We all seek reassurance from one another, particularly as children. For individuals living with obsessive-compulsive disorder (OCD) and body dysmorphic disorder (BDD), over worrying can be temporarily cured with positive affirmations and reassurance. When it comes to reassurance in OCD and BDD, Individuals with these disorders automatically seek reassurance from many sources including themselves, others, and the Internet. They will often go to extreme measures to seek out reassurance. Whether it is looking in the mirror to ensure that your nose is not crooked, checking the locks over and over, making sure your hands are clean or searching for compliments to ensure that you have not gained any weight; positive affirmations and reassurance are unhealthy and can feed the disease. By asking a friend or loved one for reassurance, you may feel a brief sense of relief: “the oven is off,” and “your hands are clean.” However, this relief is short-lived and quickly replaced by an overwhelming demand for subsequent reassurance. For individuals with OCD and BDD, reassurance and appearance-related compliments are likely to result in internal and interpersonal turmoil, even if they might produce a temporary reduction in anxiety.
Body dysmorphic disorder and reassurance
Reassurance sought by those with body dysmorphic disorder (BDD) usually revolves around appearance concerns. For example, adolescents with BDD may constantly ask their parents if “[my] nose is too big” or they may take photos to inspect themselves. Like in OCD, these quests for reassurance may do more harm than good. A brief “you look great/fine” to an individual suffering from BDD may yield unintended consequences.
Individuals with BDD have misconceived beliefs regarding their body and the most common body parts for both men and women to have false misconceptions about their skin, hair, and nose. Others include eyes, teeth, chin, legs, lips, and height. Individuals with body dysmorphic disorder often portray the following behaviors:
• Ritualistic behaviors to confirm their physical “defect.” This can include constant checking in the mirror, touching that specific area of the body or actively avoiding the “defects” recognition by others by covering that area of the body up with clothing, makeup or tattoos.
• The constant need for constant reassurance from others
• An enormous amount of time (1 hour or more, sometimes as much as 8 hours) daily on thoughts and behaviors relating to the “defect”
• Repeated visits to dermatologists or cosmetic surgeons for correction of this “defect”
Many individuals with BDD have a difficult time and may even become upset by compliments. They may interpret compliments as a joke, overanalyze the compliment or believe that “they’re just saying it because they are my friend/mom”. As a result, these compliments are no longer reassuring but are agonizing and feeding the disorder.
Obsessive-compulsive disorder and reassurance
Obsessive-compulsive disorder can be so debilitating that it affects an individual’s daily activities. A person with OCD may cook a meal but is not able to enjoy it because they are so pre-occupied with checking the stove to see if it is still on. Additionally, going out in public can cause extreme distress, as the individual may be obsessed with wondering if they locked their house or car door. The constant repetitive maladaptive thoughts can create havoc within personal relationships and although the compulsions are meant to relieve stress these actions can also cause much distress for the individual and their loved ones. Checking a stove, counting, repeating a task over and over, asking someone the same question are all forms of reassurance and individuals with OCD need reassurance to prevent their obsessive thoughts from being carried out into compulsive actions. The compulsion to “just make sure everything’s okay” usually reinforces the worry or obsession and the vicious cycle of worrying and reassurance repeats itself. In other words, the need for reassurance is an obsession within itself and only feeds the disease. Although reassurance seeking can be a challenge for all involved, it can be overcome. Appropriate psychoeducation and therapy (CBT) can help sufferers learn skills to decrease reassurance seeking gradually. Friends and family members can also learn steps to help refrain from offering reassurance.