How to help your loved one who has anxiety.
Anxiety disorders can deeply impact not only individuals but also their families. Parents, siblings, or partners often find themselves adjusting their behaviors to reduce the anxiety of their loved ones. This phenomenon, known as family accommodation, can inadvertently maintain or even worsen anxiety over time. Understanding and addressing family accommodation is particularly important when using Exposure and Response Prevention (ERP), a gold-standard treatment for anxiety disorders such as Obsessive-Compulsive Disorder (OCD).
What Is Family Accommodation?
Family accommodation refers to the ways in which family members adapt their behaviors in response to an individual’s anxiety. This can include:
Reassurance-seeking: Constantly answering questions to alleviate worry.
Modifying daily routines: Avoiding certain activities or places to prevent triggers.
Participating in rituals: Helping with or completing compulsions.
While well-intentioned, these behaviors can reinforce the anxiety by validating the idea that the feared situations or thoughts are dangerous or intolerable.
How ERP Addresses Anxiety
ERP works by gradually exposing individuals to anxiety-provoking situations (exposures) without engaging in their typical responses (rituals or avoidance). Over time, this helps the individual learn that their fears are either unfounded or manageable, reducing the intensity of the anxiety.
However, if family members continue to accommodate the anxiety, it can undermine the effectiveness of ERP. For example, if a family member avoids triggering topics or helps with compulsions, the individual misses opportunities to practice managing their anxiety independently.
Reducing Family Accommodation During ERP
Educating the Family: A crucial first step is helping family members understand how accommodation perpetuates anxiety. Therapists can provide psychoeducation about ERP and the role families play in treatment.
Setting Boundaries: Families can learn to set compassionate yet firm boundaries. For example, instead of providing reassurance, they might say, “I know this is hard, but you’re working on managing your anxiety, and I believe you can handle this.”
Active Participation in ERP: In some cases, family members may join therapy sessions to learn how to support exposures without accommodating. This can involve helping with exposure tasks or learning to tolerate their own discomfort when not stepping in.
Gradual Changes: Reducing accommodation doesn’t have to happen overnight. A gradual approach ensures that family members and the individual with anxiety feel supported throughout the process.
Challenges Families Face
It's important to acknowledge that reducing accommodation is not easy. Families may fear being perceived as unkind or worry about worsening their loved one’s anxiety. Therapists can play a vital role in validating these concerns while emphasizing the long-term benefits of breaking the cycle of accommodation.
Benefits of Addressing Family Accommodation
When families work alongside the individual with anxiety, they foster independence, resilience, and a sense of control over the disorder. Over time, this collaborative approach enhances the effectiveness of ERP and improves the well-being of the entire family.
Final Thoughts
Family accommodation is a natural and compassionate response to a loved one’s distress, but it often reinforces anxiety. By addressing these patterns within the context of ERP, families can become powerful allies in the journey toward recovery. If you or someone you know is navigating anxiety treatment, consider seeking professional guidance to incorporate family-based strategies into the therapeutic process.
Looking for support?
If you or your family are struggling with anxiety disorders, reach out to me or another qualified therapist to learn more about how ERP can help. Together, you can create a supportive environment that fosters growth and healing.
