How do I explain my OCD to my family?
December 7, 2020 6:02 PM   Subscribe

I was recently diagnosed with OCD but have yet to tell my parents. I want to tell them because I’d like to ask for their financial help in order to access appropriate treatment. I'm struggling with how to explain my OCD to them so they'll take it seriously, particularly since I struuggle with covert/non-visible compulsions. Any advice or experiences with disclosing OCD to family? Are there any resources I could share with them about OCD that might help them understand it?

A few months ago, I asked this question about potentially having OCD. I ended up raising it with my trauma therapist, and she diagnosed me with OCD. That was a huge relief, except for the issue that my current therapist is trained in trauma treatment, not OCD. While we do sometimes discuss my OCD symptoms, she’s told me she isn’t specialized in treating it directly, so if I'm looking for treatment that’s more focused on it, it might be a good idea to look for a therapist that practices Exposure and Response Prevention (ERP). I definitely agree with her, and my OCD symtoms have recently spiked, so I'd like additional professional help in treating them apart from my current therapist.

This is where my parents come in. They know about my CPTSD and my current trauma therapy, but I've yet to disclose anything about my OCD. They were (relatively) supportive and understanding of my trauma, but I think OCD might be trickier to explain, especially since I don't present with "classic" symptoms of relatively overt obsessions + compulsions like contamination obsessions and cleaning compulsions.

My compulsions are either all mental, like constant rumination, constant self-reassurance or memory-checking; or easy enough to hide, like hours of compulsive research on google, asking for reassurance from friends or compulsively writing lists to myself on my phone to stop the obession and anxiety. The one physical compulsion I sometimes get is hitting myself, but I'm able to stop myself when I’m around them or in public. So I might seem kind of spaced out during an obsessive spike, or look like I'm spending too much time on my laptop, but it’s never enough that they take actual notice.

Normally, I'd be okay with just not telling them and finding treatment on my own, but in this case, I need their financial help in order to access + afford OCD treatment on top of my trauma treatment. Even though I’ve been diagnosed with OCD, I'm still worried their minds will immediately jump to not really believing I have actual OCD because my symptoms aren’t obvious.

My mom in particular can be pretty skeptical of mental health symptoms unless they're clear as day, unfortunately. She also has a friend who struggles with severe contamination-themed OCD and has physical compulsions, and I've gotten the sense that my mom believes that this is the only way OCD presents itself—so she might dismiss me out of hand because my own OCD symptoms don't really match her friend's symptoms.

I don't blame my parents, since general-public knowledge and representations of non-overt OCD are pretty limited, but I'd still like to try to help them understand, especially since I want their help getting treatment. I’ve tried googling OCD resources for loved ones, but honestly, my mental energy for research right now is so low that I haven’t had much luck with finding articles/youtube videos/etc, especially since many don't really explain the mental compulsion side of things.

So: how can I explain my non-overt OCD to my parents so I can access treatment? Does anyone have experiences of doing so with their own loved ones successfully? Any resources (articles, videos, etc) I might show them that explain that covert/mental obsessions + compulsions are a genuine phenomenon, and that I still need professional treatment despite not being outwardly hurting or presenting with what people think of as “classic” OCD symptoms? Apologies if this ask is all over the place. I really appreciate any help with this!
posted by runnerfive to Human Relations (8 answers total)
Can you explain to to them without calling it OCD? Since they seem to accept that you have trauma related mental health issues, could you attach this to that? Like maybe tell them you and your therapist have discovered another facet to your CTPSD and that she’s recommended you access additional/different therapy for this other issue because it’s not her specialty.

Also, I’m sure this isn’t the first time your therapist has had a client whose family didn’t understand how to support them. Maybe she can help you with effective wording.
posted by hurdy gurdy girl at 6:08 PM on December 7, 2020 [7 favorites]

"Mom, I know this is hard for you to hear, but I need you to keep out of this part of my life. I need space and time to process my feelings, and I can't help you with yours right now. I am working with my doctors to take care of the underlying cause, and you can help me by [paying for treatment/rent, whatever specific thing they can help you with]. Can I count on your support?"
posted by disconnect at 6:32 PM on December 7, 2020

Since you say you want them to understand, can you show them this question, maybe edited? You lay your thoughts out clearly and say everything you need to. You could also use it as a guide for a conversation if you think that would work better.
posted by momus_window at 7:06 PM on December 7, 2020

Have you seen this list of subtypes? Relationship OCD is the one I resonate with most strongly, as someone that also has C-PTSD but isn't officially diagnosed with OCD. My obsessions and compulsions all center around relationship dynamics (same as you describe with reassurance seeking and googling), although my presentation isn't a perfect match for the examples on the website. Perhaps if you can prove there is an official subtype that isn't about contamination it will help them understand.

The International OCD Foundation also has a great list of resources for family issues.
posted by crunchy potato at 7:57 PM on December 7, 2020 [1 favorite]

An incomplete list of potential options:

1. Take a two-step approach. Step 1, tell your parents that your therapist has diagnosed you with OCD, and give them a bunch of background reading. Don't engage further until they have a chance to do the background reading, and ideally ask you about what sort of treatment you are doing or that your therapist recommends. Then, as step 2, discuss the recommended treatment but lay out the financial obstacles and ask for help. The relevant details that your parents need to know are (i) that your therapist has diagnosed you, and (ii) that your therapist recommends a specific treatment, but is not trained and able to provide it. Appeal to the authority of your therapist in this.

2. Don't mention the new diagnosis, but do mention the new treatment recommendation. "Hey parents, so my therapist believes that my mental health would really benefit from a supplemental type of treatment that they are not trained to provide themselves. Unfortunately I can't afford it on my own. Could I ask for your assistance?" Important details here: don't lie, but it's perfectly okay to talk about your mental health non-specifically without mentioning the OCD diagnosis. Do emphasize that this is a supplemental treatment on top of your current therapy (not a replacement for or alternative to your current therapy).

Honestly, I've taken a weekend mental health first aid course and thus know that there's quite a lot that I don't know, but have at least a slightly better understanding of OCD than it sounds like your parents have - yet I don't know anything about specific treatments and have never heard of ERP before. I suspect that if you say "my therapist is recommending that I supplement my current therapy with ERP, which is another sort of treatment targeted at some symptoms that I'm experiencing a spike in currently", your parents are unlikely to respond "ERP? Isn't that for OCD? But you don't have OCD!" They're much more likely to go, "I haven't heard of that. What is it?" And then you can talk about some of what is involved in the treatment, and/or some of the specific symptoms that it will help with. If your parents don't know enough about OCD to recognize that from your symptom list, there's no need to get into your OCD diagnosis (for the semi-educated on mental health issues, it all sounds plausibly related to CPTSD anyway). If your parents have heard of ERP due to your mom's friend, it's still okay to also talk about or focus on your specific symptoms that it will treat and avoid the diagnosis. Sample conversation:
Mom: "ERP - isn't that for OCD like my friend has?"
You: "I've been experiencing a spike in over-rumination, self-reassurance, and memory-checking, which have been kind of disruptive for me lately, and ERP will treat those symptoms."
Mom: "Oh, I thought it was just for obsessive compulsive stuff."
You: "Well, my symptoms are kind of related to your friend's symptoms in terms of being intrusive thoughts, where I need help keeping my mind out of ruts, and that's what ERP will help me with! But as I was saying, my therapist isn't trained in that treatment, so has recommended that I supplement my current therapy with a bit of ERP from someone who is trained in it. They've been really good at helping me with a lot of my other mental health stuff, so I'll keep working with them on everything we've been working on so far, of course. Therapist thinks that the combination of the two modalities or treatments will be really beneficial in getting me through this particular spike in symptoms I'm going through currently. I'd really appreciate being able to do that; I think it would really help me right now. I really wish I could afford it on my own. But would you and other parent be able to help me pay for it?"
posted by eviemath at 8:08 PM on December 7, 2020 [1 favorite]

When I graduated from college, I didn't have a job and couldn't afford to see my therapist anymore. While my mom didn't 100% know why I was going, her approach to telling my dad I needed financial help was, "Kitchen Witch has some health stuff going on right now. She needs our help financially, but she also needs us to respect her privacy. What can we afford to do?"

A few years later I told her about me having Bipolar II and needing both extra expensive medication and a psychiatrist. She was devastated and couldn't cope. I seemed "functional" compared to her brother, who has schizoaffective disorder and goes through extreme highs and lows frequently. She didn't know that Bipolar II was a thing, and she also had this total fear of medication because the lazy susan of prescription pills my uncle's psychiatrist put him on didn't work or made things worse. To compound things, my dad's negative opinion of psychiatry and medication for mental health purposes was also rooted in fear, denial, and misinformation, but he went so far as to label my uncle's condition as "demon possession" and "bad karma."

My mom's Momma Bear mode kicked in when she heard my dad invoke the concept of demon possession. She used the same approach to tell my dad I needed help, and this time was EXTRA emphatic that he and she could not ask questions. They were able to supplement my unemployment income just enough for me to cover what I needed most.

It's been 10 years. My dad still doesn't know about my actual diagnosis. My mom thinks it would be too much for him to handle. I don't need financial help anymore, but if I did, and if it was for something I didn't even want to tell my mom about, I'd say to both my parents, "I love you, I need help, something has happened and I am not ready to talk about it. Can you help me again?"

Sending love and support. It is so, so hard to get treatment, and it is even harder to have to ask for financial help when there's this looming likelihood that your parent(s) will dismiss the reason why as unreal or invalid. Hopefully a combination of approaches in this thread will make it easier to get what you need.
posted by Kitchen Witch at 12:35 AM on December 8, 2020 [3 favorites]

You're asking for financial assistance for treatment. Your doctor diagnosed you. Focus on the details of the treatment and its benefits. Repeat A doctor diagnosed you. That's all the proof needed.
posted by theora55 at 7:16 AM on December 8, 2020 [1 favorite]

Lots of love to you as you sort through all of this! I too have a diagnosis of PTSD* and OCD, which I didn't get (or at least accept) until my mid-thirties. I, too, got the PTSD diagnosis first and the OCD diagnosis later. Apparently it's not uncommon for them to be a dual diagnosis: I learned that having OCD/OCD symptoms like rumination makes us more likely to develop PTSD. (Ugh so many feelings about this but ultimately I've found peace with it all.) My compulsions are a lot like yours: OCD is very misunderstood, even today, in mainstream culture so having a good link you can send your family might help. But you don't need to find one either! They can research it too should they wish.

I think everyone's shared good tips for discussing this with your mom. She may be more open than you'd expect. OCD is believed to have a strong genetic connection and I realized my dad and some of my siblings probably have it. I had a great conversation with both parents: my dad talked about his own experiences, and my mom talked about my dad and his dad. (My dad has a different type than I do.) My family also was wary about mental healthcare at first but now has become super supportive as they see the positive difference it's made in my life. One of my siblings also has sought out treatment so I was setting a healthy example for my family, and that was an unexpected boost! OCD was actually much easier to discuss and feel validated/supported than my PTSD and maybe it will be for you, too. If not, I know you will do your best and it will go OK even if it's hard! You can do it!

Also, some additional thoughts: I found a low-dose of generic Zoloft made my life sooooo much better. I stopped it after 2.5 years but recently restarted it again as my current life situation has been extra complicated by COVID and I was miserable. I am so grateful for this option: my therapist once told me that while I may not need a daily SSRI for treating my symptoms, it can be an important and needed reset for when times get tough. You know who encouraged me to go back on my SSRI? My mother, who had previously been anti-medicine for mental health. Talk about a sea change!!

Whatever you pursue, you are working so hard to take good care of yourself. It's incredibly painful and frustrating at first but it does get easier with time. I feel so empowered and confident about my mental health. Sometimes I'm doing great and sometimes I'm having a rough time (ugh, pandemic life!) but my life really is better than ever. I hope you feel that way eventually, too. I hope you can keep up with your various treatment options -- it sounds like you trust your therapist, which is great and helpful (I was so distrusting at first) -- and feel good because you deserve it!

*I know CPTSD and PTSD are different but related. Just wanted to make sure I acknowledged that!
posted by smorgasbord at 4:04 PM on December 8, 2020 [1 favorite]

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