Virginia Ironside's Dilemmas: What can I do about my wife's obsessive-compulsive disorder?

Dear Virginia, My wife suffers from a form of obsessive-compulsive disorder and our house is filled with old newspapers, bags of shopping, old food cartons, boxes and rubbish. I and my two teenage sons have had to move next door as there's no room to eat or sleep. The children are happy and balanced – there's no lack of love. A doctor has said that without help, which she refuses, she'll never get better. What can I do?, Yours sincerely, Rodney

I'm constantly amazed by the feebleness of partners entwined with people who drink, gamble, take drugs or behave in some completely unacceptable way. Why do I feel so strongly? Well, of course, it's because for years I have put myself in exactly the same wet position with partners who've behaved appallingly, and now look back on my weedy behaviour with amazement and horror.

Why did I never say: "This must stop!"? Why did I never walk away? Why did I never use the huge power I knew I possessed? Why did I, like some country with an enormous army at its disposal, refuse to employ it and let some other, weaker country, overrun me? It was all because of a complete lack of nerve.

All you have to say to your wife, Rodney, is: "I refuse to live like this. This is my house as much as yours, and instead of moving next door, overwhelmed by your sickness and your rubbish, I'm going to reclaim my territory. Living like this is not good for you, me or our children." Then you should get in and clear out a number of rooms – enough for you and your sons to be able to live in, tidily and happily. If your wife wishes to keep a room or so to fill with clutter, that's her right. But she has no right to dominate the place with her illness.

Next, I think you should put your foot down about your marriage. You should say: "I can't live with you as you are. I want to divorce you. However, there is one chance you have of avoiding this route – a route which would make me and the boys very unhappy – and that's to seek help."

You mustn't say that she needs to do any more than this. She doesn't have to give up her obsessive habits. She doesn't have to get well. All she has to do is to make an appointment with a doctor or therapist and discuss the situation. She doesn't have to overcome her problem. She just has to try to overcome it. That, quite honestly, is not asking a hell of a lot.

You must ask yourself whether you're actually behaving kindly by allowing this situation to continue. What example are you setting the children by caving in to behaviour that is destructive and bonkers? What are you doing to yourself and your own self-respect by allowing your wife to take over with behaviour that everyone knows is completely potty? And how kind are you being to your poor wife by kowtowing to her obsessive compulsion rather than standing up to it and telling it to go away?

I bet you wouldn't like it if you went totally crackers and your wife just stood by humming good-naturedly and doing nothing. You'd want her to help you.

In this scenario you are, Rodney, actually part of the problem. You must stand outside and be the one person to behave, with good nature and good humour, in a perfectly normal, adult way. And insist – not ask, but insist – that your wife get some kind of help.

Readers say

Acceptance is key

Yes, obsessive-compulsive disorder (OCD) can be successfully treated with input from an experienced psychologist, although some modern anti-depressants can reduce the anxiety that OCD can generate. Unfortunately, both courses of action require an acceptance from the sufferer that there is indeed a problem to be solved and a voluntary wish to engage in such help.

Despite her family moving out, your wife has not seen the consequences of her actions and it may be that more ominous boundaries need to be explored before the enormity of her actions on those around her are recognised.

You need to realise that while you try to keep things together, your wife won't see the need to change. Contact a carers' support organisation. Those offered by the Rethink charity or via the Mind organisation are excellent.

Stan Broadwell, Community Psychiatric Nurse, Yate Community Mental Health Team, South Gloucestershire

Help is out there

As an OCD sufferer for over 40 years and a "veteran" of many therapies, I say that a mixture of medication and cognitive behavioural therapy (CBT) is the only way forward. Somehow, your wife needs to move towards agreeing to this.

I suggest she tries to spot examples of other people displaying OCD-type behaviours. There's a kind of epidemic out there of checking, hoarding, counting, tidying, making "safe". Her illness is a more extreme version of a common modern malady. Luckily, there are practitioners out there who will help her to let go of her controlling behaviours and compulsions. But a word of warning about your sons: there is a strong genetic link in OCD, so watch out for warning signs and symptoms.

Andrew Colley, Halstead, Essex

Tough love needed

The availability of a second home next door has allowed Rodney to flee from the problem.

He must take the tough love approach and deliver an ultimatum: seek help or the marriage is over. Only a decisive move will bring about any change in the situation.

Mike Hockney, Newcastle upon Tyne

Clear the rubbish

If your wife refuses help then don't force her. But why not start taking charge of your own life and making room for yourself to move back in? If your wife insists on bringing in rubbish then keep removing it until she realises that you won't put up with the situation any longer.

Start behaving like a man instead of a mouse and it could well force your wife to admit that this is no way to live.

Claire Jones, Leicester

Do your duty

I know from professional experience that OCD is a difficult condition to cure. The patient is unable to shake the belief that something terrible will happen if they stop. Don't expect an immediate agreement to treatment. But it is your duty to keep trying.

Choose times when you are both relaxed to talk to her about the way you live, so that she can see the consequences in perspective. Treatment will only have a chance to work if your wife is completely willing to undergo it.

Cole Davis, London NW2