30 practical recommendations for parents and others close to someone with OCD

Do not let frustration and worry take over everything. Keep making room for other parts of your life. Wearing yourself down does not help the person with OCD. The usual advice about getting enough sleep, eating regularly and being physically active applies to you too.

Looking after yourself allows you to cope with the strain over time.

It is important to have at least one trusted person outside the family whom you can talk to about what is difficult. You should not have to carry the whole burden alone or accept a demand that you tell nobody how OCD affects you.

You can protect the privacy of the person with OCD while still talking about your own strain. That support may matter more than you realise.

The most helpful thing is often to stay present and offer calm support without accommodating OCD. Keep your voice calm, offer company and give a hug if it is wanted. See the person, not just the OCD.

One of the most common frustrations expressed by people with OCD is that everything starts to revolve around OCD and they are no longer seen as the people they are. A person can experience happiness while living with OCD. Ordinary life still needs room.

Making room for the whole person matters both to your relationship and to treatment.

Talking about OCD as though it were a person can help you see it as the shared problem, rather than seeing each other as the problem. OCD creates the difficulties—not the person who has it. You can be angry with OCD together when it invents new demands or claims that the person with OCD is a bad person.

Many of my clients give OCD a name, such as Bob or Gertrude. We imagine a very irritating and insistent older woman with a small handbag whom we do not want to invite into our home. She thinks she is helping, but once you start debating with her, she never stops arguing.

The point is not to argue with OCD. It is to recognise it and stand together against its demands.

The visible part of OCD is only a small part of the burden the person is carrying. The mental strain can be substantial. I often compare it with having an additional full-time job alongside everything else in life. Something that looks simple from the outside may have required a great deal of effort before, during and after the situation.

The iceberg metaphor applies not only when things are difficult, but also when they begin to improve. Much of the progress may be invisible to family members. A person with OCD may win many internal battles before those changes can be seen from the outside.

Those unseen successes deserve recognition too. They are an important part of recovery.

When the person with OCD is in treatment, do not hold them to account for what was discussed, demand a summary or constantly check whether progress is being made. Treatment works on several levels at once. A great deal can happen beneath the surface before the results become visible.

Demanding an explanation of what was gained from a session can oversimplify the work and leave the person more confused. A session cannot be fully reconstructed afterwards.

When OCD suddenly becomes more prominent again, it can feel as though all the work has been lost. It has not. The person is not back at the beginning, even if it feels that way.

Look at the course of treatment as a whole. What has the person learnt? What can they do now that was not possible before? Even when experience and skills are temporarily harder to use, they have not disappeared.

Be careful not to respond with panic, disappointment or demands to get back on track. Pressure from family members can obstruct treatment. Instead, help the person notice what has given OCD more room and calmly return to the agreed strategies.

Change takes time. You do not start again from nothing. You carry on with more experience behind you.

When someone with OCD is unsure about starting treatment, you may hear a series of reasons to postpone it: they need to wait a little longer, do more research or keep trying on their own. When OCD temporarily becomes less intense, treatment is postponed again. Years can pass before the person receives the right help.

It is painful to watch someone you care about suffer while seeing them turn down help. Repeated arguments, links and ultimatums can, however, turn treatment into a battle between you.

Say clearly what you are seeing and why it concerns you. Offer practical help with exploring options, making the first contact or going with them to an appointment. Do not begin a process without involving the person.

Keep the door open without turning every conversation into another attempt at persuasion. Declining treatment does not mean that you must continue to provide reassurance or accommodate OCD. You may set limits on what you will take part in.

Motivation cannot be forced. You can be clear, available and predictable while the person works towards a decision.

You and the person with OCD may be going through a period when OCD seems to take up all the space. Even when the situation feels stuck, it can change. Treatment can help OCD take up less space and create more freedom.

The work is not only about reducing how much space OCD occupies. The person also learns to recognise patterns, manage overthinking and respond differently when anxiety and OCD exert pressure. These are skills that can remain useful long after treatment.

OCD can become deeply entrenched, but it is not immovable. It is worth challenging.

You may sometimes feel ashamed of how OCD affects the person’s behaviour. You are allowed to acknowledge that feeling. OCD is profoundly illogical, and the behaviour can at times appear unusual. The feeling can be a reminder to separate the person from OCD and to expect more tolerance from the people around us. Not everything has to fit social expectations.

If shame begins to take up too much space, talk to someone in your network or to a professional.

Remember that OCD exists on a continuum with ordinary human experience. If we included the mildest symptoms, around 80% of the population would appear to have OCD. The clinically important difference is the extent to which the thoughts and actions cause distress, strain and restriction.

Nobody chooses to have OCD. The behaviour is an attempt to solve a problem that feels real or highly significant to the person. If we shared the same belief and felt the same pressure, we too would feel driven to respond.

The idea that OCD stemmed from problems in childhood or within the family has long since been abandoned. OCD does not have a single cause, and neither its cause nor its solution has to be found in one particular event in the past. There is therefore no reason to believe that you caused the OCD.

The capacity for OCD is part of human thinking. I meet many sensitive, thoughtful and intelligent people with OCD—people who are very good at solving many kinds of problems, yet become caught in the problems created by OCD. They may be engineers, doctors or others with a strong capacity for reflection.

Sometimes a traumatic event, divorce, bereavement or another major experience occurs around the time OCD begins or intensifies. It might equally coincide with becoming a teenager, leaving home, beginning a relationship, becoming pregnant or many other transitions. At other times, anxiety and OCD are triggered during a summer holiday or by an unfortunate combination of circumstances, thoughts and feelings.

What OCD focuses on may be arbitrary, but it will nevertheless feel significant to the person experiencing it.

You are already doing what you can, and you are doing it well. You can support and encourage, but you cannot do the work on behalf of the person with OCD. That is a hard truth.

If only you could make OCD disappear with a wave of a wand. If only you could carry the burden yourself. But you cannot. Motivation for change is central to treatment.

You are responsible for your own boundaries, agreements and actions. You are not responsible for making OCD disappear.

Be careful not to treat your own habits and values as the definition of normal. The person with OCD has their own values and preferences.

They may be introverted while you are extroverted. There may also be generational differences that parents find difficult to appreciate.

For example, a mother may use the same dishcloth all day while her daughter with contamination OCD wants it changed more often. The mother’s habit can easily become the definition of normal. The daughter’s preference may be dismissed automatically as OCD, which makes it difficult for her to be heard.

Having OCD does not mean that every judgement or preference can be dismissed as part of the disorder. Existing family habits should not automatically define what is normal either.

Everyone has the right to be themselves without being made to feel wrong.

Many people with OCD seek reassurance from those close to them that something did not happen or is not true. This is not simply an ordinary conversation. A great deal feels at stake.

Every hesitation, facial expression and change in tone can be interpreted. It can feel like being put through a lie-detector test in which you are expected to be infallible—an almost impossible standard to meet every time. Even pausing briefly to think may create new doubt.

Reassurance-seeking needs to be reduced gradually, thoughtfully and by agreement.

The same applies to Google searches and questions put to AI chatbots. If they are being used to confirm that something did not happen or is not true, they function as reassurance-seeking even when they look like information-seeking.

An OCD question often contains both a feeling and a task. The feeling may be anxiety, helplessness or exhaustion. The task is for you to provide the answer that is supposed to make the doubt disappear.

You can respond to the feeling without accepting the task. You might say: “I can hear that you are frightened. I want to stay with you, but I cannot remove the doubt for you.”

Leaving the question unanswered is not the same as withdrawing from the person. You stay with them while the doubt remains unresolved.

You can show care without solving OCD.

OCD may demand that a question is answered, something is checked or a situation is resolved immediately. You may be phoned, woken, asked to investigate something or pressured to change plans because OCD refuses to wait.

Look at what you are being asked to do. Are you being asked to provide certainty, check something, investigate a doubt or change the family’s plans? Do not let the sense of urgency determine your response.

You can say: “I am not going to answer that” or “We are not changing the plan because of OCD.” You do not need to convince the person first that the situation can wait.

Be careful not to promise reassurance later either. That simply postpones the solution OCD has proposed.

OCD often demands an answer now. You do not have to follow its timetable.

Keep having positive experiences as a family, whether or not the person with OCD takes part. Many people with OCD tell me that one of the hardest things is watching their family restrict their own lives and then feeling guilty about it.

OCD is already very effective at creating guilt. If the family also restricts itself, that becomes a genuine consequence that the person may feel responsible for.

The family’s ordinary life needs to continue so that the person with OCD has something outside OCD to reconnect with and can become motivated to join in again.

When OCD is severe, families may take over tasks, cancel plans and remove every expectation. Some temporary adjustments may be necessary. The person with OCD still needs to be seen as someone who can contribute and take part.

Agree on something small and specific that they will continue to do. It might be a practical task, sharing a meal or taking part in something you have planned.

On difficult days, the expectation can be adjusted. It does not automatically have to be abandoned.

An expectation should express trust, not a demand to prove that the person has improved.

The most helpful thing you can do in an anxious situation is stay calm rather than panic. Take the anxiety seriously without taking over the task set by OCD.

Trying to make the anxiety disappear by solving OCD’s problem may produce short-term relief—a highly sought-after state that the person’s learning system can learn to pursue again. It may feel as though the solution worked, while also drawing the person further into the OCD pattern.

During intense anxiety, you can help the person regulate their breathing and gently shift attention away from what feels frightening and towards something else. This should be done gradually and with respect for how serious the situation feels.

However, many OCD situations are not episodes of acute anxiety. Instead, the person may fear that the situation will become unmanageable and trigger anxiety. It can help to name what is happening together: this is OCD. Recognising it as OCD opens up options that are not available if the situation is treated as dangerous.

Motivation matters when a person is trying to go against OCD. Immediate pleasures and benefits often offer stronger motivation because the person can feel their value directly.

Be cautious about focusing on a future that may currently feel unrealistic.

Together, identify the most immediate realistic benefit that OCD is obstructing and make it a goal. When it happens, celebrate it for the significant success it is. Give plenty of high-fives.

Families are often drawn into preventing a future situation that OCD presents as impossible to manage because of all its complications. Gradually, more and more paths may seem to lead to that feared situation. The result is increasing restriction and accommodation.

Ideally, accommodation should be limited to situations that are genuinely difficult. It should not be used to block every path that OCD claims might lead there.

Discuss this at a calm time and agree clearly on what help can be given and when. The agreement—not OCD’s immediate pressure—determines what support is provided. Accommodation can then be reduced gradually and as agreed while the person works on responding differently to OCD.

When reducing unhelpful accommodation, first agree together how this will happen. Do not make a sudden decision and pull the rug out from under the person with OCD. That will increase anxiety and weaken their trust in you.

The agreement should set out how accommodating behaviour will be reduced gradually. Include the future steps so that they are known and accepted from the beginning. This gives everyone time to adjust to the idea.

It can also be helpful to include positive experiences in the agreement: a trip to the cinema, a meal out, a favourite cake or something else you can look forward to together and use to mark both small and large successes along the way.

If one family member keeps to an agreement while another gives in, the situation becomes difficult for everyone. OCD will seek the answer or help that provides the greatest immediate relief. When the family’s responses vary, it becomes unclear what the agreement is, and relatives may end up in conflict with each other.

Talk together about how you will respond to reassurance-seeking, requests or demands for help, and changes to family routines. You do not have to respond in exactly the same way, but the overall direction should be shared.

Agreements should be specific and realistic, and the person with OCD should know what they are. They should not be made without involving the person.

If you disagree, discuss it at a calm time rather than in the middle of an OCD situation. It is easier to stick to the agreement when everyone knows what to do and why.

Once family members learn that exposure can be important in OCD treatment, it can be tempting to try things yourself—moving an object, touching or hiding something, provoking a situation or suddenly refusing help that you normally provide. Do not do this.

It is not the family member’s role to invent tests or surprises. If exposure is part of treatment, it should follow a plan that the person with OCD knows and has accepted. Otherwise, the situation may feel coercive or like a breach of trust, and the struggle moves from OCD to you.

You can support agreed exercises if the person wants you to. Agree specifically whether you should remind them, participate, encourage them or stay out of the exercise. Do not make it harder along the way or demand a report afterwards.

You are most helpful when you are predictable. Exposure work belongs to the person with OCD. Your involvement should be agreed.

It is not unusual for a person with OCD to become angry when their rituals or thinking are interrupted. The ritual feels important, and OCD often insists that it is necessary.

This anger can be very difficult to bear. It may seem unreasonable and can at times be harsh, quite unlike the person you know. The anger arises under pressure from OCD, which makes separating the person from OCD particularly challenging.

At the same time, hurtful behaviour should not simply be accepted. Boundaries and agreed ways of responding are needed so that it does not continue. Family members have a right to their place in the family and to an ordinary family life, just as we want for the person with OCD.

You are allowed to feel angry. OCD can make unreasonable demands, repeat the same discussion and change the family’s rules. You may feel trapped, ignored or drawn into something you never agreed to. Anger can be a sign that you have been under pressure for too long or that a boundary has been crossed.

There is a difference between feeling angry and using anger against the person with OCD. Do not try to resolve the issue while you are at your angriest. Say that you need a break and return to the conversation when you are calmer. Avoid threats, ridicule or comments that the person should just pull themselves together. They create shame and conflict but do not help OCD.

Set the boundary specifically. You might say: “I want to be with you, but I am not answering the same question again” or “I will not be spoken to in that way. We can continue later.”

If you react too strongly, take responsibility for how you responded. You can apologise for shouting without withdrawing the boundary: “I should not have shouted, but my answer is still no.”

You do not have to tolerate everything in order to be a good family member or friend. Your feelings and boundaries matter in the family too.

If we imagine OCD as a plant, certain conditions allow it to flourish. Boredom, excessive seriousness, a lack of external structure and too much unstructured time all give OCD room to grow.

Many people experience more OCD at weekends and during holidays, when life slows down and there is more time to relax. It is important that relaxation does not become OCD time, because that is not relaxing at all.

Periods without external demands or daily structure can give OCD many opportunities to thrive. Examples include sick leave, a gap year or a period spent writing a university dissertation. Once OCD has taken up a great deal of space, it can be difficult to push back alone.

A very serious atmosphere can also help OCD thrive. OCD feels deeply serious when it is intense, and gradually everything can turn dark. By contrast, it often has much less room when life includes play, humour and enjoyment.

Be careful not to let everything become serious simply because everything has begun to revolve around OCD. That gives OCD more room, not less.

It is right to respect other people’s space. But if the person with OCD has turned inwards and is giving OCD all their attention, leaving them alone in the name of respect may do more harm than good.

You are allowed to interrupt. Invite the person into something ordinary and concrete. This might be folding clothes, tidying up, going for a walk or playing a game.

The aim is not to pressure the person or demand that OCD disappear. It is to help them reconnect with everyday life, other people and something beyond OCD.

Helping a person with OCD become involved in worthwhile and enjoyable activities is one of the most valuable forms of support you can offer.

Some activities are better than others at interrupting OCD. Many people with OCD are good at thinking on parallel tracks. They can have many OCD thoughts while folding clothes, cooking or watching television. An entire day may therefore pass without any activity demanding enough attention to crowd out OCD, and that can be a problem.

At the clinic, we often call these reset activities: activities that require enough attention to leave no room for OCD thinking at the same time. Playing music, singing, pursuing a demanding hobby or playing computer games can all serve this function.

Knitting and crochet may work particularly well because the level of difficulty can be adjusted. A person can choose a more or less demanding project while still spending time with others.

This is not random distraction. In therapy, reset activities can be used strategically alongside exposure tasks. Support the person in using them even if you do not personally value the activity. They can be used several times during the day and as needed.

By reading this, you are already following this recommendation: learn everything you can about OCD. That means learning about OCD generally and about the particular OCD patterns affecting the person close to you.

The more openly and curiously you explore OCD, the better you both become at recognising it. When the person with OCD begins to observe its patterns, that in itself is a helpful step.

Remember that the mental aspects are at least as important as the visible actions. Do not focus only on what the OCD is about or the arguments it uses. Look at how it works: the patterns it follows and the pressure it applies.

OCD can continue to find new subjects. When one source of doubt becomes less prominent, another may take its place. The new story can feel more real, more serious and more like something that must be investigated this time.

Do not become absorbed only in the content of the story. Look at what it is making the person do. Does it demand answers, checking, analysis, avoidance or repeated reassurance from you?

OCD follows patterns that can be recognised and, over time, anticipated.

OCD changes the story. Its way of working often stays the same.

Remember your role in the relationship. First and foremost, be a parent, partner or friend. Your role does not disappear simply because OCD has entered the relationship as a third party.

You are neither OCD’s assistant nor the person’s clinician. Hold on to your own role. You also need space to be their parent, partner or friend.