Culturally Speaking

Challenging assumptions about culture, race, and mental health.

Help! I’m Married to OCD

Marriage is tough enough without the added stress of OCD.

Stressed wife with husband behind.
OCD causes distress in both partners.
purchased image from istockphoto
“When I pulled into the driveway, my husband was standing by the door. Smiling, he offered to hold my briefcase and purse. This would have been a very sweet gesture, except that he was expectantly watching me remove my shoes to make sure I put them in the ‘safe’ place he had designated for ‘contaminated’ belongings.  No one is allowed to come into the home wearing shoes, as this spreads the outside contamination throughout his safe zones. He suspects that without being right there to watch me, I might ‘forget’ the rule.  Then he would feel compelled to stay up late and clean for hours, all the while irate and likely blaming me for ruining everything.  As I opened the door, I felt the sticky sensation of liquid soap on my fingers. The doorknob was covered in it. Too late. He had been cleaning again.” – A woman married to an OCD patient.

OCD is a third person in a marriage

Most of you know that the day you get married you inherit a whole suitcase worth of additional stressors in your life.  In addition to the positives of companionship and romance, getting married certainly has its negatives.  There will be communication problems, petty arguments, disagreement over household responsibilities, issues surrounding sex, dirty socks on the floor, in-laws, and of course who gets to hold the remote control while watching television. But what if you were married to not only your spouse but also your partner’s obsessive-compulsive disorder (OCD) as well? 

OCD is a disabling and distressing brain-based disorder, which, according to the World Health Organization, has made it one of the leading causes of disability worldwide.  When you marry someone diagnosed with OCD then you are not only inheriting the usual suitcase worth of stressors, but you may also be inheriting a dump truck too – and we are not just talking about hoarders!  Previous research has found that about 60% of family members are involved to some extent in rituals performed by an individual with OCD (Shafran et al., 1995). 

Sometimes it feels like OCD runs the home

Couple back to back.
OCD can lead to conflict.
purchased from istockphoto
Imagine if you sat down to discuss with your spouse what each of your responsibilities around the house will be.  Let’s say you ask your spouse to take out the garbage twice a week, and they can’t because of worry about contracting Swine Flu from the trash can.  Would it be frustrating if your spouse wouldn’t let you use a public restroom because he didn’t want you to accidently get pregnant from someone else’s semen?  Further, imagine asking your spouse to watch the kids while you and your friends go grab a bite to eat and your mate refuses because of fears that that s/he might harm them in a “violent way.”  Would it be frustrating if you were constantly criticized for not putting the salt back in the “correct” place on the table, where the S and P are perfectly aligned?  What if your spouse was making you late for your daughter’s recital because he ran over a pothole and had to circle the block several times to ensure that he hadn’t actually run over a small child? These are a small sample of some of the additional issues that people who are married to someone with OCD experience.  Making a marriage work is already tough and adding OCD into the mix only makes things worse. 

It’s even harder when you have OCD

Not only is it hard to be married to someone with OCD, but can you imagine how hard marriage would be for the person diagnosed with OCD?  That person may have been struggling with OCD for several years and is now taking on the additional stressors of marriage.  The OCD sufferer must now cope with someone that leaves contaminated fingerprints all throughout their home, moves items out of their proper place, criticizes for refusing to take out the garbage (that could be covered in the Ebola virus), or even blamed for ruining all of their friendships.  Obviously, we all have basic problems that need work, but if your spouse has OCD, not only does that person have those basic problems but obsessions and compulsions to stress over too.  

Understanding your partner with OCD

What can you do if you are married to someone who has OCD?  Try to put yourself in the your spouse’s position as much as possible. People with OCD don’t do compulsions because they want to, but because they are terrified of what will happen if they don’t. The compulsions are often misguided attempts to keep loved ones (like you) safe from harm.  The more you empathize with that struggle, the better you will be able to demonstrate compassion, communicate efficiently, and show that you truly care.  Focus on the positive attributes of your partner and provide praise for any attempt to resist OCD symptoms.  Do not scold, criticize, or participate in their OCD rituals (when possible).

If you feel completely lost, then one good first step is to learn more about the disorder. Read some good books about OCD or join the International OCD Foundation to get support from other people who have been there. Gently encourage your partner to go for treatment and offer to go to therapy too.  When you are feeling very frustrated because of the OCD symptoms, you ask yourself, “Am I going to let my spouse’s rituals ruin our marriage, or am I going to find strength to be supportive and compassionate so that we can have the marriage that we have always wanted?” This is not easy, and if your spouse has OCD, you may need your own supportive therapist to cope with the situation.

If your spouse is being treated for OCD, it might be helpful to tag along and have a family session about the problem.  Unfortunately, very little research has focused on how OCD affects those around the afflicted individual, especially their spouses.  More work is needed to provide information that would be most helpful for therapists assisting couples experiencing difficulty with this disabling disorder.

If you are married and either you or your spouse has OCD then consider participating in an online study to help researchers better understand this issue. For more information and to participate, please click here.

 by Nicholas Bach, B.A., and Monnica Williams, Ph.D.

References

Calvocoressi. L., Lewis. B., Harris. M., Trufan. S. J., Goodman. W. K., McDougle. C. J., & Price. L. H. (1995). Family accommodation in obsessive-compulsive disorder. The American Journal of Psychiatry, 152(3), 441-443.

Riggs, D. S., Hiss, H., & Foa, E. B. (1992). Marital distress and the treatment of obsessive compulsive disorder. Behavior Therapy, 23(4), 585-597.

Shafran, R., Ralph, J., & Tallis, F. (1995). Obsessive-compulsive symptoms and the family. Bulletin of the Menninger Clinic 59(4), 472-479.

Monnica Williams, Ph.D., is the Director of the Center for Mental Health Disparities in the Department of Psychological & Brain Sciences at the University of Louisville.

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