Something that occurs in the majority of treatises and research papers on OCD, but that is not further explored, is the so-called waxing and waning of the disorder. In the same breath, writers note that it is a chronic disease with a bad prognosis, if left untreated (i.e. it can last a lifetime).
Patients know the awful feeling: in the course of a couple of weeks, it may seem that one needs somewhat less time to wash, or check, as in the preceding months. This is very uplifting. Mostly this occurs during a period in life in which things are going well, the job (if there is one) is satisfying, the kids are all right, and attention can be devoted to other issues than only the affliction – so that a person feels nicely tired at the end of the day, and sleeps relatively well.
This can be terribly deceiving, for the patient as well as the partner, and others in the inner circle. Suppose a letter arrives that announces major reconstruction work on the house or apartment in which one lives. Suppose one of the kids gets influenza. Suppose colleagues at work have started harrassing the patient again because of her/his peculiar tiny habits.
Chances are very, very high that OCD will return full-blast. Especially the feeling that the workers that will renovate the house form an ‘intrusive factor’ is utterly stressful. And stress is the devil here: it elicits another and probably long-lasting period of grave obsessions and compulsions.
Even worse: if all of the above conflict have been resolved, a new period of calm and relative peace of mind can again bring the false feeling that ‘this time is exceptional’, the hope that finally improvement is really on the horizon.
It is a sad conclusion, but this is how vicious and stealthy OCD can be. Only love and support can help people overcome the bad periods; admonishing, coaxing, or even emotional blackmail worsens the problems.