Reassuringly calm? Self-reported patterns of responses to reassurance seeking in obsessive compulsive disorder

• Although reassurance is a normal response, excessive reassurance seeking may maintain anxiety disorders.
• Reassurance seeking was found to involve anxiety relief in the short term, returning in the long term; the net effect may assist day to day coping.
• Reassurance may be best thought of as a super-check; that is, checking with an interpersonal boost.
• Telling people to stop offering reassurance to those with OCD is mostly pointless and likely to be counter-productive.

Background and objectivesThe perception of threat and associated feelings of anxiety typically prompt people to seek safety; reassurance seeking is an interpersonal strategy almost universally used to reduce the immediate perception of risk. Excessive Reassurance Seeking (ERS) is considered to be particularly prominent and unequivocally counter-productive in people suffering from anxiety disorders in general and OCD in particular, producing short term relief but a longer term return and worsening of the original anxiety. We evaluated the extent and specificity of the effects of ERS in OCD and mechanisms involved in both anxiety relief and the hypothesized later return of anxiety..MethodSelf rated effects of reassurance seeking were investigated in 153 individuals with OCD, 50 with panic disorder, and 52 healthy controls, evaluating reactions to the provision and non-provision of reassurance.ResultsReassurance is associated with short term relief then longer term return of both discomfort and the urge to seek further reassurance in both anxious groups; healthy controls do not experience significant resurgence. Greater return of anxiety and urge to seek more reassurance were associated with higher levels of overall reassurance seeking..LimitationsThe findings were based on retrospective self-report of naturally occurring episodes of ERS; prospective studies and induced behaviours are now needed.ConclusionsNot only is reassurance a quick fix for people experiencing OCD, but in the absence of treatment the only fix! The findings explain why reassurance seeking continues despite advice that it will worsen anxiety problems. Such advice is potentially harmful to patients and their loved ones..