Accommodation Fatigue: Do You Relate?

This post is written for the family members, partners, and friends of individuals living with severe anxiety disorders and OCD.

If this is you, you have likely witnessed the immense suffering of someone you deeply love. Anxiety and OCD can slowly shape a person into someone almost unrecognizable. Watching this transformation is heartbreaking. And at some point, it’s natural to find yourself wondering: How did this happen?

What Are Accommodations?

Accommodations are behaviors that others engage in to prevent or reduce the anxiety a person with OCD or an anxiety disorder experiences. These behaviors are most often carried out by caregivers, partners, and family members—but even counselors and therapists can unintentionally accommodate.

Accommodations almost always begin with good intentions.
And almost always end the same way: increased dependency and more anxiety.

You may watch your loved one engage in repetitive behaviors, striving to achieve the same outcome over and over again…tying their shoe, opening the door, turning off the stove. You notice their growing doubt about whether they did it “just right.” Concerned, you step in. You offer reassurance. You complete the task for them. You provide a solution.

And instead of relief, the anxiety intensifies.

Or perhaps you’ve become the primary reassurance provider, the protector. When you see your loved one exhausted, overwhelmed, or emotionally distressed, you feel responsible. You work tirelessly to reduce their discomfort: repeating comforting phrases, lowering expectations, lightening their load, and sometimes sacrificing your own activities, enjoyment, or career to keep the distress at bay.

The Cost of Accommodating

I want to pause here to say this clearly: your response makes sense.

Over time—just like your loved one—you begin to feel the exhaustion set in. Not only have they lost pieces of their identity to anxiety, but you may feel the same happening to you. Your patience wears thin. You find yourself reacting in ways that don’t align with who you are. You swing between over-accommodating and deep frustration—sometimes even refusing to do any more at all.

Tension builds. The relationship begins to fracture. You feel lost and unsure how to help.

What’s happening is something we call a parallel process.

Just as your loved one is engaging in repetitive behaviors to achieve a sense of safety or certainty, you are doing the same; trying again and again to relieve their distress. And the outcome mirrors theirs: more anxiety, more fatigue, and a shrinking life.

Months—or even years—later, you may find yourself wondering:
How did I get here? And is there a way out—for them, and for me?

There Is Hope

The purpose of this post is to normalize, validate, and instill hope.

Accommodations play a significant role in maintaining anxiety, which is why there are evidence-based treatments specifically designed to address them. One such approach focuses on helping parents and caregivers change their responses—without requiring the anxious individual to participate directly in treatment. See (Supportive Parenting for Anxious Childhood Emotions SPACE) for helpful resources and information.

The goal is not to be cold or withholding.
The goal is to be supportive without reinforcing anxiety.

A Few Considerations as You Begin

You are not a bad parent, partner, or support person.
Doing the “right” thing often doesn’t feel right. That discomfort is frequently where people get stuck. How do you know if you’re actually helping?

Here are a few guiding principles:

Respond with empathy first

When anxiety is activated, logic isn’t accessible. The brain is responding as if there is a massive threat—whether or not one exists. Problem-solving, reasoning, or teaching in these moments often backfires. Empathy helps regulate before anything else can happen.

Avoid removing all accommodations at once

Accommodations didn’t develop overnight, and removing them abruptly can be overwhelming. Gradual change is key. Consulting with a trained professional can help you develop a thoughtful, sustainable plan.

Compassion doesn’t mean compliance

You don’t have to agree to new accommodations—but you can respond with curiosity and care. For example:

“I worry that answering this question repeatedly feeds your anxiety. I’m going to pause before responding because I believe you are capable of handling the feelings that come up.”

This approach communicates belief in their resilience rather than fear of their discomfort.

You Don’t Have to Do This Alone

In addition to working directly with individuals struggling with OCD and anxiety, I also support families and partners in navigating the accommodation reduction process. Ideally, this work is collaborative and aligned with the individual’s treatment—but in some cases, support for family members must happen separately when participation is limited or progress feels stalled.

Change is possible—for your loved one and for you.

New Year, New You? Why Every New Day Is an Opportunity for Change

I love goals.

I love data, tracking progress, and noticing patterns…what works, what doesn’t, and what gets in the way. I’m sure my family grows tired of my frequent check-ins about what they want to work on week to week. But when goals are measurable and intentional, they give us something incredibly valuable: information.

The key, though, is how we respond to that information. Growth happens when we approach our shortcomings with curiosity and compassion—not guilt, judgment, or shame.

The Pressure of New Year’s Resolutions

This time of year, many of us set New Year’s resolutions. We’ve been thinking about them for weeks, maybe months, and January 1st arrives with the promise of change.

Dry January.
Eating healthier.
Working out more.
Being more productive.

The list goes on.

I have nothing against New Year’s resolutions—I’ve fallen for their appeal many times myself. The new year does offer a sense of reset, a symbolic clean slate where past missteps feel neatly tucked away.

But with that reset often comes pressure.

When we’ve been anticipating “the big change” for months, the weight of expectation can become heavy. Sometimes guilt and pressure keep us moving forward—but at what point do they become so costly that we give up altogether?

Why Wait for the “Perfect” Time?

My argument is simple: why wait for the new year?

Our culture often reinforces the idea that if we don’t follow through on our resolutions, we’ve failed. And when that happens, it’s easy to tell ourselves, “There’s always next year.”

This mindset quietly teaches us to wait for the perfect moment to begin working on ourselves.

But that perfect moment doesn’t exist.

Anxiety thrives on conditions. It tells us we can cope if everything lines up just right…if the weather is good, if we’re having a “good” day, if work is going smoothly.

And when those conditions inevitably change, anxiety steps in and convinces us we can’t handle it.

So we wait. Again.

But growth doesn’t happen when discomfort disappears. It happens when we move through it.

Empowerment Comes From Action

I often tell clients this: when we make choices and change behaviors that go against anxiety’s pull—for the sake of our mental health and overall well-being—the empowerment that follows is invaluable.

External validation may feel good, but nothing compares to the internal experience of doing something difficult and realizing, I handled that.

Seek out that feeling of empowerment.

It may be small or it may feel significant—but these internal rewards are available to us daily, regardless of the time of year.

Aligning Goals With Values

So how do we begin?

Start with values.

How did you choose your New Year’s resolutions? Were they intentionally connected to what matters most to you—or influenced by the season and the flood of social media messaging?

Recently, I completed a values sort exercise. I’ll be honest, it was time-consuming and frustrating. At first, I rushed through it, hoping for clarity or an “answer.” But what I realized was that the process itself was the work.

There was no dopamine hit, just reflection, slowing down, and noticing what truly matters.

Some questions that came up for me:

• Am I a bad person for prioritizing one value over another?

• Will some values change over time while others remain constant?

• Is there a desire to strengthen one value right now?

• Are my actions aligned with my values? If not, what small steps could help?

If you’re interested in exploring this, I recommend engaging in a values sort every few months:
https://learning-tools.thegoodproject.org/value-sort

Turning Values Into Action

Anxiety often interferes with our values, pulling us toward avoidance and short-term relief rather than long-term meaning.

One helpful tool is a goal attainment scale:

• Identify a value

• Name actions that reflect alignment with that value

• Describe what full alignment would look like

• Notice where you are currently

• Consider what drifting away from that value might look like

This isn’t about perfection—it’s about awareness and direction.

A Gentle Challenge

I challenge you to go after your goals on the imperfect day.

When you take steps forward despite discomfort or uncertainty, you’re training your brain to become more flexible. You’re building resilience. And you’re cultivating a sense of empowerment that no calendar date can provide.

Ready for Support?

You don’t need a new year to begin—just a willingness to take one imperfect step.

If anxiety has been getting in the way of following through on your values or goals, therapy can help you practice moving forward with intention and self-compassion. Feel free to contact me to schedule a consultation and learn more.

’Tis the Season for… Skin Picking! Why BFRBs Flare in Winter & What You Can Do About It

As I was talking to my cousin during our Thanksgiving gathering—discussing anxiety and all our little maladaptive habits—I looked down and caught myself in the act. My right hand was fidgeting with the scaly fingertips and rough cuticles on my left hand, picking at loose bits of dry skin.

Some of you might read that and think, GROSS, why are you sharing this?
Others—perhaps most—are nodding in solidarity, mildly “triggered,” recognizing your own urge to pick just from the description.

Why Skin Picking Gets Worse in Winter

When the seasons shift and colder temperatures roll in, the humidity drops—and our skin dries out. For people who struggle with skin picking (Excoriation Disorder) or other Body-Focused Repetitive Behaviors (BFRBs), this dryness becomes the perfect storm. Loose skin, hangnails, rough patches—all of it raises the volume on sensations that your brain already finds difficult to ignore.

Personally, I’ve made great progress this past year using harm reduction strategies to reduce my picking. But when winter hit? My hands practically begged me to “fix” the imperfections. And that’s exactly how the cycle starts.

Understanding Skin Picking (Excoriation Disorder)

Skin picking is complex, and multiple factors can reinforce the behavior. When I reflect on my own experience, I’ve noticed two major themes:

1. The Urge to “Fix” Imperfections

I pick when I notice rough patches, peeling skin, or uneven cuticles. My brain labels these as flaws that need immediate correction—as if I’m performing self-grooming. It doesn’t consider the long-term consequences (bloody cuticles, pain, or even missing nails). What it does consider is instant gratification—the feeling of fixing something right now.

2. Picking as Self-Soothing

People often pick more when they’re overstimulated (stress, noise, emotions) or understimulated (boredom, downtime). Skin picking becomes a regulating behavior—something familiar, repetitive, relieving.

When I think back to childhood, the pattern is clear: picking fuzz off a blanket, sucking my thumb and gnawing on my nails - classic self soothing.

You Are Not Helpless—Winter Doesn’t Get to Win

Dry weather might increase temptation, but it doesn’t dictate your behavior. Here are strategies—both blocking and replacement behaviors—that can help you manage urges during peak picking season.

Helpful Strategies to Reduce Skin Picking

1. Blocking Behaviors

Blocking strategies physically interrupt access to the areas you tend to pick. Winter actually makes these easier to implement:

Wear Gloves

• Great for finger and cuticle pickers

• Useful during driving, boredom, or stressful commutes

• Bonus: winter gloves don’t look out of place

Use Hats or Beanies

For scalp pickers or hair pullers (trichotillomania), covering the area reduces opportunity and increases awareness.

Moisturize—Strategically

I lotion up for two reasons:

1. Softer skin = fewer loose edges to pick

2. Oily fingers = harder to grip anything you want to pick

A thick barrier cream works wonders in the winter months.

Nail Polish or Gel Coatings

Instead of picking your skin, you end up picking the polish—far less harm done.

Aversion Techniques

If you’re a biter, a spicy or bitter-tasting barrier (thanks, Mom) can interrupt habitual chewing or picking.

Why blocking works:
It forces an extra step between the urge and the action, which builds awareness. Most people don’t even realize they’re picking until they’re already doing it.

2. Replacement Behaviors (My Favorite Strategy)

Replacement behaviors do not fully satisfy the picking urge—but they channel the urge into something safer.

My go-to: small magnetic balls.

The key isn’t just rolling them around—it’s creating something with them. Structures, patterns, shapes. Giving the fidget purpose. That mild sense of completion makes them almost (almost!) as satisfying as picking.

Other options:

• Textured fidgets

• Putty or therapy dough

• Smooth stones or worry stones

• A silicone popper

• Clay or molding wax

The goal is redirecting sensory input while lowering harm.

Final Thoughts: Awareness, Practice & Self-Compassion

Managing BFRBs like skin picking requires awareness, patience, and consistent practice. Setbacks happen—especially in the winter—but progress is absolutely possible. I’ve seen it in my clients, and I’ve lived it myself.

If you struggle with skin picking, excoriation disorder, or other BFRBs, you’re not alone—and you don’t have to navigate it by yourself.

Contact me or schedule an appointment if you want support building healthier coping strategies.

Avoidance Blockers: Breaking the Cycle of Avoidant Behaviors

We avoid things for a reason. Sometimes we’re trying to escape uncomfortable emotions — boredom, anxiety, fear, pain, sadness. Other times we choose avoidance because something else feels more enjoyable, exciting, or soothing. Avoidance can temporarily relieve discomfort or give us a quick dopamine hit, making it feel like a smart idea in the moment.

But avoidance always comes at a cost.

A Personal Example

I grew up in Texas — hot, humid, sunny Texas — where rain meant a quick thunderstorm followed by more sunshine. When I moved to the Pacific Northwest in the summer of 2015, it felt like paradise. Cool temperatures, blue skies, and endless opportunities for biking, hiking, and weekend adventures.

Then November arrived.

The rain started, the temperatures hovered around 45°F, and my instinctive “Texas response” kicked in: wait it out. Surely it would pass in a week or two.

So I stopped riding my bike to work.
I stopped going on hikes.
I waited… and waited… and waited.

It didn’t stop raining until July.

What was I avoiding?

Primarily, the physical discomfort of being cold and wet.

What was the cost?

I drifted away from my values — being outdoors, being adventurous, exercising, connecting with nature. My mood worsened. I felt resentful toward the PNW and its “tricky” weather.

And beneath that, there was a more subtle layer of avoidance: I was anxious at the time, and sleeping in helped me avoid facing my worries. Riding my bike required waking up earlier, which meant more time alone with my thoughts. Driving my car was easier. Canceling plans was easier. Constantly checking the weather to find the “perfect” day was easier.

I became clever at avoiding discomfort…
but not any happier. Just exhausted.

Why Avoidance Makes Anxiety Worse

If you live with OCD or an anxiety disorder, you already know how tempting avoidance is. It offers quick relief in the short term, which strengthens the habit and reduces your tolerance for discomfort in the long run.

This is why simply telling ourselves to “stop avoiding” usually doesn’t work. Avoidance is a well-practiced behavior pattern, not a character flaw.

To break it, we need to understand it — and then block it.

How Do We Overcome Avoidance?

1. Understand the function of your avoidance.

What emotion are you trying to escape?
Anxiety? Boredom? Fear? Shame? Physical discomfort? A sense of incompetence?

2. Explore how the avoidance impacts your values.

How is it pulling you away from what matters most to you?
(If you missed it, see my previous post discussing Value Traps.)

3. Introduce Avoidance Blockers.

These are intentional strategies that make avoidance harder and push you closer to meaningful action — even when it’s uncomfortable. The goal isn’t to suffer through discomfort, but to give yourself the chance to learn that discomfort is tolerable and temporary.

My Avoidance Blocker

Using the three steps:

1. Identify the discomfort:

Being cold, wet, and physically uncomfortable.

2. Identify the value conflict:

I was losing my connection to outdoor activity and adventure, and that disconnection was fueling my depression and anxiety.

3. Block the avoidance:

I got rid of my car.

Drastic? Absolutely.
Effective? 100%.

It forced me to ride my bike every day — a 40-minute commute in rain, cold, and darkness.

My anxiety didn’t magically disappear, but riding gave me space to work through my worries instead of running from them. It became a daily opportunity to practice mindfulness, attention shifting, and tolerating discomfort. And once I got moving (with the right rain gear), I found the experience empowering.

Avoidance Blocker Ideas for Clients

• Accountability Buddy

Choose someone you don’t want to disappoint. The fear of letting them down often outweighs anxiety about the task.

• Commitment Contracts

Tell your friends to pick you up — no matter what — on the date you’ve committed to an activity. Bonus points if they ring the doorbell until you emerge!

• App or Phone Blocks

Your phone is one of the easiest avoidance tools.
Use an app to block games, social media, or other escape behaviors until a specific time of day or until you’ve completed your uncomfortable task.

• “Camera Alarm” Apps

Some alarms require you to take a photo of a specific object (like your neighbor’s cat) before they shut off. Surprisingly effective. It gets you out of bed if you are avoiding the day.

Get Creative

Avoidance blockers are meant to help you disrupt the automatic retreat from discomfort and step closer to your values. They don’t eliminate anxiety — they create the conditions for growth, tolerance, and resilience.

The list is endless. You can tailor blockers to your lifestyle, your values, and your unique avoidance patterns.

Ashley Wray, LCSW, provides ERP therapy for OCD and anxiety disorders in North Texas, serving Sherman, Denison, Plano, Frisco, McKinney, Allen, and all of Texas via virtual sessions.

If you’ve noticed avoidance pulling you away from the life you want to live, you’re not alone.
I help clients reconnect with their values and build skills to navigate discomfort.
Reach out today to begin ERP therapy and create a path aligned with what matters most to you.

Responding to Holiday Stress When Living with OCD and Anxiety

If you read my last post about the hidden side of holiday stress when living with OCD and anxiety, you already know how easily the season can trigger intrusive thoughts, worry, and perfectionism.

Now, let’s talk about how to respond.

One of the most effective, research-backed approaches for managing OCD and anxiety is Exposure and Response Prevention (ERP). It works—but it takes patience, determination, and a willingness to lean into emotional vulnerability. It’s also about repetition, repetition, repetition.

But let’s be honest—the holidays are approaching quickly, and many of the scenarios I mentioned in my earlier post are right around the corner. When you’re juggling travel, family gatherings, and expectations, it can be hard to “turn on” your vulnerability switch or find time for consistent exposure practice.

Here are a few practical ways to prepare yourself this holiday season.

Realign With Your Values

Anxiety often targets what we care about most—our values.

Imagine this: you actually enjoy Thanksgiving because it means reconnecting with your favorite cousins. This year, you’re asked to lead the annual family activity. Within seconds, anxiety hits you with 101 possible disasters. To calm yourself, you start problem-solving each one—because that’s what anxiety tells you to do.

But here’s the trap: the more you problem-solve, the further you drift from your value (connection), and the stronger anxiety becomes. You start dreading Thanksgiving.

Instead, take a step back and realign with what truly matters to you.

Ask yourself:

• What upcoming situation or event are you most anxious about?

• What is most important to you about this situation or event?

• If anxiety or OCD weren’t around, how would you approach it differently?

• Are your current action steps truly aligned with your values—or with anxiety’s demands?

Sometimes, value-based action means showing up imperfectly but meaningfully.

Don’t Fall Into the Value Traps

A Value Trap happens when anxiety exaggerates what a valued action should look like.

Example: Anxiety might convince you that your home must be spotless and perfectly decorated before guests arrive. But the deeper value isn’t perfection—it might be creativity, connection, or comfort. When anxiety hijacks those values, you end up stressed, exhausted, and disconnected from what matters most.

Check in with yourself:

• Do you feel distressed or dissatisfied despite working hard toward a goal?

• Are your actions fueled by anxiety or by values?

If you notice you’re in a trap, experiment with doing things differently—what I like to call “breaking the anxiety playbook.”

Start small: maybe that means keeping the slightly overcooked dish instead of remaking it. Embrace imperfection as a quiet act of defiance against anxiety.

Beat Your Anxiety to the Punch

Here’s the truth: you can’t get rid of anxiety—and that’s okay. The more you fight it, the more power it gains.

So instead of waiting for anxiety to find you, go find it.

That’s right—beat it to the punch.

It may sound strange, but try leaning in. Notice where anxiety tends to show up—at the grocery store, while cooking, during conversations—and practice approaching those moments intentionally rather than avoiding them.

When you take the lead, you remind your brain that you can handle discomfort without needing to run from it. That’s ERP in action.

Final Thoughts

Anxiety and OCD don’t take holidays off—but you can still create meaningful, value-driven moments in their presence. With small, consistent shifts in how you respond, you can step into the season with more flexibility and self-compassion.

If you’d like to learn more about ERP, ACT, or ways to manage anxiety through the holidays, you can read my first post here or schedule a consultation to see how therapy can help you find calm and confidence this season.

“Holiday Stress with OCD and Anxiety: Why It Feels So Overwhelming”

This is not just another post about holiday stress.
Let’s talk about the unspoken stress of the holidays when you’re living with an anxiety disorder.

The season often brings family, gatherings, and expectations — but for people with anxiety or OCD, it can also bring a surge of symptoms, worry, and self-criticism.

Social Anxiety

The holidays often mean reconnecting with family you haven’t seen since last year. Suddenly, there’s pressure to say the right thing and appear like you have it all together.
You might find yourself rehearsing conversations in your head or worrying how others will perceive your work, relationships, or life choices — all while trying to hide how anxious you feel inside.

Panic

There’s the sense of inescapability.
You arrive with your loved ones, and the energy, chaos, or drama starts to rise. The “what ifs” appear:
What if I feel trapped? What if I get hot, dizzy, or short of breath?
The fear of having a panic attack in front of others can make even the most joyful gatherings feel unbearable.

Health Anxiety / Emetophobia

Maybe Grandma offers you her famous pecan pie — and your brain immediately flashes to an article you read about foodborne bacteria.
You start worrying about nausea, contamination, or what might happen if you get sick. For people who struggle with health anxiety or emetophobia, these worries can take over moments that are supposed to feel comforting.

Obsessive-Compulsive Disorder

You’re hosting this year, and it’s consuming every ounce of energy. You’ve spent the week rearranging decor, compulsively checking the appliances, and trying to make everything “just right.”
Underneath all of it is the thought: If I can control this, maybe I can prevent something bad from happening — or maybe people will be happy.
By the time guests arrive, you’re already exhausted.

And then there’s the gift giving — a value you care about deeply — but perfectionism and decision paralysis can turn what used to be joy into stress.

When the Holidays and Anxiety Collide

Holidays naturally come with stress, but when you add OCD and anxiety spectrum disorders, it can feel like the perfect storm.
If this resonates, please know: you’re not alone — and there are tools that can help you reclaim these moments rather than avoid them.

In upcoming posts, I’ll share ways to manage these triggers through evidence-based strategies from ERP and ACT that can help you reconnect with what matters most, even when anxiety shows up.

Anxiety may be part of your story, but it doesn’t have to define the season ahead.
Together, we can work toward freedom from avoidance and fear — one step at a time.

If you are ready to take the next step, you can read more About my services above, or schedule a free 15 min consultation call below.