Neuroscience
Imagine you and your partner are about to enjoy a meal together. They have obsessive compulsive disorder (OCD) and get incredibly anxious until they've completed a time-consuming sequence of checks and rituals involving their cutlery. Do you offer to help with the checks in the hope of assuaging their anxiety?
The process of helping an OCD patient in this way is called "accommodation" and though it may be motivated by compassion and empathy, the authors of a new paper say that it can be a barrier to recovery and puts a strain on relationships. Accommodation is thought to be counter-productive because it prevents a key component of CBT for OCD, which is learning that everything will be okay even if checks and rituals are not completed (known as "exposure and response prevention").
Sara Boeding and her colleagues investigated 20 heterosexual couples, each including one person with OCD, as they embarked on 16 joint sessions of cognitive behavioural therapy. Accommodation was measured at baseline and after the course of treatment was over, as were the symptoms of the partner with OCD, and relationship satisfaction.
The researchers found that accommodation was commonplace - all partners of someone with OCD reported doing at least some of their checking for them. Higher rates of accommodation went hand in hand with more serious OCD symptoms, both at the study start and after treatment was complete. This study is unable to show that accommodation by one partner caused the other partner's worse symptoms - the causal direction could run either way. However, past longitudinal research in a family setting has shown that reductions in accommodation precede patient improvement.
In the current study, Boeding's team also found that individuals who performed more of their partner's OCD checks tended to report less relationship satisfaction, consistent with past research suggesting the process of accommodation can be "taxing and frustrating" for care-givers. In turn, patients with a partner who performed more accommodation tended to report that their partner was more critical of their OCD. "Although accommodation might serve to alleviate patient distress momentarily, it does not do so within the framework of a positive, satisfying relationship," warned Boeding and her colleagues.
This is a pilot study with a small sample size, and in 19 of the couples, the patient was the woman. This limits how much we can take larger lessons from these results. However, it's the first time that OCD accommodation has been studied in a couple context and this marks an important first step towards understanding the role of relationship context in recovery from OCD. Although it is tempting to help a person with OCD complete their checks and rituals, Boeding's team advised that it is more beneficial in the long run "to provide esteem support and encourage the patient to 'get through' the anxiety until it habituates, rather than trying to avoid or neutralize it for the patient."
_________________________________
Boeding, S., Paprocki, C., Baucom, D., Abramowitz, J., Wheaton, M., Fabricant, L., & Fischer, M. (2013). Let me check that for you: Symptom accommodation in romantic partners of adults with Obsessive–Compulsive Disorder. Behaviour Research and Therapy, 51 (6), 316-322 DOI: 10.1016/j.brat.2013.03.002
--Further reading--
What is it like to have OCD?
Post written by Christian Jarrett (@psych_writer) for the BPS Research Digest.
- The Psychophysiology Of Post-sex Pillow Talk
After sex, are you the kind of person who whines about things, rolls over and promptly goes to sleep, or do you lie awake, whispering sweet nothings into your partner's ear? Whether you're a man or woman, a new study says your answer at least...
- Which Is Worse: Your Partner Having A Heterosexual Or Homosexual Affair?
Assuming you're in a heterosexual relationship, which is worse: for your partner to be unfaithful with a person of the opposite or the same sex? According to a pair of US psychologists, the answer depends on whether you're a man or woman. Men,...
- Why Do Some Men Insult Their Partners?
Men who habitually insult their wives or girlfriends do so, somewhat paradoxically, as part of a broader strategy to prevent them from leaving for someone else – what evolutionary psychologists call 'mate retention'. Steve Stewart-Williams and...
- Does Your Boyfriend Let You Out Of His Sight?
So your boyfriend wants to hold your hand when you’re out together – that’s probably just a sign of affection and shows that he’s proud to be with you. But then he starts showing up unexpectedly to check that you’re doing what you said you’d...
- Ocd And Fearing Who You Really Are
It’s not the content of the persistent, unwanted thoughts experienced by sufferers of obsessive compulsive disorder (OCD) that is particularly abnormal, it is their interpretation of these thoughts. Now Sue Ferrier and Chris Brewin have shed new light...
Neuroscience
Should you help a person with OCD do their checks?
The process of helping an OCD patient in this way is called "accommodation" and though it may be motivated by compassion and empathy, the authors of a new paper say that it can be a barrier to recovery and puts a strain on relationships. Accommodation is thought to be counter-productive because it prevents a key component of CBT for OCD, which is learning that everything will be okay even if checks and rituals are not completed (known as "exposure and response prevention").
Sara Boeding and her colleagues investigated 20 heterosexual couples, each including one person with OCD, as they embarked on 16 joint sessions of cognitive behavioural therapy. Accommodation was measured at baseline and after the course of treatment was over, as were the symptoms of the partner with OCD, and relationship satisfaction.
The researchers found that accommodation was commonplace - all partners of someone with OCD reported doing at least some of their checking for them. Higher rates of accommodation went hand in hand with more serious OCD symptoms, both at the study start and after treatment was complete. This study is unable to show that accommodation by one partner caused the other partner's worse symptoms - the causal direction could run either way. However, past longitudinal research in a family setting has shown that reductions in accommodation precede patient improvement.
In the current study, Boeding's team also found that individuals who performed more of their partner's OCD checks tended to report less relationship satisfaction, consistent with past research suggesting the process of accommodation can be "taxing and frustrating" for care-givers. In turn, patients with a partner who performed more accommodation tended to report that their partner was more critical of their OCD. "Although accommodation might serve to alleviate patient distress momentarily, it does not do so within the framework of a positive, satisfying relationship," warned Boeding and her colleagues.
This is a pilot study with a small sample size, and in 19 of the couples, the patient was the woman. This limits how much we can take larger lessons from these results. However, it's the first time that OCD accommodation has been studied in a couple context and this marks an important first step towards understanding the role of relationship context in recovery from OCD. Although it is tempting to help a person with OCD complete their checks and rituals, Boeding's team advised that it is more beneficial in the long run "to provide esteem support and encourage the patient to 'get through' the anxiety until it habituates, rather than trying to avoid or neutralize it for the patient."
_________________________________
Boeding, S., Paprocki, C., Baucom, D., Abramowitz, J., Wheaton, M., Fabricant, L., & Fischer, M. (2013). Let me check that for you: Symptom accommodation in romantic partners of adults with Obsessive–Compulsive Disorder. Behaviour Research and Therapy, 51 (6), 316-322 DOI: 10.1016/j.brat.2013.03.002
--Further reading--
What is it like to have OCD?
Post written by Christian Jarrett (@psych_writer) for the BPS Research Digest.
- The Psychophysiology Of Post-sex Pillow Talk
After sex, are you the kind of person who whines about things, rolls over and promptly goes to sleep, or do you lie awake, whispering sweet nothings into your partner's ear? Whether you're a man or woman, a new study says your answer at least...
- Which Is Worse: Your Partner Having A Heterosexual Or Homosexual Affair?
Assuming you're in a heterosexual relationship, which is worse: for your partner to be unfaithful with a person of the opposite or the same sex? According to a pair of US psychologists, the answer depends on whether you're a man or woman. Men,...
- Why Do Some Men Insult Their Partners?
Men who habitually insult their wives or girlfriends do so, somewhat paradoxically, as part of a broader strategy to prevent them from leaving for someone else – what evolutionary psychologists call 'mate retention'. Steve Stewart-Williams and...
- Does Your Boyfriend Let You Out Of His Sight?
So your boyfriend wants to hold your hand when you’re out together – that’s probably just a sign of affection and shows that he’s proud to be with you. But then he starts showing up unexpectedly to check that you’re doing what you said you’d...
- Ocd And Fearing Who You Really Are
It’s not the content of the persistent, unwanted thoughts experienced by sufferers of obsessive compulsive disorder (OCD) that is particularly abnormal, it is their interpretation of these thoughts. Now Sue Ferrier and Chris Brewin have shed new light...