An excessive need for reassurance is often found in individuals struggling with Obsessive-Compulsive Disorder (OCD). They may repeatedly ask friends and family members to make certain everything is okay, especially when experiencing an obsessive thought. Since no one wants to see their loved ones struggle, friends and family are often quick to provide reassurance, with the belief they are taking away any anxiety, discomfort, and pain, and that providing an answer will put an end to the relentless questioning. However, as anyone who has been in this position before has experienced, providing reassurance does not solve the problem. In fact, you may have realized that the request for reassurance only intensifies, and everyone's frustration, anxiety, and exhaustion increases, rather than decreases. This often leaves those involved wondering, "How Do I Address this Cycle of Reassurance?"
A small sample of reassurance questions are as follows:
"Will I be okay?"
"Are you sure I won't get sick?"
"Tell me one more time you love me."
"Are you sure I didn't hurt anyone?"
"Am I a good person? Are you sure?"
"Are you sure I won't contract a disease?
"Tell me I'll have a good day."
If you or someone you know is experiencing excessive reassurance-seeking behaviors, the best way to address it is with a team approach to eliminate it. While sufferer's work to refrain from asking, loved ones work to refrain from providing. More reassurance = More intense obsessions.
Here's why:
--> OCD hates uncertainty. Let me repeat that: OCD hates uncertainty. As a result, it thrives off of reassurance to minimize any uncertainty that shows up. OCD will convince you that uncertainty is bad, and that it must be avoided at all costs. However, this is one of the many lies that OCD is telling you. The more you buy into this lie and feed OCD with reassurance, the more intense it becomes, the more you fear uncertainty, and the more reassurance you seek. Round and round this pattern goes, only intensifying your frustration along the way. The relationship between reassurance and OCD is like gasoline to a car. Keep filling up your car, it will keep driving. Keep feeding OCD with reassurance, it will keep taking control.
How do we know uncertainty is not bad? Well, think about all the uncertainty we experience in the world every day. We get into our cars with the uncertainty of whether we'll have an accident. We are uncertain about the kind of day we will have, the unexpected events that will show up, the latest happenings on the news, and the list goes on... Despite this uncertainty, we still manage to lead our every day lives, perhaps have a job, a family, feel productive, and engage in meaningful activities. Therefore, uncertainty itself is not bad. Not knowing what the day will bring does not mean it will be a bad day. Not knowing whether you will have an accident does not mean you automatically will. However, if you always strive for certainty, you never give yourself the chance to learn that you can still thrive in the midst of not knowing, and be able to handle any problem that shows up along the way.
--> The gold standard treatment for OCD involves exposure to the situations/thoughts that make you most anxious, and then sitting patiently with that anxiety, waiting for it to decrease all on its own - no compulsions, no reassurance, no distractions. This is called Exposure and Response Prevention. Seeking reassurance is a compulsion, and therefore does not allow you the necessary exposure to these feared thoughts/situations.
--> Reducing reassurance is a team effort. While it is important to work on not asking for reassurance, it is equally as important not to receive it from others when you accidentally seek it. This is when the support of family and friends becomes crucial.
--> Not feeding your OCD causes it to become angry. Therefore, when reassurance is withheld, it is expected that your anxiety will increase. This is OCD’s way of screaming, “I am angry!” That is a good thing! You do not want OCD to be happy, or it will keep coming back for more.
--> In an effort to reduce that uncomfortable feeling of anxiety, you may think that reassurance (or any other compulsion) is needed. This is another lie that OCD is telling you – that anxiety is bad and must be eliminated and avoided at all costs. You may initially become frustrated, even angry, with your support system for not providing you with reassurance when you think you need it most; but remember, anxiety is not dangerous, it is merely uncomfortable.
--> When reassurance is withheld, it may seem like your anxiety will never go away. However, when anxiety is left alone, it will gradually decrease over time. This is important for you to experience. By getting reassurance (or carrying out a compulsion), you never quite have that learning opportunity, and will continue to associate anxiety as never-ending and "bad."
--> The more you deprive your OCD of its “fuel” (reassurance, compulsions…), the weaker it becomes. The weaker it becomes, the less distress you will experience when faced with uncertainty, and the more freedom, independence, and happiness you will gain.
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A common question I hear is, "How Do I Respond When A Loved One Asks for Reassurance?"
Several helpful responses include:
1.) "Are you asking for reassurance right now?" Asking this question helps you and your loved one become aware together when reassurance behaviors present
themselves. In the early stages of curbing reassurance, an individual with OCD
may ask for reassurance automatically, especially in the throws of an obsessive
thought. Asking that question helps them take a step back to recognize that what they
are asking for is reassurance.
2.) "Since you are asking for reassurance, and I want to help you, I am not going to
answer that." Before using this response, it is essential that all those involved,
especially the individual with OCD, understands the rationale for reducing
and eliminating reassurance, as described above.
3.) "What do you think?" - Asking this question helps to empower the individual with OCD to start relying more on their own opinions and thoughts, and trusting themselves over the doubt stirred up by their OCD.
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If you struggle with sitting with the anxiety that accompanies a lack of reassurance, always remember that while sitting with anxiety is difficult, so is living with OCD. Sitting with anxiety until it naturally declines may be uncomfortable temporarily, but it will reduce your long-term discomfort, since the more you sit with the anxiety, the weaker the OCD becomes. Engaging in compulsions (including asking for reassurance), provides short-term relief, but since it is feeding the OCD, it will not provide that long-term relief you are looking for.
If you or someone you know is struggling with OCD, don't be afraid to reach out for help. Getting started with OCD treatment can be the most challenging part, but a licensed therapist specifically trained in Cognitive Behavioral Therapy, including Exposure and Response Prevention, can help get you started on the path towards putting the quality back in your life.
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