Reassurance-Seeking OCD, Anxiety, And Obsessive-Compulsive Disorder Therapy
It's common for people to experience an urge to seek a second opinion or double-check their work occasionally. However, it may be a sign of obsessive-compulsive disorder (OCD) when people seek reassurance excessively or to the point that it interferes with their emotional well-being and everyday function. For example, someone with OCD may be regularly late for work or appointments because they repeatedly check that the stove is off as a form of reassurance. Reassurance in OCD may also manifest externally when an individual repeatedly asks someone else to validate that they checked the oven.
These behaviors are called "reassurance-seeking behaviors," and they can lead to emotional distress, heightened anxiety, and lower self-confidence. This article explores the cyclical relationship between obsessive-compulsive disorder and reassurance-seeking, as well as the impacts it can have on mental health. It also outlines OCD treatments and offers suggestions for managing reassurance-seeking behaviors.
What is obsessive-compulsive disorder (OCD)?
Obsessive-compulsive disorder (OCD) is a mental health condition typically characterized by recurring thoughts (obsessions), repetitive behaviors (compulsions), or both. These thoughts and behaviors are often excessive and seem uncontrollable to the person experiencing them.
OCD symptoms can manifest differently between individuals depending on a variety of factors, including genetics, environment, and brain function. These factors may interact and "feed off of" each other, sometimes making OCD complicated to manage. An estimated 1% to 3% of individuals experience OCD.
How reassurance-seeking reinforces OCD
Reassurance-seeking can reduce one's tolerance to uncertainty and prevent individuals from addressing the root of OCD. This can create a cycle of distress and relief that keeps them from seeking treatment.
Anxiety and other mental health impacts
Reassurance-seeking can impact mental health in several ways. For example, it can reinforce the individual's belief that their fears are significant enough to warrant external help to manage them. People with OCD may seek reassurance to reduce the perceived threat of a feared event, reinforcing anxiety with the belief that the feared outcome is likely. Here are a few other ways that reassurance-seeking can impact mental health:
- Reliance on external validation can hinder self-confidence and self-efficacy, leading to a diminished sense of self-worth. This can also lead to decision paralysis when the individual believes they cannot trust their own judgment.
- Excessive reassurance-seeking can strain relationships, as others may become resentful of constant requests for validation.
- Excessive reassurance-seeking can be associated with anxiety disorders and may contribute to the development or exacerbation of depression.
- Individuals with reassurance-seeking tendencies may also be more likely to experience health-related anxieties like hypochondria.
Reassurance vs. support for people with OCD
Loved ones may unintentionally reinforce reassurance-seeking in OCD. Recognizing the difference between helping and enabling can be key to supporting someone in the healing process. For example, support can help individuals manage their anxiety and learn to tolerate uncertainty, whereas reassurance can perpetuate a cycle of anxiety and compulsive behaviors. This can prevent people with OCD from developing more effective coping mechanisms.
While receiving reassurance might offer relief in the moment, this relief is often temporary. It ultimately reinforces the cycle of anxiety and the need for reassurance, potentially worsening OCD symptoms in the long run.
How to support vs. reassure someone with OCD
Effectively supporting someone with OCD-related reassurance-seeking behaviors often begins with psychoeducation. Learn about OCD and how it impacts individuals to better understand their challenges and how you can offer appropriate support. Education can help you create a supportive vs. enabling environment in which the individual knows they are understood.
Additionally, support the individual in seeking professional treatment and avoid using logic to reassure them, as this can be counterproductive and reinforce the need for more reassurance. Resist the urge to participate in compulsions or provide excessive reassurance, as this can contribute to increased anxiety.
Challenges in OCD recovery
OCD treatment can be a complex process involving periods of progress, plateaus, setbacks, and more progress. This pattern, combined with the nature of OCD symptoms (including reassurance-seeking behaviors), may reinforce the OCD cycle, making it even more challenging for individuals to trust the therapeutic process. This can be highly frustrating and discouraging for people with OCD.
Shame and stigma
Symptoms and variations in progress can present challenges to recovery, but individuals with OCD may also face feelings of shame associated with obsessive thoughts and compulsive behaviors, and this shame can present further obstacles. Some may view their obsessions and compulsions as personal flaws or failures. Such shame, coupled with external stigma around OCD and mental health challenges, might lead individuals to be reluctant to seek treatment or support.
Misunderstanding
As a condition, OCD is often misunderstood by others. For example, compulsive behaviors like excessive cleanliness rituals or repetitive checking might be labeled "quirky." OCD behaviors may also be misunderstood as personality traits, such as perfectionism or organization, rather than OCD symptoms. This lack of understanding from others can exacerbate experiences of isolation and alienation, as well as reinforce negative self-beliefs and shame.
The importance of self-kindness in OCD treatment
Self-compassion can play a key role in helping individuals with OCD manage the challenges associated with the disorder, including low self-confidence, self-judgment, and shame. Self-kindness can lead to reduced isolation and increased motivation to engage in treatment. It can also help individuals regulate emotions and develop coping skills to manage anxiety, fear, and distress.
The non-linear nature of OCD recovery frequently requires perseverance and emotional resilience. By fostering a more compassionate self-view, people with OCD can build resilience and foster a mindset of acceptance, helping them recognize that setbacks are often necessary for learning and progress. This may encourage greater engagement with and trust in the therapeutic process.
Overcoming shame and building emotional resilience for healing
For many, building self-esteem and confidence can be the most challenging part of the therapeutic process. Guidance from a mental health professional is often integral to cultivating self-esteem, but there are ways you can enhance self-esteem in daily life, too.
- Use mindfulness techniques: Practice mindfulness through journaling or other techniques to identify the specific situations, thoughts, or behaviors that encourage feelings of shame. Understanding the root of the shame can help you develop strategies for managing it.
- Try cognitive restructuring: Learn to recognize and question the validity of negative self-talk associated with shame, replacing it with more balanced and realistic perspectives.
- Cultivate acceptance and empathy: To combat shame and build emotional resilience, it helps to understand and accept that setbacks are common in OCD therapy. Instead of criticizing yourself for experiencing setbacks, treat yourself with the same empathy and encouragement you would offer a friend experiencing similar challenges.
- Celebrate successes: Remember that every step in the recovery process is important, no matter how small. Celebrate small victories to reinforce a sense of accomplishment and self-worth.
- Embrace vulnerability and connect with others: Allow yourself to be seen and understood. Connect with friends, family, or a therapist specializing in OCD. Sharing your journey and receiving empathy can combat isolation and shame.
Coping strategies for anxiety and OCD
Coping with anxiety and OCD often requires self-care, self-awareness, and support from others. Take care of your physical well-being with adequate exercise, nutrition, and sleep. Manage anxiety with relaxation techniques like deep breathing exercises or progressive muscle relaxation. Engage in activities that promote well-being, such as spending time in nature or engaging in a fun hobby. Spend quality time with friends and loved ones for support and encouragement.
Some find that a structured daily routine can offer a sense of stability and control, which may be helpful in managing OCD. When experiencing obsessive thoughts or compulsive behaviors, refocusing attention with mental exercises (like reciting the alphabet backward) or physical activities (like taking a walk) may also help.
Mindfulness for mental health
Studies suggest that mindfulness activities promoting present-moment awareness may play a key role in OCD management and recovery. Meditation, deep breathing exercises, and relaxation techniques can help manage stress and anxiety, and they can also help you identify and reduce the intensity of intrusive thoughts and compulsive behaviors. Try using mindfulness to observe your thoughts and emotions without judgment, allowing them to pass without reacting.
Setting boundaries as a form of self-care
If you have reassurance-seeking symptoms of OCD, it may be necessary to set boundaries for yourself as well as in relationships and social situations. Identify the specific reassurance-seeking behaviors, such as excessive questioning, checking, or rituals, and their impact on your anxiety symptoms. Explain to family members or friends how and why these types of behaviors may worsen OCD symptoms. Establish clear boundaries around reassurance and ask for support instead.
Socially, try to identify situations or conversations that lead to anxiety and reassurance-seeking. Enforce your boundaries consistently to maintain your mental health and improve your relationships. It may be challenging, but learning to say "no" might be necessary to protect your boundaries.
Therapy and support options
Cognitive behavioral therapy (CBT), most commonly exposure and response prevention (ERP), is the primary treatment method for OCD. ERP helps individuals stop seeking reassurance, confront feared situations, curb obsessive thinking, and resist compulsions. Prescription medication is also commonly used in combination with therapy.
Group therapy can be effective in treating OCD as well. In group therapy, participants with similar experiences can support and encourage one another and learn coping strategies together. Group therapy is often used as a complementary treatment to individual therapy.
Online therapy for obsessive-compulsive disorder and anxiety
Many people with OCD turn to internet-delivered cognitive behavioral therapy (iCBT), as it offers an excellent solution to many potential treatment barriers. For example, severe anxiety associated with OCD might lead people to feel uncomfortable or fearful of commuting to and attending face-to-face sessions in an office setting. Through online therapy platforms like BetterHelp, individuals can attend sessions from the comfort of home. Telehealth treatment is also flexible and often more affordable than traditional therapy without insurance.
Additionally, research shows that internet-delivered treatment for OCD is effective for many people. In a 2022 study published in The Journal of Medical Internet Research, researchers reported that the participants' symptoms were reduced by 43.4% after online ERP treatment. The treatment also improved symptoms of stress, anxiety, and depression, as well as led to a significant improvement in quality of life.
Takeaway
How do I stop excessive reassurance-seeking?
The Anxiety and Depression Association of America recommends the following steps:
- Recognize the difference between true danger and doubts or distress
- Embrace uncertainty
- Avoid seeking reassurance
- Let time pass as you float above the feeling
These steps may be challenging to implement on your own if you live with obsessive-compulsive disorder (OCD). Consider seeking support from a licensed mental health professional who can create a personalized treatment plan.
What is an example of reassurance in OCD?
Many people with OCD seek constant reassurance and engage in frequent support-seeking behaviors. Although it may seem that another person offering reassurance could be helpful, it usually results in negative reinforcement, worsening OCD obsessions and compulsions over time.
Why do overthinkers need reassurance?
Many people who overthink or are often anxious use reassurance-seeking as an unhealthy coping mechanism. While seeking reassurance isn’t necessarily a bad thing in the short term, it can cause harm in the long term.
How to respond to someone with OCD seeking reassurance?
It may be ideal to speak with your loved one’s therapist about how best to respond when they are seeking reassurance. A mental health professional may be able to provide context and specific guidelines to follow. In general, validating the distress your loved one is feeling and expressing that you don’t want to worsen their symptoms by providing reassurance may be helpful.
Why do I crave reassurance so much?
A persistent desire for reassurance may indicate that you lack self-esteem, are experiencing anxiety, or could be living with a mental health condition like obsessive-compulsive disorder (OCD). OCD comes in various forms, but a common symptom is checking repeatedly. For example, a person who has obsessions about their house burning down may repeatedly check that the stove is off. Checking behaviors can also manifest as constant reassurance-seeking.
What is the vicious cycle of reassurance-seeking?
While receiving reassurance from someone may help people feel calmer in the moment, it can worsen anxiety and symptoms of other psychological disorders over time. Seeking reassurance can reinforce the idea that reassurance is necessary.
What does OCD reassurance-seeking look like?
OCD reassurance-seeking can take many forms. For instance, someone might ask, “Are you sure I turned off the oven?” or “Are you sure I locked the door?” They might also repeatedly ask questions like, “Do you still feel the same way about me?” and “Did I do anything to upset you?” The goal of seeking reassurance is usually to relieve doubt, worry, concern, and other challenging emotions. Rather than seeking reassurance, it may be better for a person to take responsibility for their feelings and make efforts to manage emotional distress on their own.
What should you do when someone with OCD asks for reassurance?
You could explain to the person that you don’t want to worsen their symptoms, so you won’t be providing reassurance. However, you can still support the individual. You might distract them or help them use coping skills like mindfulness and deep breathing to manage emotional distress.
How do you treat reassurance-seeking in OCD?
Exposure and response prevention (ERP) is often used to treat OCD. It typically involves gradual exposure to situations and stimuli that provoke obsessions. It can benefit individuals who struggle with OCD by helping them become more comfortable with distress and avoid engaging in compulsions.
Which counseling approach is best for OCD?
Exposure and response prevention (ERP) is a type of cognitive behavioral therapy (CBT) that’s frequently used to treat OCD. It tends to be more effective than traditional talk therapy for this particular disorder. ERP combined with self-help strategies, such as lifestyle changes, may be especially helpful.
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