Getting Help For Family Members Who Refuse OCD Treatment

By Dr. Herbert L. Gravitz, Ph.D.

Many people have expressed great concern about family members who are either reluctant to enter treatment, remain in treatment, or take medications.The problem of getting a family member into treatment or getting the person to take medication isn't unique. Nor is it a simple matter. Because I have received numerous requests about this issue recently, I would like to provide a generic response.

Fortunately, the OCD sufferer will often respond positively if approached in a straight-forward, loving way with accurate, non judgmental information. When the person doesn't, it is often because he or she has some missing or inaccurate information which creates fear.

This fear (my favorite definition of fear is False Evidence Appearing Real) blocks the person from receiving help (e.g., only crazy people need treatment/medication; the person doesn't need treatment/meds; treatment/meds won't help; the medication is dangerous; it is a crutch; the treatment/meds will in some other way harm them; treatment/meds is a sign of weakness; or the medication is addictive or will foster dependence; it will rob them of creativity; or it will in some way rob the person of his or her unique personality).

Sometimes, too, people are afraid of the side effects of medications.

Less frequently, but still possible, the person is afraid to give up the role she or he has had. (The latter is the most problematic blocking fear.)

These fears and worries are normal and natural and must be addressed. What often helps in all of these situations is to "speak to the fear," not the person refusing treatment or medication -- (e.g., you are not crazy; you have a diagnosable and treatable disorder; your body will adjust to the side effects; you will be more creative; your true self will be more present). Also, mental illness still has much stigma attached to it, so you might trying "speaking to the stigma." (e.g., it takes a courageous person to know when they need help; only strong people seek help).

It has also been my experience that family members become more unreachable when they are abusing alcohol or some other substance. And ironically more family members than we might want to realize use drugs to blunt their pain. If you suspect your family family is abusing drugs, the substance abuse must be addressed before any productive movement will occur. Get professional help/coaching if necessary.

When a loved one is either a danger to self or others, including the family, it may become necessary to insist that a family member enter treatment or take medication. You may need to intervene by calling the police, the local crisis intervention team, or, if the person's doctor if he/she has one.This may seem harsh, but life often demands us to take difficult actions. OCD can be horrible disorder, but it is no excuse to allow oneself or loved one to live a bizarre life.

Sometimes, of course, there is nothing you can say that will matter and then you must take care of yourself and, if needed, get help for you. In my experience I have found that one of the most difficult parts of a family members' recovery is the conscious decision to leave the loved one to her or his own fate and accept their fate as family members of a person with a chronic and sometimes severe illness.
　