“Every family is a system of constantly moving parts. When one part of the system changes, it creates change in all the other parts. What this means is that when one family member experiences a mental health challenge, all family members are affected.”
– Jon Hershfield, MFT, in When a Family Member has OCD
Obsessive compulsive disorder can be incredibly disabling for the affected individual and completely baffling for the family. So much more than frequent hand washing, OCD can take over the life of those struggling with this disorder and that of their family. In his new book, When a Family Member has OCD: Mindfulness & Cognitive Behavioral Skills to Help Families Affected by Obsessive-Compulsive Disorder, Jon Hershfield provides a guide for navigating the many twists and turns of supporting a family member with OCD, from understanding the illness and its treatment to coping with the complex family dynamics.
Hershfield’s book provides a unique perspective as he has been on both sides of the therapeutic coin. In the introduction, he shares, “I grew up in an OCD family. By the time I asked for help for my OCD (around age fourteen), I was already used to hearing about ‘his OCD,’ ‘her OCD,’ ‘their OCD,’ and everybody else’s OCD throughout the family tree.” The son of a psychiatrist, he had the good fortune of a supportive and understanding family that helped him deal with his own mental illness, noting, “Mom sent me care packages in college with the usual — you know, mail from home, a new pair of socks, a Prozac refill.” When he decided to complete a Master’s degree, he focused on CBT for OCD. His professional focus still remains on OCD, but, as he points out, “I live and breathe OCD, but in a much different way now. The irony is not lost on me.” He brings this experience — as provider, family member and patient — to bear in his book.
In the first section of the book “Understanding OCD,” Hershfield gives an overview of the illness. While written in a way that is understandable for the uninitiated, he covers the important aspects including biological, genetic, and psychological contributions to the disorder. But he goes beyond the textbook understanding to incorporate true-to-life examples and apparent paradoxes, anticipating the frustrations of those living with OCD. He writes, “If your family member has Contamination OCD, you may wonder how he can be so particular about some things and so complacent about others. How can he wash his hands 100 times a day yet leave garbage on his bedroom floor?” His explanations of these conundrums resonate with the feeling of someone who has been there. “Don’t judge yourself too harshly if you think [the behavior of the person with OCD] is somewhat ridiculous. It boggles your mind and it doesn’t make sense because you can’t help but look at it from a more logical standpoint.” His understanding for the family members of those with OCD offers reassurance in what can be a frustrating process.
The second section, “Supporting your Family with OCD,” builds upon the first. Living in a family, Hershfield notes, requires accommodation. However, when living with someone with OCD, “there’s a hole in the system and a nearly unlimited supply of accommodation to fill the hole…” Rather than helping, accommodation can provide fertile ground in which OCD can flourish. Thus, this section offers specific, detailed strategies to help divert this unending need for accommodation and provide support for dealing with their obsessions and compulsions. He goes into further detail in separate chapters focusing on various common issues with OCD families may encounter, such as repetitive checking, an incessant need for reassurance, and constant washing and cleaning.
The final section examines the perspectives of various family members dealing with a loved one with OCD. Whether you are the parent, partner, or sibling, Hershfield offers a series of dos, don’ts and observations about how to support both the individual affected with OCD and yourself. He also provides an overview of the treatment providers and treatment options to help the family negotiate the process with the affected person.
Overall, When a Family Member has OCD is packed with important information on living with and loving someone who struggles with obsessive compulsive disorder. OCD affects the entire family, but also the whole family can be involved in addressing it. As Hershfield eloquently writes, “When your family system comes together to battle OCD, the system will evolve: your family will grow closer, more cherished, and more reliable than ever.”
When a Family Member has OCD: Mindfulness & Cognitive Behavioral Skills to Help Families Affected by Obsessive-Compulsive Disorder
New Harbinger Publications, December 2015
Paperback, 200 pages