For Therapists

Tough Love, Let’s Talk About It

May 2, 2023

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As a therapist, my goal is to help my clients overcome their challenges and achieve their goals. Sometimes, this requires a “tough love” approach. Tough love involves being honest and direct with the client, even if it is uncomfortable or difficult. While it may seem harsh, tough love can be an effective tool in therapy, particularly when working with conditions such as OCD and anxiety.

One of the most effective therapies for OCD and anxiety is exposure and response prevention therapy. ERP involves gradually exposing the person to their fears or triggers in a controlled and supportive environment, while simultaneously resisting the urge to engage in compulsions or safety behaviors. ERP can be uncomfortable and even scary at times, but it is a highly effective treatment for these conditions.

How therapists can use tough love effectively

During ERP therapy, tough love can be used in several ways.

I see this happening most frequently when my clients are repeatedly asking for reassurance, especially after we’ve had conversations about the impacts of reassurance and how it makes the OCD cycle stronger. When other methods have not worked, such as basic psycho-education and soft redirection, it may be necessary to be a bit more firm about curbing this compulsion. 

Aiding in redirection as needed

Not only do I want to let them know that I won’t be participating in harmful rituals, but I want them to know that I’m willing to do the hard work in the moment in order for them to benefit later on. The hard work in the moment is resisting the compulsion and not telling them what they want to hear. The benefit later on is when they eventually beat OCD and no longer seek that initial reassurance.

Holding accountability and setting boundaries

The therapist can also set boundaries and hold the client accountable. People with OCD and anxiety often engage in avoidance behaviors or give in to their compulsions, which can perpetuate their symptoms. By setting clear expectations and consequences for these behaviors, the therapist can help the client take responsibility for their recovery.

Giving motivation and encouragement

Lastly, the therapist can provide motivation and encouragement. ERP can be challenging, and it is natural for the client to feel discouraged or overwhelmed at times. By offering support and positive feedback, the therapist can help the client stay motivated and focused on their goals.

It is important to note that tough love should always be used compassionately and with the client’s best interests in mind. The therapist should never belittle or shame the client, and should always be sensitive to their needs and emotions. Tough love is not about being mean or authoritarian, but rather about being honest and direct in a supportive and caring way.

Fostering compassion and trust during treatment

In addition to tough love, it is also important for the therapist to foster a strong therapeutic relationship with the client. Trust and rapport are essential for effective therapy, particularly when working with conditions such as OCD and anxiety. The therapist should be empathetic, non-judgmental, and attentive to the client’s needs and concerns.

Tough love can be an effective tool in therapy, particularly when working with conditions such as OCD and anxiety. By providing a reality check, the therapist can help the client overcome their challenges and achieve their goals. However, it’s important to use tough love compassionately and with the client’s best interests in mind to foster a strong therapeutic relationship.

This post is for informational purposes only and may not be the best fit for you and your personal situation. It shall not be construed as mental health or medical advice. The information and education provided here is not intended or implied to supplement or replace professional advice of your own professional mental health or medical treatment, advice, and/or diagnosis. Always check with your own physician or medical or mental health professional before trying or implementing any information read here.

© 2023 Jenna Overbaugh, LLC

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