OCD and Excessive Reassurance Seeking

Providing reassurance to someone with OCD can actually make the issue worse

Safe and secure behind the wheel
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One of the things that family and friends of people affected by obsessive-compulsive disorder (OCD) find to be the most stressful when interacting with their loved one is the excessive reassurance seeking that can often accompany the condition. Excessive reassurance seeking is the need to check in with someone over and over again to make sure everything is OK with respect to a particular worry or obsession. While responding may seem supportive, it only serves to perpetuate OCD behaviors and thoughts.

Examples of Excessive Reassurance Seeking

Excessive reassurance seeking is a compulsive act done in hopes of reducing the anxiety associated with an obsession. The compulsion often goes up when levels of distress are high and/or when the person feels unable to tolerate uncertainty. What people feel the need to be reassured about varies, but there are often consistent themes for each individual.

Running through a few hypothetical examples can help illustrate the various forms this tendency can take and how those around people with OCD may respond.

Safety

Paola experiences obsessions related to hitting someone while driving her car and not realizing it. When on the road, she asks her husband to look in the rearview mirror over and over again to make sure that pedestrians are safe. Although annoyed, her husband does not want her to feel anxious, so he does as asked and tells her everything is OK.

Sexual Thoughts

Jake has sexual obsessions related to raping a stranger. Even though Jake finds these thoughts distressing and does not want to have them, he is convinced these thoughts mean that he is a molester. He is constantly asking his brother whether that is true and whether he has ever seen him harm someone in this way. His brother refuses to discuss the issue, which causes Jake to become even more distressed.

Health

Donna is extremely worried that she will contract a sexually transmitted disease from doorknobs in public places. After washing her hands, she will often ask a friend, or even a stranger if her anxiety is high enough, whether her hands look clean or whether she should be worried about contracting an illness. Even if they tell her that she shouldn't be worried, she asks a number of "but what if" questions until she feels completely confident that her hands are clean. Friends and family now avoid going with her to public places because of her behavior.

Death

Zhang has obsessions related to his spouse dying in an accident. He will often call her many times a day at work to make sure she is alive and will sometimes become angry if he is unable to speak with her. His wife's coworkers have started to become concerned about the number of times he calls her at the office, and she is worried about the impact of this behavior on her career.

How It Can Backfire

No doubt, if you cater to someone's excessive reassurance seeking, your intentions are probably in the right place. It can be difficult to watch someone, especially someone you love, struggle in such a way, so your inclination may be to simply give them what they seemingly need to feel better.

However, in the end, your efforts are likely only hardening the hold OCD has on them. It can also end up having a negative effect on you.

Excessive reassurance seeking can result in the following unwanted results:

It Gives the Obsession Validation

Every time someone with OCD engages in a compulsion, it serves to reinforce the validity of the worry or obsession. After all, why seek reassurance if there is nothing to worry about?

It Promotes Avoidance 

It also reinforces the idea that the person cannot cope with the uncertainty or distress associated with an obsession, and that avoidance is the only way to deal with it. Avoidance is particularly harmful in the case of OCD as it keeps the person from discovering that their fears may be unfounded. In this way, although excessive reassurance makes the person feel better in the short-term, in the long-term it only serves to perpetuate the symptoms of OCD.

It's Harmful to Relationships 

Friends and family members, who are often vital sources of social support, often become annoyed and withdraw from the affected person, which only serves to raise stress levels for all parties. Of course, stress is a major trigger of OCD symptoms and needs to be managed effectively.

Providing Helpful Support

Understanding that excessive reassurance seeking is a compulsion that needs to be reduced or eliminated is the first step. This can often be done very effectively in family meetings facilitated by a mental health care provider or OCD therapist. Broadly speaking, there are two ways key strategies to keep in mind:

Agree to Stop

In the context of OCD treatment, patients, family, and friends alike must agree that the asking for/providing of excessive reassurance needs to stop. This can be difficult for everyone. However, once family members realize that excessive reassurance seeking is a form of compulsion, many are able to commit to this.

Target the Main Issues

It is often helpful for those with OCD and their family members to identify a number of situations in which the need for excessive reassurance arises and write down the response the individual typically seeks (such as "your hands are clean and disease-free") on a card. He or she can then agree to pull out the card and read it whenever they would otherwise directly ask someone for the answer. While this still represents a compulsion, it reduces distress within the family and improves relationships with others.

With respect to reducing the reassurance seeking itself, one of the most effective strategies can be to teach your loved one with OCD strategies for dealing with uncertainty.

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Article Sources
  • Osborne DWS, Williams CJ. Excessive reassurance-seekingAdvances in Psychiatric Treatment. 2013;19(6):420-421. doi: 10.1192/apt.bp.111.009761.