When OCD controls family life: a day with the Jensen family
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OCD affects not only the person experiencing the symptoms. The family’s routines can gradually change as everyone tries to ease distress, avoid conflict and keep everyday life running. This change rarely results from one major decision. Instead, it develops through small adjustments that each make sense on their own.
A day with the Jensen family shows how care and necessary adjustments can develop into family accommodation, with consequences for the person with OCD, their parents and a sibling.
The family and their situation
The Jensen family consists of Lone and Lars and their children, Mille and Magnus. They live in a detached house on the outskirts of Odense. Both parents are schoolteachers and used to be very involved in their local community.
Mille is the eldest child and has just returned home from boarding school. Magnus is 14 and attends the local independent school. He has had a pronounced fear of dirt and germs for some time and has recently been diagnosed with OCD. His fear leads to lengthy rituals and many rules at home.
A day from 6 am to 8 pm
6.00 am: The family is up. Mille needs to catch the bus to upper secondary school at 7 am, but the bathroom door is locked. Magnus is in the shower, and Mille knows that his showers usually last an hour. She asks her parents to get him to finish. Lars replies that putting pressure on Magnus does not help because it makes him very angry. Mille washes her face at the kitchen sink and goes to her room, where she has moved her make-up. Lone and Lars do not want to move their own things out of the bathroom. Instead, they get up at 5.30 am so they can finish before Magnus needs to shower.
7.00 am: Mille and Lars have left the house. Magnus comes out of the bathroom and asks Lone whether he is clean enough and whether there could still be germs on his body. “I’m sure there aren’t,” she replies. Magnus asks Lone to wash her hands thoroughly before serving breakfast and to wipe down every surface while he eats. She does as he asks.
8.00 am: Lone is waiting in the car. Magnus is due at school at 8.15 am but does not come out for another fifteen minutes. He is convinced that there are germs on his hands. Lone reassures him that he is clean and drives him to school. She has arranged with her headteacher to start work later for a while.
4.00 pm: The family is home again. It is Friday, and Mille wants a friend to stay overnight. Magnus objects because he is afraid of contamination. Lone and Lars persuade Mille to stay at her friend’s house instead. It has been several months since the family last had visitors.
6.00 pm: The family is sitting at the dining table. Before they eat, Magnus demands that everyone reassure him that they have washed their hands thoroughly. They say that they have, although they know they have not washed them in the way Magnus wants.
8.00 pm: Mille is at her friend’s house. Lone has been up since 5.30 am and is exhausted, so she goes to bed early. Lars and Magnus watch a film together.
When adjustments come to shape everyday family life
No one in the family decided that OCD should control their mornings, working hours or opportunities to have visitors. The changes arose one by one. The parents have tried to protect Magnus from intense distress, avoid conflict and still make mornings, school and work fit together.
Each adjustment may seem modest. Taken together, however, they have organised the family’s daily routine around Magnus’s OCD. Family accommodation can therefore be difficult to recognise: the help begins as a solution to a specific situation but, over time, can become a condition on which everyday life depends.
Direct family accommodation
Direct family accommodation is most apparent when Lone reassures Magnus that he is clean and when the whole family reassures him at the dining table that they have washed their hands thoroughly. Their responses ease his distress in the moment. When the doubt returns, the family is asked to reassure him again that he is clean.
Lone also participates directly by washing her own hands especially thoroughly and wiping down surfaces to comply with OCD’s demands. Her actions stem from care and a wish to help Magnus through the morning. At the same time, they become part of a system that keeps his doubt and distress at bay.
His parents did not cause the OCD or consciously choose to reinforce it. They have gradually been drawn into the effort to create certainty.
Indirect adjustments
Family accommodation also takes place through changes to the circumstances surrounding the person with OCD.
The parents get up earlier, Mille has moved her things, Lone starts work later and the family no longer has visitors. The adjustments make conflict less likely in the moment but leave the rest of the family with progressively less space.
Some adjustments may be necessary for a time. If everything changes at once, the family may lose the calm and capacity needed to work with the OCD. Holding the level of help steady can therefore provide a temporary anchor, even though the help remains family accommodation. The amount of help must not quietly increase while the next changes are prepared as part of treatment.
What happens to Mille?
Mille has adapted her room, her morning routine and her social life to her brother’s OCD. She cannot use the bathroom when she needs it, and when she wants a friend to visit, the solution is for Mille herself to leave home.
Her parents are trying to spare both children an intense conflict. Instead, much of the strain is transferred to Mille. She also risks being treated as though she is not considerate enough when she objects to circumstances that genuinely restrict her life.
Siblings need an explanation appropriate to their age. They need to know that they did not cause the OCD and that it is not their responsibility to create calm, take part in rituals or give up more and more of their own lives.
What happens to the parents?
Lone and Lars are trying to manage their work, protect Magnus, take Mille’s needs into account and keep the household running. They get up earlier, change their working hours and have withdrawn from their local community. Lone goes to bed early, while Lars stays with Magnus for the rest of the evening.
Even between the visible conflicts, the parents remain on alert for the next question, the next delay or the next demand. This constant vigilance can affect sleep, concentration, work and their relationship.
The parents’ own needs cannot be postponed indefinitely. They need breaks, relationships and opportunities to share the responsibility, even while Magnus continues to have significant symptoms.
Why can’t the help simply be withdrawn?
The family knows from experience that Magnus becomes very angry and distressed when they try to change something. Such reactions can last a long time and make both his parents and his sister afraid of the next conflict. Out of love, they naturally try to prevent him from becoming so distressed again.
For Magnus, a sudden end to the help may feel like another unpredictable and threatening change. Change needs to be introduced through small, agreed and predictable steps that Magnus and his family can prepare for. Difficult reactions may still occur. A plan made in advance makes it easier for the family to keep to the agreement.
For some families, the first small step needs to remain in place for longer while help in other areas remains unchanged. The pace depends on the intensity of the symptoms, the strain on the family and the framework of treatment.
The plan is developed together with the person with OCD. If the person is in treatment, the therapist is involved. Magnus and the rest of the family need to be on the same side against OCD. Otherwise, the parents’ boundaries can easily be experienced as opposition to him rather than as a shared stand against the pattern that restricts the whole family.
The family has not ended up here because anyone did too little. Every adjustment solved a specific problem. The help therefore cannot be brought to an end with a single decisive no. It must be changed through small, shared and predictable steps.
More support and information for family and friends
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