“He’s really oppositional!” The mom vents. “Honestly it takes a miracle to get him to do anything. Don’t even get me started on how long it takes him to get out of the house in the morning.” She takes a breath and continues, “And no one can go into his room. One time I entered his room without his permission and he had a complete meltdown.” This is often my initial introduction to a teen whose main issue isn’t opposition, but rather OCD. OCD symptoms in teens are often misconstrued as oppositional or quirky behavior.
Her small frame sits, hunched over on my therapy couch. She looks at the ceiling. She looks at the floor. She looks everywhere and anywhere as long as it is not my eyes. Finally, she opens her mouth to speak. “I have bad thoughts.” She whispers. “Sometimes to get rid of them I have to do things in threes.” She sits, waiting for the condemnation. Waiting for the concern and judgment to ooze from my face. I sit nodding and she continues. She tells me things I have heard a zillion times before. Things that come from living in the shadows of child OCD.
Your child is balled up on the floor – again. She has been like this for hours. Nothing you do or say seems to penetrate her wall of pure terror. You remind her of all the tools she’s learned in therapy, but the words just drip off her limp body. It looks like another school day will be passing her by. How long can this go on? When should you start considering anxiety and OCD medication for her?
“Mom I need to talk to you,” you hear your son whisper again. “I’m having bad thoughts.” You know where this is headed. This is the tenth time today he’s pulled you aside to talk. “Two years ago, I think I did something bad,” he confesses. His voice trails off as your mind starts to wonder. What is going on? Why does my son have to confess every thought, behavior and memory he thinks is bad? Why don’t my reassurances make him feel better? You remember once reading something about scrupulosity OCD, could that be what is going on?
“No!” He screams at the top of his lungs. “I’m not doing it!” You look at his red, sweaty face and you know what is about to come. You have seen that lost look many times before. You hold your breath and wait for the inevitable. He rages. He destroys. He brings chaos to the entire family. And then…he is done. Exhausted, no more fight left in him. A wake of destruction left in his path. Everybody wants to tell you your son has issues with oppositional defiance, but you know under all that rage is an anxious, scared boy.
You stare as your daughter lines up her toys, first by color and then by size. You’ve long ago ignored the well-intentioned friends and family who told you her behaviors were “typical.” There was nothing typical about it. You spend most of your morning sitting where she wants you to sit, following her very specific demands. Demands that if not followed to the letter, will result in a catastrophic meltdown that can go on for hours. You are pretty sure your child is showing early signs of OCD. That is not rocket science to you. But what you really want to know is how to deal with OCD – especially in a child this young.
“You’re going to be okay honey,” you say for the hundredth time that hour. Your words drip off her deaf ears. Why won’t she believe you? She asks you to tell her again. You take a deep breath and offer her more reassurance. It is like pouring water into a bucket that can never be filled up. Is this how you are supposed to help children with anxiety and OCD?
You would think that offering reassurance would help anxious children, but in reality it isn’t helpful at all. Sorry to burst your bubble. But parenting children with anxiety or OCD is like trying to write with the wrong hand. Everything you typically do as a parent just won’t work. Reassurance is the enemy of anxiety and OCD and instead of putting out the fire it is like pouring gasoline on a blaze. It’s just not a good idea.
Your child is paralyzed. She stares at the bathroom door unable to go through. She grabs the door handle with her shirt, fumbling to get it open. You’ve watched her wash her hands until they are raw. It seems like most questions that come out of her mouth are about germs. What is going on with her? This new fear of germs is taking over her life. How can you help?
Your child is doing another “quirky” behavior. It seems like it is always something. You remember the time she had to twirl as she entered a room. And then there was the time that she had to blow on her fingers. You stare as your daughter is tapping the kitchen table four times with each finger. What do these behaviors mean? Once a well-intentioned friend suggested it was child OCD. You had scoffed at the idea. She obviously didn’t know your daughter. Her room looks like a bomb hit it and don’t even get you started on her hygiene. But if it isn’t child OCD, what is it?
So many parents dismiss the possibility of childhood OCD because they don’t understand it. OCD isn’t just about germs. OCD isn’t about being neat and orderly. Sure, those are two components in some OCD themes, but what about the thousands of other themes?
Your child is imploding. You stand there in disbelief. What happened? You run through the last ten minutes in your head looking for the trigger, the spark that lit this fiery storm. Like a needle in a haystack, your mental search is futile. You come up empty handed – again. Meltdowns and poor behavior are becoming par for the course in your home.
You want to throw the parenting rule book at him. You want to strip him of every privilege and shut this nasty party down. But this isn’t your first rodeo. You’ve been here many times before and you know how it goes. This isn’t your ordinary, run of the mill poor behavior. These aren’t your typical meltdowns. These meltdowns are born from a build up of anxiety. A build up a stress. A build up of such strong emotion there should have been an emergency alert before it hit your home.
A child with OCD sits in my office. I ask if she is ready. She gives me a nervous nod. I place a Clorox wipe in her hand. She begins to breath heavily. Her OCD convinces her she is holding a death wipe. She imagines her hands spreading the contamination throughout her body, the poison flooding her veins.
I am not having a torture session, I am treating a child with OCD.
OCD is like a game of chicken. A game I am determined to help her win. We are calling OCD’s bluff, refusing to blink.
Your child is begging you for reassurance. This is the tenth time in less than fifteen minutes. Do you give it to them again? And again? When does it end? Are you helping them when you get sucked into their OCD compulsions? No one ever tells you how to parent children with OCD!
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Kids are picky eaters, but some kids take picky eating to a new level. Has your child moved beyond picky and into the realm of a Selective Eating Disorder? Kids with anxiety, OCD or sensitivities will often have major issues with food. Learn the most common causes for extreme picky eating and what approaches you can take to help your child.
Your child is tapping, washing, counting over and over again. As a parent, you want to make it stop and make it stop right away. Watching your child be mentally tortured by OCD can be excruciating. You fast forward five years, ten years from now. What will life be like for your child? Can OCD be cured? What is the long-term prognosis for OCD in children?