don’t tell me – did that door just unlock itself again?" OCD individuals often realize that their fears are unreasonable, even though they find them irresistible. Humour can sometimes provide the objective point of view that’s needed to break the chain.

It's not her identity

It can also help to objectify the obsessive compulsive disorder by separating it from your spouse’s personality. When she says, "Do you think I should go back and check the door?" you can respond, "That’s your OCD talking, not you." If she starts fretting about the mortgage, show her your bank book and say, "You know that those fears aren’t valid. They’re the voices of your ‘condition’ or ‘disorder,’ and you have the power to tell them to go away and leave you alone."

If all else fails, medication can be another option in the treatment of OCD. This approach should be adopted only if you and your wife are agreed that it’s necessary, and only after a thorough psychiatric evaluation. Counselling can also be an effective tool, and should be regarded as a necessary first step toward more intensive drug-based types of therapy. Focus on the Family Canada’s counselling department can provide you with a list of referrals to psychologists in your area who specialize in the treatment of OCD. Our staff would also be more than happy to discuss your spouse’s situation with you over the phone. You can reach one of our registered Christian counsellors Monday through Friday between 8 a.m. and 4 p.m. Pacific time at 1.800.661.9800.

For further information, we recommend that you visit the website of the International OCD Foundation. You may also find it helpful to consult the book Brain Lock: Free Yourself from Obsessive-Compulsive Behavior by Jeffrey M. Schwartz and Beverly Beyette. Both the book and the website are secular in nature, and as a result we can’t guarantee that all of the perspectives they represent are fully compatible with Focus on the Family Canada’s Christian world view. In spite of this, we believe that they contain a great deal of material that may prove useful as you seek to manage your wife’s condition as effectively as possible.