Reassurance Seeking in Postpartum Anxiety: Why It Backfires

What counts as reassurance seeking?

Reassurance seeking is anything you do to get an answer that makes the fear go away for now. When you're anxious, your brain tells you to get more reassurance: Google it, ask someone you trust, check again just to be sure.

For new moms, it often looks like:

• asking your partner, your mom or a group chat, "Do you think she's okay?" and then asking again
• searching a symptom, then searching it a different way, then reading the forums
• checking the monitor, her breathing or the locks over and over
• going over it in your own head: replaying the day, looking for proof you did everything right

Everyone double-checks things sometimes, and checking on a new baby is part of caring for her. It becomes a loop when the answer doesn't stick.

Why does reassurance stop working?

In the video above, I talk about the trap: reassurance does work, briefly. It calms your nervous system for a moment. Then the anxiety comes back and asks again.

Research backs this up. In a 2015 study, Paul Salkovskis (University of Bath) and Osamu Kobori (Chiba University) asked 153 people with OCD, 50 with panic disorder and 52 with neither what happens when they get reassurance. Both anxious groups reported short-term relief, followed by a return of the discomfort and of the urge to ask again. The healthy group didn't report a significant rebound. And the more reassurance people sought overall, the bigger the rebound they reported.

The quick relief after you look is what keeps the loop going. Your brain learns that checking is what made the fear go away, so the next time the fear shows up, it asks you to check again. Over time, reassurance seeking teaches your brain two things: that uncertainty is dangerous, and that you can't handle it on your own.

If you feel stuck here, nothing is wrong with you. Checking can feel necessary even when the answer only helps for a few minutes. That is a pattern you can work on with support. If the fear is a constant sense that something will happen to her, new mom hypervigilance may sound familiar too.

Is reassurance seeking a sign of postpartum OCD?

It can be, and it's also common with postpartum anxiety. An article can't tell you which one you have, but here's the rough difference.

With postpartum anxiety, the worries tend to be about real-life dangers like sleep, feeding or illness. With postpartum OCD, there are usually intrusive thoughts or images, often of harm coming to the baby, that feel horrifying and foreign. Reassurance seeking then becomes one of the compulsions that keep them going, along with checking, avoiding, and trying to mentally "undo" the thought. Postpartum OCD vs. anxiety walks through the differences.

If your loop is about scary thoughts of harm, please read what those thoughts mean, and what they don't. Having a thought isn't the same as wanting it.

How do I stop seeking reassurance?

Gradually. Trying to quit everything at once tends to send anxiety so high that you go right back to asking. These steps are for the everyday version of the loop. If it's taking over your day or it's tied to intrusive thoughts, do this with a therapist (more on that below).

1. Notice it for two or three days. Jot down each time you ask, search, check or replay. Don't change anything yet.
2. Pick one loop, the easiest one. Maybe it's the third time you ask your partner the same question, or searching after 9 p.m.
3. Delay first. When the urge to ask or check again hits, wait 10 minutes before you act, and notice what the urge does. Often it peaks and starts to ease. Either way, you've practiced handling it. If you still need to ask after 10 minutes, you can. Next week, stretch the wait.
4. Answer the doubt with uncertainty. Instead of proving the worry wrong, try: "This is the doubt again. I can't know for sure right now, and I can handle not knowing." Then go back to what you were doing. It will feel unnatural.
5. Expect it to feel worse at first. The first few times you don't ask, anxiety will probably rise. The National Institute of Mental Health (2023) notes that exposure-based treatment may raise anxiety early on, and that compulsions decrease for most people as they continue treatment.
6. Keep ordinary care. I'm not asking you to stop checking on your baby. Safe sleep and everyday care stay. If something about her health worries you, call your pediatrician. That's a real question, and it deserves a real answer. The loop is when you already have the answer and the doubt asks again anyway.

What should my partner say when I ask, "Are you sure she's okay?"

It's natural for partners to answer, because answering feels kind. But each answer can feed the loop. Clinicians call this family accommodation: the people close to you take part in the checking or reassuring to ease your distress. A 2016 meta-analysis of 41 studies, led by Monica Wu at the University of South Florida, found a moderate link between family accommodation and more severe OCD symptoms. That's a correlation and doesn't prove cause, but it's why therapists often bring partners into the plan.

Your partner also shouldn't suddenly go cold. In their 2015 paper, Salkovskis and Kobori pointed out that for someone with OCD who isn't in treatment, reassurance may be the only thing that brings relief, and they cautioned that simply warning people it worsens anxiety may harm patients and the people who love them.

So make a plan together, ahead of time, on a calm day:

• Agree on which question you're working on first.
• Choose a phrase that comforts the feeling without answering the question: "I can tell you're scared. I think this is the anxiety asking. Want to sit with me for a minute?"
• Decide what happens if you can't settle. Maybe one answer, then only the phrase after that.
• If this is OCD, build the plan with your therapist, who can set the pace.

Your partner's role is to stay with you while the anxiety rises and falls. Nobody has to be the enforcer.

When should I get help for reassurance seeking?

It's time to talk to a professional if:

• asking, searching or checking takes up an hour or more of your day
• you can't rest or sleep even when someone else has the baby
• you have scary, unwanted thoughts or images you can't shake, or you feel you have to "undo" them
• you're avoiding things because of fear, like bath time, the stairs or being alone with your baby
• the loop is straining your relationship, or you've tried cutting back and the anxiety is more than you can manage
• you're also feeling low, hopeless or numb

If you're thinking about suicide or need crisis support, call or text 988. Call 911 if you or your baby is in immediate danger. For support that isn't an emergency, you can call or text Postpartum Support International's HelpLine at 1-800-944-4773, and a trained volunteer will get back to you.

If this is OCD, please don't try to white-knuckle it alone. The treatment is exposure and response prevention (ERP), a type of CBT, and NIMH says research shows it effectively reduces compulsive behaviors. A trained therapist helps you face the fear in planned steps and drop the checking or asking a little at a time, at a pace you can manage. They'll also help you sort out which checks are compulsions and which are ordinary baby care.

If you'd like to talk it through with me, you can book a free 15-minute consultation. I see moms in person in Austin, TX, and online in Texas and 40+ PSYPACT states.

Sources

• National Institute of Mental Health. Obsessive-Compulsive Disorder: When Unwanted Thoughts or Repetitive Behaviors Take Over. 2023.
• Salkovskis PM, Kobori O. Reassuringly calm? Self-reported patterns of responses to reassurance seeking in obsessive compulsive disorder. Journal of Behavior Therapy and Experimental Psychiatry, 2015.
• Wu MS, McGuire JF, Martino C, Phares V, Selles RR, Storch EA. A meta-analysis of family accommodation and OCD symptom severity. Clinical Psychology Review, 2016.
• National Institute of Mental Health. Perinatal Depression. Revised 2023.
• 988 Suicide & Crisis Lifeline. What to Expect.
• Postpartum Support International. Perinatal Mental Health: Signs, Symptoms and Treatment and Get Help.