Support for Family & Friends

1. The first step is education. Read all you can about OCD. The more you learn, the more you can understand what life with OCD is like. Good places to start are the links provided here on Suite101. As you learn more about OCD, you will discover that no one is to blame for your family member’s illness. OCD isn’t due to improper parenting or trauma. It is a brain problem.

2. Ask your family member if you can communicate with the doctors and therapists. If the person consents, ask what your role should be in assisting with the struggle with OCD.

3. Talk about OCD and how it is affecting your family. Give it a name. OCD is the problem, not the sufferer. Find out what kinds of support groups meet in your area. Ideally, there will be a support group for families of people with OCD. But probably not. How about a support group for family members of people with mental illness? Try to get together with people who are dealing with similar difficulties. There are also support groups and message boards online. The Internet has made the world much smaller.

4. Take a look at your relationship with the person with OCD. List the ways you participate in OCD rituals. Some examples are laundering clean clothes that the person with OCD insists are “contaminated,” checking appliances because the person just can’t be sure they are turned off or unplugged, repeating magical-like phrases to reverse negative things said. By doing these things, you are enabling the OCD to continue unchecked in your family. It would be extremely difficult to suddenly stop all participation in OCD rituals. Discuss your list with your family member and formulate a gradual plan for eliminating your participation in OCD rituals. If your family member has a therapist, talk with him or her about your plan.

5. Look especially for ways that you are offering reassurance. Reassurance-seeking becomes a ritual. This has been a big problem in my family. When the obsessive thoughts arise, I feel I must check. Even after checking something, I might still have doubts and I ask my husband or son, “Did I lock the door?” “Were the cats in the house when we left?” We have a rule. They are to answer my question once, then refuse to offer further reassurance. It makes me angry, but it does help to break the cycle.

6. Encourage compliance with the medication treatment. It can take up to 12 weeks for anti-obsessional medications to work, and then another one might have to be tried if it doesn’t relieve OCD symptoms. Meanwhile, side effects can be difficult to deal with. Encourage your family member to take the medication as ordered and communicate with the doctor if side effects are extreme. Compliance with cognitive behavior therapy is challenging too. Be a cheerleader as your family member struggles to break free from OCD.
7. Stress exacerbates OCD symptoms. Especially in the beginning of treatment, try to reduce the stress in the household. Try to keep a structured routine for a while.

8. And most important – take care of yourself! As with any illness, caregivers often lose sight of their own health requirements. Be good to yourself and spend time alone or with friends.

Keep in mind that there is more to life than OCD. It may be severe at the moment, but there is hope. Offer encouragement and praise for each step toward breaking free from OCD. And praise yourself for your part in recovery.

Friends Supporting Friends
by Cherry Pedrick, RN
Reprinted from Suite101.com, August 3, 1999, revised

Michael Jenike, MD moderated a panel discussion about overcoming the stigma of mental illness at the 1999 Obsessive Compulsive Foundation conference. Special guests were Mike Wallace, William Styron and Art Buchwald. Life-long friends, they taught us the importance of friends. They had each experienced clinical depression. 

The OCF could not have planned a better panel discussion. I guess the panel discussed the stigma of mental illness. Like a good reporter, I had my notebook and pen in hand, ready to write copious notes on the featured topic. At the end of the hour I looked down to see two sentences on my lavender paper. (I have a teenage son, also a writer, who steals my paper. He has an aversion to lavender and pink notebooks, thus my affinity for those colors.)

The first sentence on my lavender paper was “Mike Wallace helped educate his psychiatrist.” I could relate to that! I helped educate my psychiatrist and therapist about OCD. I tried anyway. Then I wrote articles to help educate my fellow nurses, school teachers and the public. Then I coauthored The OCD Workbook with Bruce Hyman, Ph.D., an experienced cognitive-behavioral therapist. Released in October 1999, The OCD Workbook has educated thousands of people with OCD – and their doctors, therapists and families.

Note: After selling over 40,000 copies, an updated Second Edition of The OCD Workbook was released in 2005.

The second sentence, and the point of this column, was “Mike Wallace, Bill Styron and Art Buchwald had depression around the same time. Buchwald called both to offer encouragement. Keep in touch.” I’m sure there was more said, questions were asked and the panelists responded. But the audience took away more than words. These three friends showed us the importance of friends supporting friends through the difficulties of life, which often includes mental illness. As they bantered back and forth about who had the worst depression, I could feel the love and concern they held for each other.

I was impressed with the honesty they shared with each other – and with us. They could have each kept their mental illness a secret and missed out on valuable support and friendship. These could have been fatal secrets!

After much applause, the three friends stayed a few minutes to shake hands, sign books and pose for pictures. I had bought Bill Styron’s and Art Buchwald’s books at the conference book table, but they were in my room. I went up front and watched the long line of people file by. I took a couple pictures and chatted with my friends (cyberfriends I normally only get to “see” online). “I don’t need my books signed. The line is too long.” I said.

Then suddenly I wanted more than a picture of the moment. I raced to the elevator and up to my eighth floor room. I grabbed the two books and rushed back to the conference room. But I was too late. The three friends were posing for pictures in front of the side door. I took a couple more pictures, then they were gone.

The OCF reception followed. We lined up at the buffet, then sat down to eat pasta, veggies and cheese. I mingled with people I knew and people I didn’t know. After the reception I joined some cyberfriends for dessert at a local restaurant. It was wonderful to be surrounded by people who knew what it was like to live with OCD.

I started reading Bill Styron’s Darkness Visible, A Memoir of Madness on the plane home. He wrote of the support he received from a close friend, a celebrated newspaper columnist, who had just recovered from manic depression. “ . . . and we were in touch by telephone nearly every day. His support was untiring and priceless. It was he who kept admonishing me that suicide was ‘unacceptable’ (he had been intensely suicidal), and it was also he who made the prospect of going to the hospital less fearsomely intimidating. I still look back on his concern with immense gratitude. The help he gave me, he later said, had been a continuing therapy for him, thus demonstrating that, if nothing else, the disease engenders lasting fellowship.” 

And in Leaving Home, A Memoir Art Buchwald wrote, “Bill Styron and I had depressions within months of each other. Once we recovered, we teased each other about whose had been the stronger. I claimed that mine had been a 9.9 on the Richter scale, and he said that I had suffered nothing more than a rainy day at Disneyland.”

At home, I tried to follow the example of the three famous friends, Mike Wallace, Bill Styron and Art Buchwald. My friends don’t all have OCD or depression – or any mental illness. But they can all use support as they deal with life’s problems. And I can certainly use help and support. I’m reminding myself to take Art Buchwald’s advice – keep in touch and offer encouragement. We need each other.

Worried No More - A Book Review
By Cherry Pedrick, RN
Reprinted from Suite101.com, March 20, 2002, Revised

Worried No More: Help and Hope for Anxious Children by Aureen Pinto Wagner, Ph.D. will help families develop healthy habits that can help children take control of anxiety and lead more peaceful, happy lives.  

In Worried No More, Dr. Wagner describes the normal anxiety of childhood and adolescence and the anxiety disorders that may need professional treatment. After reading this book, parents can more confidently determine if their child’s anxiety is normal and age related or evidence of a deeper problem. Dr. Wagner helps the parent through the confusing process of seeking help from mental health professionals and school personnel. Worried No More also addresses school personnel, from a mental health perspective, giving them much needed advice about educating the anxious child.

One of the difficulties families have when a family member has a mental illness, or even just excessive anxiety, is guilt. What caused this problem? Who caused it? Is it my fault? Your fault? Dr. Wagner handles this problem compassionately. No one can say definitively what caused a particular person’s anxiety disorder. Research is showing that some children have a genetic predisposition toward anxiety. They seem to inherit a general tendency to being sensitive and emotional, but also fearful and anxious. Sometimes one or more parent, or another close relative, has an anxiety disorder; sometimes more than one family member can have an anxiety disorder and not always the same disorder the child has. Research is also finding differences in brain function and chemistry in people with anxiety disorders. Life experiences, stress, medical conditions, and other factors can interact with the genetic predisposition and physical characteristics to set the stage for anxiety.

So, no one is to blame for anxiety disorders. We’re all made a little different and need to learn different ways to handle the daily stress of life. Dr. Wagner points out that there is not much that can be done about genetics, temperament or major life events, but we can affect the factors that perpetuate anxiety. Rather than worry about the cause of anxiety, she encourages an understanding of the factors that maintain or fuel anxiety. Then she explains how parents and children can change those factors using cognitive-behavioral therapy principles.

For parents, chapter 11 is the core of the book. Dr. Wagner provides specific parenting behaviors that can help children control their anxiety. These are practical strategies that would help any parent bring up confident and capable children. I was most impressed with “The 3 S’s: Security, Structure and Stability.” Unconditional love, nurturing, and respect build security and help children trust their parents. This lays a foundation for parental authority and structure. Structure is a systematic framework of rules, expectations and routines. This in turn provides dependability and predictability that enhances a child’s sense of stability and security. Feeling safe makes it easier to take chances.

Security, structure and stability means building family habits: rules that are constant, bedtimes and mealtimes, homework, chores, time spent reading together and playing games. Most of all, I guess, this all takes planning and some priority shifting.

Worried No More is available at Amazon.com or through the publisher at http://www.lighthouse-press.com/ or 1-888-749-8768 (toll free US).

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