How do I say 'no' to a friend? Advice needed from those with first hand or caring experience of OCD or other mental health issues

[ConcernedYetFrazzledFriend]

How do you say a clear 'no' to a friend who is refusing to accept 'no' for an answer? And how do you do it when said friend is so lost in her own OCD rituals that she is unable to realise how manipulative her behaviour seems?

Before I had DCs, Friend and I had always met up at 9.15 every Thursday morning. It suited us both well: she has severe OCD which makes her unable to cope with any sort of change in schedule or routine, and I had a job which meant that Thursday morning was virtually my only guaranteed time off.

However, I am currently hugely pregnant with DC3 and finding the 9.15-on-a-Thursday-morning slot increasingly difficult to manage, just through having two increasingly energetic toddlers and a busy job. Friend lives over an hour away (I don't drive - I walk to work) and I'm finding the two-bus journey with DS1 and DS2 (both still in a buggy) absolutely exhausting. I've had to cancel on Friend several times, and she's been getting incresingly angry with me. She doesn't have children, essentially due to her illness.

For the past few weeeks, Friend has been talking about how she now needs us to meet at 11.45 on a Tuesday morning. I work all day Tuesdays and meeting her at 11.45 would require me to either to take the whole day off or spend half my weekly salary on taxis to and from hers: I don't want to. I've told her this. She's told me that she's done the research into my job and into DP's work schedule to be able to tell me that my flexitime should accommodate this and DP should be able to look after the DSes. I've told her I still don't want to.

In the past few days, Friend's phone calls and twitter messages have become increasingly chaotic, bizarre and frantic. She has been repetitively and almost childishly asking if we can meet on Tuesdays now, giving increasingly odd and desperate reasons why we meet to and getting incresingly upset with me telling her I can't.

I'm worried about her, and I do care, but her demands are just becoming impossible.

How can I be firm, whilst still conveying that I honestly do care?

Hi CYFF. I really recommed you take a read of the book I mentioned. It will help you to identify your friends rituals and the tactics she will sue with you.

I really would not blame yourself over not supporting your friend enough. OCD is not a very
well understood condition and it is counter intuitive for people to do the exact opposite of what a loved one wants us to do in order to support them better. It is not unusual after all for friends to have regular meeting times and places. The problem with OCD sufferers is when they come to rely on these routines as part of their rituals and can't abondon them or change them due to the fear that if they do 'something bad will happen'. My husband had to stop going to mass regularly for this reason. He had come to fear missing it and therefore had to miss it to 'prove' that it wasn't his attendance protecting the family. Asking a person of faith to miss worship is not a request you would normally make of non-OCD sufferers but OCD sufferers cannot be accommadated in the same way 'normal' people can for their own sake.

You will not be able to cure your friend but you will be able to stop facilitating her. This may result in her ending the friendship at least initially. All you can do is be clear about your reasons and present alternative times and venues that suit you.

balia I am glad you find my experience of OCD useful. I am not an expert in OCD by any means, just someone with more experience of it than most people. My experience though is (fortunatly) just limited to one case. Certainly facilitating and acommadating OCD sufferers routines is enabling them and is not at all recommended for successful treatment.
As for lack of insight, I am not sure about that. I am sure it is possible as OCD sufferers are just like everyone else and doubtless there are those who have little insight to how their behaviour effects themselves and others just as there are 'normal' people like this. In my experience it is not so much that OCD sufferers can't see that their routines and rituals are cumbersome it is that to them they and the inconvenience they cause are worth it. To not do these rituals and reduce anxiety is inconceivable to them. I once heard it compared to someone asking me or you to walk into a toilet and wipe the inside of it with our bare hands and then to walk out and eat a sandwich with the hands we hadn't washed. We know that this would probably not kill us but there is no way we would do it. And no matter how inconvenient to us or others we would wash our hands.
The problem with joining and aiding with rituals and as you have discovered with your family member, they become more complicated and time consuming, and the anxiety relief lasts less and less time. It is a spiral the rarely improves without intervention.

OP, I have a friend who is very biploar (technically hypomanic) and she had a severe crisis last summer. I actually ended up getting her sectioned.

I agree with others, especially bluefergie whose posts are excellent. You need to step away and not get caught up in her 'games'. I think an earlier question about what do you get out of this friendship is important.

My friend was my best friend when we were growing up and many of my formative teenage experiences were with her. I miss her terribly (she hasn't really come back down to earth since last year's sectioning). But I have a DD who is 6 and I can't have my friend sitting around drinking a bottle of wine every morning and smoking dope thinking she is Alice in Wonderland (seriously). I still feel guilty because I know she is struggling, but I have had to be firm in my boundaries.

I think you just stick to "no that time isn't convenient for me" and don't go.
Friendship is a 2 way thing. She should be considering you as much as you consider her.
Having OCD doesn't mean you have to be selfish and self centred.
I agree make sure you get something out of this friendship as well. Friends who exhaust you aren't real friends, more like patients. Sometimes friendships come to the end of their mutually beneficial life.
You should never dread meeting a friend, if you do and it's not a temporary phase the friendship has probably run its course and neither of you are really benefitting from it.

I have limited experience of OCD as something which affects some of the people I work with, although it is not what I work with them about. I also have experience of demanding and draining people in my personal life, although not specifically people with OCD.

The advice you are getting seems to me to be predominantly correct. That if you cave in or hide behind excuses it will only make matters worse for both you and for her. She wont see it this way of course. I found the petrol analogy very good too.

It seems to me that you have really got to say no, mean it and give the honest reason why not- that you are working. Do tell her you love her, do tell her that she is not responsible if something bad happens, but do not cave. It's an awful situation and it's going to be hard for you to say no and mean it but it's the right thing to do.

CBT, as many have suggested, it generally the best treatment/ set of coping skills for managing CBT but you as a friend are not responsible for seeing that through, she is. If she isn't responding to the help she is getting then you do have to take a step back and accept that you can do no more. It is between her and the professionals as to if she can improve her quality of life.

I see a responsibility divide here. I am reminded of the serenity prayer, that one that goes... God, grant me the serenity to accept the things I cannot change, Courage to change the things I can, And wisdom to know the difference. I'm not Christian, but I do find this to be good advice to bear in mind when dealing with demanding people. You can't change how they feel, you can only change how you react. React with as much honesty, understanding and fairness (including to yourself and your own family) as you can because that is all you can do, and allow yourself the forgiveness to know that was all you could do.

*for managing OCD (not for managing CBT, sorry)