When Parents Stop Recognising Themselves in OCD Work

Whenever I find myself working with an adolescent and their family where OCD has begun to take hold, there is a point in the work that arrives with a certain predictability. A parent, often after a period of careful listening and reflection, will ask what they should actually do. By then they usually understand the reassurance seeking cycle. They can see how they’ve been drawn into it, how their responses, given with care, have also been maintaining something that no one really wants to maintain. And so the question carries weight. If we know this is part of the problem, why not just stop.

A part of me understands the pull of that completely. There is a logic to it. If the rituals are being supported, withdraw the support. If the reassurance is feeding the anxiety, remove it. Clean, decisive, even a little appealing in its clarity. And yet I find myself hesitating, not out of uncertainty about the model, but because the moment of change is rarely as neutral as it sounds when described in theory.

I remember a young person who came back after their parents had, with the best of intentions, begun to reduce their accommodation following a conversation we had. It was not done harshly. It was thoughtful, measured, in line with what we might ordinarily suggest. But something shifted rather quickly. The child did not speak about anxiety increasing, at least not in the way one might expect. What they spoke about was their parents. Or rather, the sense that they no longer quite recognised them. There was something in the tone, the stance, a kind of firmness that felt unfamiliar. It was as though, overnight, the parents had taken on a different character, one that was harder to locate emotionally.

It reminded me, in an odd way, of the usual adolescent process in reverse. We often hear parents describe the experience of their child as suddenly different, at times distant or opaque, then briefly returning to themselves before shifting again. Here, it was the child describing that experience of the parents. Not as a complaint, exactly, more as a quiet disorientation. The people who had felt known now felt altered, and that altered quality seemed to matter as much as, if not more than, the reduction in the rituals themselves.

Since then, I have found it harder to think about accommodation purely in behavioural terms. Of course it plays a role in maintaining the cycle. That remains true. But it also sits within a relationship that the young person is using to organise something more difficult to hold on their own. When that relationship changes too abruptly, the loss is not only of reassurance. It is a loss of a particular way of knowing and feeling the other.

That does not mean we should avoid change. Avoidance has its own consequences, and prolonged accommodation often tightens the very pattern we are trying to loosen. But it has led me to think more carefully about the pace and the manner of that change. Not as a technique to be applied, but as something that needs to be negotiated within the relationship itself.

In practice this can look deceptively simple. A parent might say, today I will not go all the way with you on this, I will step back just a little. Not a refusal that arrives all at once, but a small shift that both can notice. And then, crucially, an attention to what that shift does. How it feels for the young person. What it stirs in the parent. Whether something between them becomes strained, distant, or perhaps, at times, unexpectedly more open. The movement is gradual, but it is not passive. It is deliberate, observed, thought about together.

I am aware there are clinicians who would take a more direct route, and there are situations where that may well be effective. But my experience has been that the more enduring changes tend to come when parents are able to stay recognisable to their child even as they begin to do something different. Where the reduction in accommodation does not arrive as a kind of character shift, but as something that can be felt, questioned, even resisted, without the relationship itself feeling lost.

So the question has shifted for me over time. Less about whether to stop accommodating, and more about how to do so in a way that the young person can bear. Something slower than instinct might dictate, but not so slow that nothing changes. A kind of careful dismantling, where what is being let go of is held in mind as it is being reduced, rather than dropped all at once and left for the adolescent to make sense of on their own.