Advice Needed: Partner with POCD

[EBD]

Hi there,

First time writing in. I've been suffering in silence for some time now but have recently taken comfort in this forum. I'm hoping someone out there can please help me. My post may be a little long but please stick with it, I'm so desperate for help. 

I've been with my partner six years, we've lived together almost the entire time. We're a strong, tight knit couple and we just got engaged this year. But our relationship has been often dominated by my partner's mental health.

To try and briefly summarise: my partner is a victim of domestic abuse. His dad physically abusive and mother psychologically abusive. This went on into late teens and they both act like nothing happened now (my partner is almost 30). 

My partner has battled depression and anxiety his whole life. In the last two or so years this has manifested in obsessions. He became obsessed with health around two years ago. Obsessed he had cancer and similar upsetting illnesses. I didn't understand at the time that this was a mental health issue and supported my partner by checking if he thought he felt a lump. I spent several days in A&E and walk in centres and took him to get blood tests. I was enabling him without realising. When it started to get worse, the penny dropped for me. He would see rashes that weren't there. We finally got help, he spoke to his GP who referred him to CBT and eventually he managed to stop the obsessive checking and googling (supported by medication too which he has recently returned to taking). 

He continued to see his CBT therapist to deal with the childhood abuse. In the past six or so months however, the obsessive behaviour is back. Now it manifests as an obsession with being a peadophile. 

It's been upsetting and disturbing as a partner. He will show me pornographic images and ask if the girls look young. He will point out women in the street and ask if they look underage. I have no idea what the right thing to do is. I know if I reassure I am making it worse for the future and am fuelling the fire. If I explain "I'm not engaging today" and talk about how he can trust his own mind, he begins to shut down. He begs and pleads with me to just tell him this once. Just look at an image this once or reassure. But it is never just once and goes on and on. Sometimes he is aggressive and verbally abusive - sometimes blaming me for his anxiety. 

He has spoken to his CBT therapist who refuses to engage with the obsessions and encourages him to open up about his childhood abuse. They outright refuse to talk about the OCD tendancies. Some days I have no idea if this is right and am far from qualified enough to challenge their way of working, but it means he brings it all home. He worries himself to the point of throwing up every week after his session. 

Please can someone advise? How do I support without enabling? How do I show love and compassion without becoming a therapist to him? We've lost all intimacy in our relationship because of these obsessions. I'm trying so hard but it's just the two of us and the therapist who know about this and I'm often taking this all on my shoulders and have no one to confide in or talk to. I'm at breaking point and desperately want my partner back. 

 

[snowbear]

Hi EBD and welcome to the forum. 

11 minutes ago, EBD said:

How do I support without enabling?

Your instinct of refusing to engage with the obsessions is correct. As you've discovered, looking once at the pictures is never enough reassurance for him, so looking once isn't helping anyway and can safely be stopped. Same in the street, refuse to even look at the women he points out or get involved in doing his obsessive age-checking in any way. It's all reassurance seeking.

13 minutes ago, EBD said:

How do I show love and compassion without becoming a therapist to him?

This is a tricky one, because it will often feel like you're doing therapy with him in order to be the support he needs.

Telling him to trust his own mind is good because it helps him have confidence in his ability to judge, but the problem is that at present he hasn't got that confidence and that's why he withdraws when you say something that suggests he ought to have some confidence of his own to fall back on.

Rebuilding confidence in himself and his ability to judge can't be done by telling him he's capable. You have to do it by demonstrating that you trust his judgement even if he doesn't - which is why you're not going to look at girls in the street, or at the pictures. Not just because you're not engaging for reassurance purposes, but because you trust his heart, trust that deep down he knows what's what and that he won't act against that moral compass. You're building his self-trust by demonstrating your confidence that he already has the ability to judge for himself (and just doesn't know it.) 

21 minutes ago, EBD said:

He has spoken to his CBT therapist who refuses to engage with the obsessions and encourages him to open up about his childhood abuse. They outright refuse to talk about the OCD tendancies.

For what it's worth, my own opinion is this is the right approach.

His mind is, of course, full of OCD thoughts so naturally that's where he'd like the focus to be. But at present his ruminations and fears are really a symptom of a bigger illness rather than the main illness that needs sorting. Giving him room to discuss his OCD thoughts in therapy would be like rubbing cream on a meningitis rash and not treating the infection itself. 

Childhood abuse is hard to talk about. Really hard. Hardest thing he'll ever have to do (second only perhaps to surviving the abuse itself.) It takes patience and perseverance from him, from you, from the therapist. Given any leeway, side path, or temporary escape (option for silence or focusing on another topic) he'll want to take it and leave the abuse side under wraps. But if he can face it, talk it through, realise how it's influenced his thinking, and learn to forgive himself, the results will be well worth the effort and more.  

I don't know how much you're aware of the effects of abuse, so if you're not familiar with the recovery process saying 'forgive himself' might strike you as odd. Personally I don't agree with those few therapists who say you have to forgive the abusers. I'm not even sure it's truly possible without going back into denial. Better to be honest and say you don't forgive them so your 'new' self has integrity and you feel you can trust that 'new' self. But what is very important is forgiving yourself for surviving and starting to see yourself as worthy of enjoying a normal (good) life without further self-doubt or self-punishment. 

He's lucky to have you standing by him as he goes through this. If ever you need someone to chat to (or offload on!) the forum is always here.   

[EBD]

@snowbear I can't thank you enough for your compassionate response. It's given me so much focus and confidence that I'm doing the right thing. I adore my partner and want to help him get better, but it's often a rocky road. Part of it is being strong myself, sometimes I offer the reassurance because I want to see him comforted, even if it's just for a moment. That's the habit I need to learn to break myself. I will work hard to show my confidence in his ability. When he pleads with me to reassure what would you recommend I say? Reassure him by showing that I trust his judgement? 

[snowbear]

4 hours ago, EBD said:

When he pleads with me to reassure what would you recommend I say? Reassure him by showing that I trust his judgement? 

That's an excellent idea. 

Don't beat yourself up over the occasional reassurance-giving. It's so instinctive to comfort the one you love that it's hard not to do it now and then. There may be times when you see all he needs is a quick reassurance to get back on track, so you do have to go with your gut feeling and experience rather than being completely rigid. And remember you're human and very occasionally need the self-comfort of being allowed to comfort him!

You sound strong and sensible. I'm sure you'll both find a way through this together.  

[stepforward]

@EBD Thank you for posting. Whilst my wife's challenges are different to your partners I resonate with much of what you are saying and of the challenges. I have chosen to be what I think of as 'tough' with the 'bully' that is OCD. My wife and I are fortunately able to talk openly about what we both find so hard and she knows that when I challenge her behaviours or actions, I am acting against the bully and not herself. We have almost separated the two. I think it has helped her understand that it is a separate thing and therefore she can challenge it as well.

Having said that, although she is better now than she was a year or two ago (and I can see the potential for our lives to not be dominated by this forever) it is still really really hard. Tonight I am feeling desperate as she has had maybe her third major panic attack in the last two weeks over an irrational fear. The problem is in part the panic attack but for me the worse thing is I know this will now be impacting us for months or years to come.

For example, four years ago her godmothers daughter committed suicide. She scattered the ashes and then visited us. My wife has spent four years believing she left ashes in our house and it has meant I haven't been allowed in two rooms, that she believes I am contaminated and can't take my daughter to places with other children and that many things have been thrown away. She knows this is irrational but it is so powerful in her head she can't control it. We have been getting to a better place with this but a Christmas card from her godmother sent her over the edge again this year. It is so hard.

I believe that CBT has done as much for my wife as it can. She is now considering EMDR which we have heard has some good evidence behind it. I continue to be tough but hopefully loving as well. At the end of the day we both know she has to want to challenge the bully and to fight it and that it will be one of the hardest fights of her, and my, life...but we have no other choice.

[EBD]

@stepforward Thank you for your reply. There's comfort and courage in sharing experiences. I wish you lots of strength through these tough times. Keep going, the greatest gift you have is each other in this battle x