Struggling with living with my sister's OCD

[Anon 123]

Hello,

I'm reaching out as I'm really struggling with living with my sister's OCD during lockdown and need some advice.

She developed OCD around 8 years ago when she was 15. It began with health anxiety and her obsessions and routines are around keeping people she loves and herself from harm. This then stemmed into her cutting out certain foods and products she's not familiar with as she then got worried she may have undiscovered allergies. She has now also become obsessed with calorie counting and exercise as well and has had a massive weight loss which is also starting to worry me.

She's always been open about discussing her OCD with me and I have always been the only person to fully know the ins and outs of it all. She has had CBT on and off through the NHS but as she only is provided with an allotted amount of sessions there is a tiny bit of progress but then she gets into a very negative frame of mind where she doesn't see the point in getting help cos she will never be 'normal' (her words not mine) and so after these sessions stop she doesn't carry on with the work and goes straight back to how bad she was before. She suspects she may be on the autism spectrum as well which she has also pointed out herself recently.

She moved in with me last year which is when I noticed her routines had gotten bad again and since lockdown she seems to have spiralled even more. I know I enable her routines but if I don't she can fly off the handle and then I feel guilty for upsetting her but in reality I now feel like I'm walking on eggshells all the time and work extra hard not to do or say the wrong thing to her. It's causing me so much anxiety and I've found myself so upset over the past few months cos I know she's in a bad place but then when I suggest getting help or her looking at private therapy she won't as she 'doesnt see the point'. I just feel trapped and stuck really and I would never say that to her cos she instantly takes that as me saying I don't want to live with her and no one ever will (she has also said this before when I have pointed out some things that were upsetting me). She went through a pretty dark point with it all last year where she was having intrusive thoughts that no one loved her or wanted her here and had to get emergency help. So I am avoiding telling her how bad I feel cos I'm terrified of triggering that again.

I just need some advice really. Am I doing the right thing enabling her compulsions? Should I call them out even though it causes her major distress/anger towards me? It's frustrating as no one else knows/sees how bad it is so I feel like I can't talk to family about it as it's so complex and feel a bit on my.own with trying to help her.

Thank you

 

[snowbear]

Hi Anon 123 and welcome to the forum. I'm sorry things are so tough for you both just now.

The fear with OCD can be so intense that perfectly lovely people turn temporarily into manipulative monsters! But you aren't helping her by enabling her compulsions. It helps to have a quiet chat to explain calmly why you're going to stop doing what she wants before you start challenging her behaviour. It's distressing to be challenged 'mid-ritual' but less so if you know it's coming.

Similarly, you can choose a quiet moment to try to explain how her behaviour is affecting you (making you anxious, feeling stuck) and before she goes off into one on nobody loving her etc you explain it's because you do love her and want to go on living with her that somethin g needs to change.

Encourage her to go back to therapy. If she says she doesn't see the point, ask bluntly why not. Chances are she'll say 'it didn't work' so challenge that with something like, 'CBT isn't something that's done to you, but something you work at yourself under the therapist's guidance. So if it didn't work maybe that shows you weren't ready to put the work in back then. When do you think you will be ready? What has to happen for us to get to that place? Let me help you get there.'

I'd try not to let her dwell on the autism spectrum issue if possible. It can be a great excuse for not tackling the more difficult (emotional) aspects of CBT, but truth is we're all on 'the spectrum' to various degrees and this stuff isn't easy for anybody. Hanging onto labels like autism doesn't mean you can't achieve success, it just means you might have to work even harder to achieve your goals and at the start of therapy the goals seem hard enough without adding more obstacles for yourself!

While waiting for therapy to re-start, consider investing in a self-help book and suggest you read it together. Information is power, so even if she refuses to read it you'll likely learn a lot just reading it yourself. There are lots of good books available so browse a bit to see which clicks with you, but I usually recommend 'Break Free from OCD' as readable and explaining the do-it-yourself CBT well. You can find more titles and advice here.

 

[emmiew]

I wonder if she has an eating disorder? It might be worth looking at the charity BEAT and its resources.

 

[emmiew]

OCD like behaviours can increase with weight loss as the brain loses mass which has behavioural changes. I would concentrate on supporting weight restoration as best you can.

[emmiew]

https://www.beateatingdisorders.org.uk/types/arfid