Couples and OCD (Obsessive Compulsive Disorder)

Obsessive-Compulsive Disorder, OCD, is an anxiety disorder and is characterized by recurrent, unwanted thoughts (obsessions) and/or repetitive behaviors (compulsions). Repetitive behaviors such as handwashing, counting, checking, or cleaning are often performed with the hope of preventing the thoughts and reducing the terrible anxiety that accompanies them. In spite of the disorder, many people with OCD function at high levels.

Adrian Monk, the TV detective played by Tony Shalhoub comes to mind as an OCD sufferer plagued by the urgent need to engage in certain rituals to ward off germs or dirt, to keep objects perfectly ordered, to count steps, and to check things repeatedly.

Typically, the treatment for a person with OCD is cognitive-behavioral therapy and medication.

However, two clinical psychologists at the University of North Carolina at Chapel Hill will, for the first time, use cognitive-behavioral therapy (CBT) to treat couples in which one partner has OCD.

According to an article on PsychCentral:

"Jonathan Abramowitz, Ph.D., associate professor and associate chair of the psychology department in UNC’s College of Arts and Sciences, who is also director of UNC’s Anxiety Disorders Clinic, and Donald Baucom, Ph.D., professor of psychology and director of UNC’s Couples Therapy Clinic, will provide treatment for about 20 couples as part of a new study funded by the Obsessive Compulsive Foundation."

“First we will find out about the OCD symptoms and how the couple has been managing with these problems,” Abramowitz said. “Then we will help the couple learn to work together to address the OCD patient’s obsessions and rituals and assume a healthier relationship in which their interactions do not make OCD worse.”

“The hope is that when both partners learn the CBT techniques, the partner without the disorder can be more helpful in encouraging the OCD mate to work through fears realistically,” Abramowitz said. “This would be good for the OCD sufferers and their spouses.”

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Musings

How can it be that the couple is being seen as the nexus of treatment for OCD "for the first time?"

Couples are intertwined, for better or for worse. We carry our conjoined lives with us wherever we go. One goes to the supermarket and remembers that the household is out of the other's favorite brand of yogurt. We call each other up when one is going to have to stay late at work. Our memories of joys celebrated and injuries inflicted are everlasting. And when one is sick, both lives are dislocated.

When one partner is ill, with OCD, PTSD, GERD, or any other acronym, the other partner is intimately involved. The well partner knows all about the other's diet and bathroom habits, how far she can walk, when well intentioned company begins to tire her out. And the ill partner can read her sweetie's face from across the room and see signs of hope or weariness. One person may do internet research on the ailment, while the other deals with insurance labyrinths. They may go to specialist appointments together and dissect what they heard and understood afterwards.

Whether they talk openly or not about the illness, the illness changes two lives, not one. And the two partners combined have exponentially greater potential for having impact on the experience of illness, also for better for for worse.

After so many years, I can tell what's on Richard's mind by tiny changes in his breathing pattern. He can hear in the first diphthong of the first work I utter when he phones me if I've had a good or a bad day. We carry each other. We defeat each other. We save each other. We grow each other up. Over and over again.

How can this be the first time that the unit of treatment is the couple? I am not suggesting that the patient should abdicate control to the partner. The person in whose body the illness resides gets dibs on making treatment and personal choices. But why would care providers not use the interconnectedness of the couple as a channel for healing?