by Molly Schiffer, LCPC

“Discussing in an honest way what made this situation difficult to talk about allowed us to be open to what the other had to say and to treat each other with the compassion and respect that we both deserved.”

Recently, I had an experience that was both tremendously anxiety producing and incredibly beneficial.  While I typically wouldn’t share this sort of thing with the entire universe, I feel driven to write about this personal situation.  I consider myself to be in a unique position to discuss communicating effectively when one has OCD, as I am a person who has OCD, and I have also been impacted by growing up with a parent with untreated OCD.

So, here goes! I was stunned when I found out that we had bed bugs living in our mattress. The topic of bed bugs was very familiar to me, as it had been one of the many topics that seemed to be on rotation with my OCD. In the past though, we never actually had bed bugs. In fact, I had done exposures to the topic of having bed bugs several years earlier and for the most part was completely free from worrying about them. Finding out this time that we actually did have bed bugs presented quite a challenge initially. I was well aware of the countless times I have said, “this time is different”, but this was my first experience where it legitimately seemed different.

While I think my response to the situation was fairly typical, there were times where my OCD tried to infiltrate it by demanding that I (which really always meant “we” – my husband and I) follow a very extreme protocol.  This protocol included getting rid of a piece of furniture that we both loved. As a result, my husband and I agreed to sit down and discuss the situation. This blog is born from this conversation.

Calling a Spade a Spade

My husband asked me if I thought we should start by setting some guidelines for a safe conversation and if so, what would I tell my clients and their families faced with similar circumstances? His seemingly obvious question took me aback. I really didn’t have an immediate answer. While talking about communicating is always some part of treatment, I had not come across a situation with clients where the content of one’s OCD was also a “real life” issue. It seemed like a great opportunity to illustrate how to work collaboratively to improve communication when one person has OCD and the other does not.  It can make all the difference when it comes to keeping the disorder from dominating otherwise productive conversations.

The first step was acknowledging that the situation was very difficult for both of us. The pain of the OCD sufferer is often quite obvious, but it is easy to overlook how exasperating and distressing it can be to be on the receiving end of the sufferer’s persistent claims of imminent disaster. Having some guidelines established can be a healthy way to acknowledge the needs of both the individual with OCD and their loved one.

Establishing the terms

One of the painful things I remember about my upbringing was waiting for my mom’s OCD to allow her to come out of her room so that we could move forward. OCD was the great decider. It didn’t matter how much she loved us or how much she wanted us to have a normal family life.  If OCD said she needed to do one more compulsion, then that is what happened. I really didn’t understand as a child that it didn’t feel like a choice for her.

As someone who treats OCD, and has also had treatment for OCD, I think it is important to say that, even after treatment, there will be times when OCD tries to hijack everyone’s attention. Setting some basic guidelines for the conversation based on mutual goals (as well as individual needs) can set the stage for a respectful conversation where both parties feel heard.

“Setting guidelines” probably sounds really official, but these are not meant to be rigid rules (like OCD loves).  Rather, they are general principles that both people agree to keep in mind during the conversation. For example, those that have OCD may not know how they come across to their loved one when they are anxious; that the look on their face may be one of sheer panic, anger, or despair. It can be helpful to talk about how these emotions will be addressed in advance.

For the person with OCD, you may already know that your OCD is involved and you fear that your loved one will ignore your concern, chalking the entire thing up to your disorder. In my situation, I wanted it to be acknowledged that we actually did have a problem (bed bugs) and that it wasn’t all my OCD.  I wanted to feel heard. If you are the one without OCD, you may be concerned about how to listen only once without being accused of minimizing the situation or not hearing what was said. You also want to come up with a solution to the actual problem, not the part of it that is OCD. What can be helpful is to recognize that you both want the same thing, not to be taken hostage by OCD.

 Key points to consider before difficult conversations:

  • What are your mutual goals for the conversation?
  • How do you, as a team, want to deal with insistence and repetition if/when they crop up?
  • How will you convey to each other that you have heard what the other has said?
  • How do you want to handle it if/when OCD begins to flare up?
  • How do you know when you need to pause the conversation for a period of time?
  • How do you come to a reasonable decision both can agree to?
  • How do you address requests for reassurance?

The answers above will vary based on the nature of the relationship and the situation. It may be useful to decide in advance how many (if any) reassurance questions will be responded to and what a supportive statement might sound like if one of you respectfully disagrees with a point without feeling dismissed or unheard. I found that being willing to pause and consider these challenges helped me to be mindful during the conversation so I could better focus on what was real and what was OCD.

It wasn’t too difficult to recognize which things were demands of my OCD versus reasonable guidelines that were necessary to address the problem. For example, we were informed that bed bugs are killed at high temperature and one recommendation was to put linens, pillows and towels in the dryer at the highest setting.  But OCD said if once is good than certainly 2, 3, 4, and so on… would be better. OCD also began to whisper that it was reasonable to put everything that ever might have been on the floor into the dryer, including items that were already cleaned and dried. Of course the worst of all was my advisor, Google, who never stopped providing new and wonderful ways these superpowered creatures might be lying dormant, ready to come out 6 months later for a “bloodmeal” (isn’t that the worst word ever?). The panic and urgency had set in, and I needed some help.

The Endgame

My first inclination had been to treat the situation as a national crisis! It felt like an emergency. OCD was shouting its national anthem, “oh, say can you see, that disaster is imminent…no, it’s not… yes, it is!” This was nothing new to me. While I have the knowledge and training to identify this obvious OCD prank, it was helpful to have my husband (who has an honorary blackbelt in understanding OCD language) to remind me that this was not an actual emergency.  Our house was not on fire, we just had some bugs. It was a bummer, but nothing exciting.

Together we came up with a game plan that addressed the real problem without allowing OCD to make all the rules and decisions. We decided to hire extermination professionals and follow their guidelines. In regard to the questionable piece of furniture, my husband proposed that we ask the professionals about what we should do with the furniture, and then do whatever guidelines they suggested.

A Winning Hand

One of the most painful things about having OCD is the way the disorder can make you feel isolated and alone, as if you, and you alone, are in a private nightmare. When I was young, my whole family would rally around my mom offering what we believed to be support but was actually reinforcing her anxiety and ultimately keeping her stuck. We didn’t know how to help her. My husband’s simple gesture was an act of support and genuine compassion, because he was able to convey to me that he empathized with how difficult the situation was.  But at the same time he was not going to allow OCD to make our decisions. Rather than dictating how the conversation should go, he offered some simple suggestions for me to consider.

In the end, anticipating and identifying the challenges that can arise allowed us to collaborate and come up with a game plan that we both could agree was reasonable.  Discussing in an honest way what made this situation difficult to talk about allowed us to be open to what the other had to say and to treat each other with the compassion and respect that we both deserved.  I once thought that having bed bugs was one of the most horrible things that could happen.  Now I think experiencing them first hand has given me more confidence in myself and my family’s ability to deal with whatever cards we are dealt.

Molly Schiffer, LCPC is a psychotherapist specializing in OCD and related disorders at The OCD and Anxiety Center of Greater Baltimore.