Does your child engage in repetitive behaviors such as counting, washing, or checking? Do they insist on lining up their shoes or toys? Do they ask you the same questions over and over, seeking reassurance? Do they get stuck in certain patterns of action, distraught when unable to perform the action the “right” amount of times or unable to move on with their day until they complete these repetitive behaviors?
If so, it might be worthwhile to get your child evaluated for OCD. Child OCD, or Obsessive-Compulsive Disorder, is a psychiatric diagnosis that signifies troubling thoughts and behaviors that interfere with everyday functioning. OCD consists of obsessions (unwanted and repeated thoughts, fears, and/or impulses), coupled with compulsions (behaviors designed to reduce distress). The severity of OCD varies from child to child. At one end of the spectrum, symptoms might be manageable. At the other, they might be disabling. Parents can be negatively impacted too, when their child is in the throes of OCD.
If your child is struggling with OCD, there are a few things you can do in addition to seeking out professional help.
1. Name the beast to tame the beast. Explain OCD to your child at an age-appropriate level. For the younger set, you might say something like, “Your brain is playing a little trick on you and telling you you have to touch that again, but you don’t.” One book, specifically for younger children, refers to OCD as “OCFlea.” If you feel your child is developmentally ready, introduce the name, “OCD.” As your child matures, your explanations can evolve, as you move toward more complex ways of externalizing OCD symptoms. The more a child can externalize their OCD, the more likely they’ll be able to see it for what it is – an illness – versus something wrong or defective with them. Make OCD the problem, not them.
2. Get educated. Learn what OCD is and what OCD isn’t. Understand what causes child OCD (hint: it’s a brain disorder). Research evidence-based care. The treatment of choice for OCD is a behavioral method called exposure and response prevention (ERP). ERP involves exposing your child to the anxiety-provoking stimulus while preventing the behavioral response, or compulsion. For example, if your child has obsessive fears about contamination, they might feel the pull to compulsively wash their hands. ERP would task them with sitting with the fear of contamination without turning to hand-washing.
3. Recognize your role as critical to healing. While a qualified therapist can work with your child using ERP, that’s typically only an hour or two a week. The rest of the time, you, as a caregiver may be tasked with carrying out ERP. That might involve your engaging in exposures with your child or coaching your child through an exposure session (e.g., “You’re doing great at not lining up your toys. How bad is your OCD right now?”) While exposures might be uncomfortable, they shouldn’t cause distress. Go at a pace at which your child can succeed, and explain the rationale so that your child understands that any discomfort is temporary and meaningful.
4. Embrace the dialectic of acceptance and change. While you want to challenge OCD symptoms with ERP, it’s also important to be a safe, supportive ally for your child. Validate how challenging it is to struggle with these symptoms. Accept your child for who they are while conveying the importance of tackling their symptoms. Remind your child that despite their OCD symptoms, they are lovable and have a lot of which to be proud. Give specific examples of what you value in them and why you enjoy spending time with them. Reinforce their efforts at combating OCD symptoms, even if they aren’t as far along as you – or they – would like. Support efforts and exposures that aren’t so black-or-white. For instance, while your child may ultimately “give in” to a compulsion, see if you can get them to delay the urge or engage in the compulsion for a shorter time period (or perhaps fewer repetitions) than OCD demands.
5. Get support. Child OCD is an exhausting disorder, both for the individuals who suffer and those around them. Symptoms are repetitive and can be disruptive and tiresome. Seek out your own support through friends/family, your own therapy, or an organization, like the International OCD Foundation. Cut yourself some slack. Allow yourself to feel annoyed or impatient. That’s human. If you’re overwhelmed, consider getting your own therapy. Parenting is challenging enough. Adding something like child OCD, perhaps another child or more, and various other life stressors can be just too much.
Remember to seek out professional guidance, specifically from an expert on OCD. Child OCD is a serious concern but can be successfully treated with appropriate interventions. And get support for yourself too. You don’t have to do this alone.