Being Kind vs Nice: Symptom Accommodation in OCD
Mia held her teddy bear and squeezed as her mom, Jen, began tucking her in for bed one night. At 9 years old, Mia was already beginning to show some perfectionistic tendencies, primarily related to wanting to be a “good girl.” On this night, she told her mom, “My room’s too messy.” She didn’t think she could relax and fall asleep until she picked up the clothes that were still left on the floor from earlier in the day. Mia wanted to tidy up her room before trying to fall asleep.
At this crossroads, Jen had to make a decision to support her daughter. She could help Mia tidy up the room so she could relax and fall asleep, or she could show Mia that it’s ok for things to be a little messy. Jen stood up from Mia’s bed and made her way to the dresser. Jen pulled several items of clothing out from the dresser and tossed them so they were strewn about the room. She then went back to sit at the side of Mia’s bed and told her, “It’s ok that your room is messy. We don’t have to be tidied up all the time. See? It’s not so bad. I know you can still fall asleep.” Jen stayed with Mia until she drifted off. Mia never had the same issue again.
When Removing Discomfort Isn't the Answer
When a loved one is suffering, there is a strong impulse to do anything to comfort them and make them feel better. This impulse is a beautiful part of how humans relate to and care for each other. Often, the simplest solution is to simply remove the cause of the suffering. Many loving parents, in Jen’s position, would have tidied the room up for Mia. It would have made Mia immediately feel more relaxed. In many situations, finding the quickest and simplest solution for removing discomfort is wise. If Mia came to Jen with a splinter, the best way to help Mia is to carefully remove the splinter. However, when it comes to treatment for OCD and anxiety disorders, removing the trigger actually makes symptoms worse in the long run.
If Jen had cleaned up Mia’s room, Mia would have felt relieved that night. But what would Mia have learned? She wouldn’t learn that she can have a messy room and still be ok. Instead, this action would have reinforced the idea that her room should always be neat. It would make it more difficult to challenge this when the situation comes up again.
Nice vs Kind: What’s the Distinction?
In the Midwest, where I live, there is a strong cultural value placed on being “nice.” Folks here will go out of their way to be friendly, polite, and accommodating. On the flip side, this can mean avoiding conflict and difficult emotions. Don’t get me wrong, I prefer to be nice. It feels good to hold the door open for others and to smile and greet the barista before ordering my coffee. But there are times that “nice” gets in the way of being “kind.” Kindness is prioritizing what someone needs over what is wanted. It’s having difficult conversations with your partner about their persistent requests for reassurance. It’s feeling uncomfortable that your child is in emotional pain, but letting them feel and work through it so that they can live a fuller life.
Being nice looks like:
Doing what someone wants in the moment
Avoiding distress, conflict, or hard emotions
Providing reassurance, helping with rituals, and accommodating avoidance
Short-term relief
Long-term worsening of their symptoms and dependence on others
Prioritizing short-term relief over long-term growth
Being kind looks like:
Doing what someone needs to get better
Allowing distress without rushing to remove it
Declining to give reassurance, challenging them, and refusing to participate in rituals
Short-term distress or conflict
Long-term healing, growth, and independence
Prioritizing overall well-being and health over short-term comfort
What is Symptom Accommodation?
Symptom accommodation refers to making it easier for someone to engage in behaviors that are consistent with obsessive-compulsive symptoms.
For OCD, symptom accommodation may involve:
Giving reassurance (e.g., “you are a good person,” “The oven is off,” “Nothing bad will happen”)
Changing your schedule around to accommodate a loved one’s completion of compulsions
Purchasing supplies needed to complete compulsions (e.g., excessive amounts of soap, additional locks, or security cameras)
Taking on responsibilities that they are not willing to complete because of their OCD (e.g., one parent always changing their baby’s diaper because the other has OCD, or a parent bathing their child even though the child is capable of bathing themself)
Directly participating in a loved one’s compulsions (e.g., checking the locks or washing your own hands at the loved one’s request)
Helping the loved one to avoid feared triggers or protecting them from the consequences of their own avoidance
Symptom accommodation is frequently revealed during OCD treatment. It is a very common issue and, unfortunately, involves being “nice” over being “kind.” This is because accommodation serves the same function as compulsions: It provides immediate relief from anxiety, which reinforces the patient in asking for more symptom accommodation and feeds the OCD.
Additionally, more accommodation is demanded over time, leading to decreases in functioning and worsening OCD symptoms. The graphic to the left illustrates the family accommodation cycle.
What Does Research Say About Symptom Accommodation?
Research on symptom accommodation for OCD and anxiety has shown that more symptom accommodation is associated with higher OCD symptom severity, worse treatment outcomes, more family dysfunction, and higher family stress:
In one study focused on individuals in intensive/residential treatment for OCD, it was found that increased family accommodation of symptoms was followed by increases in OCD symptom severity after discharge:
Reducing symptom accommodation is so important to treatment, especially for children, that an entire treatment program was created to treat OCD in children by training parents to reduce accommodation:
How to Support Without Accommodating OCD
There are lots of ways to respond with compassion without accommodating symptoms. At Leap Counseling, I reinforce validation as an important skill to learn. We can always validate how a person is feeling without trying to fix it.
Validating statements include:
“I can tell this is very tough for you”
“That sounds really scary”
Remind your loved one that you are there to support them, and you are not willing to feed their OCD:
“I am going to support you, not your OCD.”
“You know my answer - I’m not going to repeat it because it feeds the OCD”
Encourage your loved one to think about what they are asking and why:
“Is this something you want, or something your OCD wants?”
“Is this going to feed your OCD if I do this for you?”
Help your loved one lean into the uncertainty if they ask for reassurance:
“Maybe, maybe not”
“It’s impossible to know the future”
Instill confidence about their ability to get through it:
“I know you’re scared, and I know you can handle this”
“I believe in you”
Redirect to a different topic:
“Let’s talk about something else.”
What Not to Do:
It’s common and understandable to feel frustrated with a loved one who has OCD. It’s important to be mindful of how we react and to remember that they are sick and they are very scared. When people let their frustration get the best of them, it can lead to shame and greater emotional pain for the loved one with OCD. There are some things that people may do that are unhelpful for people with OCD.
Don’t:
Compare them to other people or to how they were before OCD
Don’t imply that the person can “just stop”
Tell them they are a burden
Only talk about OCD or treatment with them
Encouraging Words From an Online OCD Therapist in Wauwatosa
Even though it can feel mean or callous to deny someone in a high emotional state, it is an incredibly important and kind action that we can take to support our loved ones. When we accommodate our loved ones’ symptoms, we are denying them the opportunity to learn from their experiences and are actively contributing to their symptoms. We may also be fragilizing them, and communicating to them with our behavior that they cannot handle feeling anxious, which is a belief their anxiety is already trying to tell them. As an OCD therapist, I want to remind you: Humans can handle strong emotions, ride them out, and see them through to the other side.
Further information:
If you want to learn more, use the following resources:
https://www.melbournewellbeinggroup.com.au/the-wellbeing-blog/family-accommodation-in-ocd
https://www.justinkhughes.com/jog/family-accommodation-in-ocd/
Discover Supportive Boundaries Learned in Online OCD Treatment in Wauwatosa, WI
When OCD affects daily life, loved ones often step in to help—but accommodating symptoms can unintentionally keep anxiety and compulsions going. OCD therapy can help you and your support system learn when kindness means setting limits, so everyone can move toward lasting relief rather than short-term reassurance.
Leap Counseling and Consultation is a Wisconsin-based solo therapy practice led by Dr. Johanna Wood, who specializes in OCD and anxiety disorders. Using personalized, evidence-based treatment, Dr. Wood helps clients and families understand symptom accommodation and develop healthier responses that support recovery. Taking the first step toward change is simple:
Get in touch today to schedule a free 15-minute consultation
Meet one-on-one with an experienced OCD therapist in Wauwatosa
Begin learning how to reduce accommodation and face fears with support
Other Services With Leap Counseling in Wauwatosa, WI, and Beyond
OCD can affect not only your thoughts and behaviors, but also your relationships and sense of independence. Through effective OCD therapy, many people learn how to reduce anxiety, step out of reassurance-seeking patterns, and build confidence in handling discomfort without relying on others.
While treating OCD is a primary focus of my Wisconsin-based online therapy practice, it is not the only area where support is available. Anxiety often overlaps with OCD symptoms in different ways. As a licensed online therapist serving Wisconsin and all PSYPACT states, I also work with individuals experiencing Panic Disorder, Agoraphobia, Generalized Anxiety Disorder, Social Anxiety Disorder, and specific Phobias.
Wherever you are in your journey, compassionate, evidence-based therapy can help you move forward. I invite you to explore my mental health blog to learn more about OCD, anxiety, and treatment approaches. And when you’re ready, reach out to schedule an appointment and take a meaningful step toward relief and greater independence.
About the Author
Dr. Johanna Wood is a Wisconsin-based clinical psychologist who helps individuals and families better understand OCD and reduce patterns that unintentionally keep symptoms going, using evidence-based therapy such as Exposure and Response Prevention (ERP). Having personally experienced the anxiety loop of relationship OCD, she understands how reassurance seeking and accommodation can feel helpful in the moment while reinforcing fear over time. Her own ERP work reframed exposures as intentional “leaps of faith,” a perspective that now guides how she supports clients in responding to uncertainty with kindness rather than compulsive avoidance. Dr. Wood earned her PhD in Clinical Psychology from Northern Illinois University, completed her doctoral internship at Rogers Behavioral Health’s OCD and Anxiety Adult Residential Program, has supervised clinical staff in residential treatment settings, is licensed in Wisconsin with PSYPACT authorization, and remains actively involved with the International OCD Foundation through education and advocacy.
