Freeing Your Child from Obsessive-Compulsive Disorder, Revised and Updated Edition

Freeing Your Child from Obsessive-Compulsive Disorder, Revised and Updated Edition

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Understanding OCD

Living by the Rule of “Just in Case, or Else”

You see your child putting on her socks for the tenth time, screaming that the seams aren’t straight. The blood is pulsing through your veins and your temperature’s rising; late for work, you’re furious and you feel helpless. The temptation to shout “Stop this and just get over it” is gaining on you. Watching your child melt down before your eyes leaves you desperate, as if you’re running in place. Unfortunately, your basic assumption about your child’s behavior—­that she is doing everything of her free will—­does not apply here. To understand OCD, you must accept the involuntary nature of the condition. Your child isn’t doing this to frustrate or disobey you, or even because she wants to. She derives no pleasure or satisfaction from OCD; in fact, she hates it. Children with OCD endure scrutiny, pain, and embarrassment because they are victims of a brain disorder that turns the simple task of surviving each day into an all-­consuming battle between what she knows to be true and the irrational fears OCD unleashes.

Understanding OCD requires a shift in perception, from seeing your child controlling you to seeing your child being controlled by the commands of the invisible nemesis in her brain. The Greek word sciamachy means “a battle with an invisible foe.” This is the essence of OCD. The brain gets stuck in gear, not allowing the mind to be rational, to be free, to believe what makes sense, for example, that washing forty times a day will not ensure that no one dies. There’s no connection. Instead, the frightening .0001 percent chance that a rogue germ will kill someone becomes the message—­the only message—­blasting over your child’s internal PA system. From the outside, OCD looks so stoppable, so easy to walk away from, but it is the invisible internal grip of anxiety that keeps the fires fueled.

Children don’t like to be bossed around by anyone. So how does OCD get them to pour time and energy into doing jumping jacks for it? We could say OCD plays dirty; it doesn’t play fair. It raises the stakes as high as they can go—­safety, survival, and health. There are some things you would never do under ordinary circumstances, but you would do it in a heartbeat if you thought it would save your child. Though OCD is a brain glitch, the circuitry takes this basic instinct and twists it by distorting the true possibility of danger and grossly exaggerating our personal responsibilities and ability to control them. Your child knows it’s not likely that washing hands and preventing cancer are connected. Yet when these circuits fire over and over, triggering discomfort and fear, kids with OCD think: You don’t know 100 percent that it won’t, so don’t be selfish, you better wash to be sure.

Wouldn’t you check the locks ten times to avert a disaster befalling your family? We know that the world doesn’t work that way, but when faced with the threat of the unbearable enormity of worst fears come true, children with OCD decide not to take a chance. That is what we call living by the rule of “Just in Case.” Because, despite plenty of adults telling them, “Just stop it—­don’t recheck,” the pictures of bad things happening continuously intrude in their mind, anxious feelings result, and they don’t feel free enough to think beyond There’s no way I could do that. I can’t take that risk. I have to do it just in case—­or else. I’ll never forgive myself for not just following OCD’s rules. OCD is not about the inability to think rationally; it’s about the anxiety that results from the inability to believe what you know to be true in a given situation. Children with OCD feel like they need to be certain beyond a shadow of a doubt, which is impossible. It makes its sufferers believe that a remote possibility is a clear and present danger requiring our most urgent attention—­and preventative action. But is it really the sink or the lock, or the socks, or is it what OCD is telling them about it? And more to the point, what OCD is telling them they need to do to protect themselves (i.e., avoiding or doing a ritual). Understanding this key distinction will help you more quickly pivot away from debating whatever the specific content of OCD is in that instance and toward helping kids distinguish between a “I have to” and “I feel like I have to.”

Obsessions: Sticky Thoughts That Don’t Go Away

Obsessions are intrusive, unwanted, distressing thoughts or pictures that barge squarely into your mind’s eye, refuse to budge, and keep replaying in the mind. Intrusive thoughts are involuntary, occurring spontaneously whether the child wants to think about them or not. When obsessions hit, they create an uneasy, anxious, or dreadful feeling. Kids try to stop, ignore, undo, or get rid of the thoughts, but that seems to only make the thoughts stronger. The thoughts sit there, occupying their mind, clogging the information superhighway in their brain, preventing them from moving on. In fact, the word “obsession” comes from the Latin for “to besiege or to occupy.” Think of how you feel when you realize you made a big mistake, you forgot an important message for someone at work, or you have a near miss while driving. That realization triggers the fight-­or-­flight response; your heart races and you start to sweat. You also try to quickly put it out of your mind and get back to business, because you are compelled to rid yourself of the anxiety brought on by the thought. The actual danger has passed; an internal “all clear” has sounded. When a child with OCD experiences an intrusive thought, it creates an uncomfortable feeling that doesn’t go away. The all-­clear signal doesn’t come. The brain has called “911” and it feels like there’s no turning back.

There are three main reasons why intrusive thoughts make kids feel uncomfortable. First, the content itself is typically unpleasant; like the most ruthless enemy, the obsessions fire off “what-­ifs?” such as: “What if someone dies because you didn’t double touch the table when you bumped into it? What if that doorknob gives you HIV, it looked dirty?” Second, kids are distressed because they know that there really is no interrogator, no enemy, that the voice they hear is coming from inside of them. In an instantaneous flash this sends waves of dread: Why am I thinking this? What’s wrong with me? Am I going crazy? The thoughts multiply and won’t relent. Third, intrusive thoughts are troubling because they take so much mental energy and time to listen to them and work through them. If you’re in the middle of biology class when Mr. Franklin is giving study tips for one of his killer tests and you’ve missed the whole thing because you keep picturing the cafeteria worker rubbing her nose—­Did she then touch your hamburger?—­now on top of everything else, you also have to contend with an understandable and expected childhood stress: how to pass the test.

Sometimes intrusive thoughts are relatively harmless; but it’s the repetition of the mundane—­a word, a thought, a picture, or a tune—­that is as maddening as a dripping faucet.

Obsessions Are Thoughts That Are:

• Intrusive: They come into your mind without you wanting them there.

• Irrational: They concern things that make no sense.

• Recurrent: They keep replaying so you can’t shake them from your mind.

• Disturbing: Their content is frightening because you know it’s not “normal.”

• Anxiety producing: As you try and fail to get rid of them, you feel out of control.