The Hidden Cost of Reassurance Seeking, and What to Do About it

Reassurance seeking is very common in neurodivergent people, particularly those with anxiety-related difficulties. Sometimes it exists as part of obsessive-compulsive disorder, and sometimes it just exists on its own. It usually begins as a way to feel safe or reduce uncertainty, but over time, it strengthens anxiety and can generalise into multiple unhelpful behaviours. The thinking that triggers reassurance seeking can be called an obsessive thought or intrusive thought.

Reassurance seeking behaviour can look like:

• Repeatedly asking others if everything is “okay”

• Checking whether a decision was the “right” one

• Asking for certainty about future outcomes

• Seeking confirmation that you haven’t upset someone

• Googling symptoms or situations again and again

• Mentally replaying conversations and seeking internal reassurance

In the short term, reassurance feels helpful. Anxiety drops, tension eases, and the nervous system settles. The problem is that this relief doesn’t last. The brain quickly learns: “I feel better because I checked.” I describe it to my clients as the reassurance seeking behaviour reinforcing the obsessive or intrusive thought, thus increasing the strength of their pairing and making it more likely that the reassurance seeking will occur in the future in response to the triggering thought.

This cycle can be especially powerful for neurodivergent people because:

• Uncertainty can feel more intense and harder to tolerate

• Past experiences of being misunderstood may increase fear of “getting it wrong” or "not being liked"

• ADHD can make doubt and second-guessing more frequent

• Autism can heighten the need for clarity and predictability

So, reassurance seeking is understandable. It is the nervous system trying to stay safe. And it is also something that can respond well to therapy.

How reassurance seeking can affect relationships

When reassurance is frequently sought from another person, it affects not only the person who feels anxious but also the person who provides it.

At first, loved ones are often willing to help. Reassuring someone feels like being caring and supportive. But when reassurance becomes repetitive or constant, it can become exhausting. The other person may start to feel:

• Pressure to “get it right” every time

• Responsible for managing someone else’s anxiety

• Afraid of saying the wrong thing

• Emotionally drained

• Frustrated or helpless when reassurance never seems to be enough

Over time, this can shift the balance in a relationship. What began as support can start to feel like an obligation. The relationship may become organised around anxiety rather than mutual connection. So, treating reassurance seeking may not only be beneficial to the person affected, but also to those whom they seek reassurance from.

Exposure and Response Prevention (ERP): the basics

ERP is a cognitive-behavioural treatment that is a gold-standard psychological treatment for reassurance-driven anxiety patterns, including those seen in OCD and chronic anxiety.

ERP has two parts:

1. Exposure This means intentionally allowing obsessive or intrusive thinking to be present. This may happen naturally in the course of a day, or it may require someone to put themself in a situation where the intrusive thoughts that lead to reassurance seeking are triggered.

I have had several clients for whom reassurance seeking presents as reading symptom lists of possible physical or mental health disorders that they believe they might have, and that this happens predictably one or more times a day. In this case, we can predict that it won't be long until that person has a chance to practice ERP. From this example, you may also notice that reassurance seeking is usually a prominent behaviour that reinforces health anxiety.

2. Response Prevention This means not doing the usual behaviour that reduces anxiety. With obsessive-compulsive disorder, we would call this the compulsive behaviour: You don’t seek reassurance. You don’t check. You don’t mentally review or Google. Sometimes I joke that this is the "Don't do it" therapy.

Instead, you allow the discomfort to rise and fall on its own without being reinforced by reassurance seeking. One thing to expect when cutting out the response or compulsive behaviour is a tendency to feel more anxious than usual. This is called the post-extinction response burst, and is a predictable outcome of trying to stop a reinforced behaviour. It will be strong initially, but if the behaviour is not consistently performed, it will typically decrease over the first few days.

Below are some examples of intrusive thoughts and reasurrance seeking behaviours:

1. Thought: "I'm a narcissist", Behaviour: repeatedly research online all the symptoms of narcissism and think of examples that might confirm those symptoms.
   

2. Thought: "I'm never going to get better", Behaviour: talk repetitively with a friend, parent, or partner about how unwell you feel and asking when you will feel better or what you should do to feel better.
   

3. Thought: "I acted so pompous, they must hate me", Behaviour: go over and over the scenario in your mind, or talk it over repeatedly with a friend, parent, or partner to determine if this is true.

Many people may benefit from having an alternative behaviour to perform. I'm a fan of explicitly noticing and naming the intrusive thoughts: "Ah, I'm having the thought that I'm a narcissist, and that I should go and read about narcissism to check". I also think this can be a really good time to use a strategy to help shift attention to the here and now, such as grounding to feel more present in the body and environment, and then choosing a new behaviour to engage in, like going for a walk, washing the dishes, or reading. Urge Surfing can be another useful option for observing and monitoring how an urge changes and diminishes over time, which will be the topic of a future blog post.

When reassurance is being sought from another person, it can be really helpful if that person can be brought on board with ERP treatment. Once they understand how reassurance works, they can stop giving it and can instead supportively acknowledge the person's anxiety and suggest that they practice the ERP strategies that are part of their therapy homework.

Important points for neurodivergent people

ERP should be:

• Collaborative, not forced

• Structured, but flexible

• Compassionate and paced

• Adapted to sensory, emotional, and cognitive needs

Many neurodivergent adults benefit from:

• Clear explanations of why ERP works

• Predictable plans

• Gradual steps

• Validation that the anxiety makes sense

ERP is not about changing who you are. It is about changing your relationship with anxiety and uncertainty. If you are unable to do this work on your own, I recommend seeking ERP from a therapist with some experience in treating OCD or anxiety more generally.

In summary

Reassurance seeking:

• Is understandable

• Brings short-term relief

• Strengthens anxiety in the long term

ERP:

• Builds tolerance of uncertainty

• Restores trust in yourself

• Reduces anxiety’s control

• Supports emotional independence

Learning to sit with “maybe”, otherwise known as being flexible, is one of the most powerful skills in mental health. It allows you to live more freely, make decisions with confidence, and trust your own resilience rather than relying on constant confirmation from the outside world.