Helping Kids With Their Obsessive-Compulsive Disorder
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OCD, Obsessive-Compulsive Disorder, is characterized by obsessions- unwanted thoughts that repeat over and over and make you feel bad and anxious and compulsions- unwanted behaviors or actions you feel you have to do over and over again to stop bad things from happening or to get rid of the bad thoughts or feelings. OCD always demands more and needs more from you, consuming your time and comfort. These are some strategies to help kids challenge their OCD thoughts and behaviors more effectively, but they also hold true for teens and adults. These can be done alongside help from a therapist or psychiatrist. The gold standards of treatment for OCD is psychotherapy and medication, often a combination of the two.
The first step is to identify the OCD thought, which can be tricky, so that you can begin talking back to it. OCD thoughts are irrational and can trigger our fight-or-flight stress response when there is no actual threat occurring. They can convince us that maybe something bad will happen or that we should not feel content when things are going well. We need to do something immediately and repeatedly to prevent the possibility of future catastrophes. OCD is like a system error in our brain that we need to learn to detect. Help kids list their fears and habits and then circle the ones that may be OCD in disguise. Common examples can be the fear of dirt or germs, fear that we are being watched, poisoned, followed, we’re unknowingly doing something bad or will do something bad, or that we need to wash our hands, touch something, or follow a ritual or there will be danger for us or someone we love. When we get in a habit of naming that thought as OCD, we are giving ourselves the opportunity to challenge it. With kids, I often like to have them draw a non-threatening OCD creature or color block that they can visualize as their OCD to make it easier to comfortably talk back to it.
The next step is to pick a method that works best to talk back to your OCD thoughts. I’ll list a few, but we recommend picking one to use consistently at first to increase its effectiveness before rotating through more. If you find that one is not working for you though, then you should try another method. The first method is to Delay. Delaying giving into a compulsion by at least 10 minutes can impact OCD’s control over your anxiety response. It teaches you to better tolerate the discomfort of not listening to your OCD (so that uncomfortable stress response) and helps you to build your tolerance further each time. Delay is a great method to help us build better control over all of our reaction responses.
The next method is to leave the area where those thoughts are being triggered or where your compulsions want you to be. Removing yourself from an area with sinks when your OCD wants you to wash your hands and instead going to the living room where you can distract yourself with TV can help you not only delay but possible refuse your OCD entirely. The next method is to change how your OCD wants you to complete a compulsion, so don’t do it exactly how it wants you to or even better, do the exact opposite of what it wants. So again for handwashing- you could wash your elbow instead or you can choose to draw something on your hand instead of washing it. That tactile stimulation can help ground yourself while you delay or refuse what your OCD actually wanted you to do. If you can’t change the compulsion you can try to add a funny element to it so you can build more control over it and relieve some of the intensity surrounding the action. So wash your hands while singing a silly song, saying jokes out loud, or making silly faces in the mirror.
The last method is to set a limit for yourself. OCD always wants more, so washing your hands once or twice in that day won’t feel like enough- it will keep demanding more from you to feel safe. Setting a limit is saying to your OCD, “Ok, I will do it, but only 3 times today”. The goal is to keep building your tolerance to the distress of challenging your OCD after that third time so that you can keep reducing the impact it has on you and then eventually eliminating the need to wash your hands any time other than when you naturally should. It breaks the connection between hand washing and imaginary safety for you or a loved one.
Remember, OCD is tricky and it will try to move to another compulsion or set of obsessive thoughts. It can feel discouraging to begin a new battle with OCD, but each time you challenge it you can help keep it from continuing to build and grow. You can have better management of your OCD. Even as you work to identify and address OCD in your children, or in yourself, please don’t rule out the benefits of also working with professionals. The gold standards of treatment for OCD is psychotherapy and medication, often a combination of the two. Forms of therapy, like exposure therapy, are highly effective for OCD. Many therapists recommend using visual aids and workbooks in conjunction with your therapy or psychiatric sessions to build the habits necessary to manage your OCD long-term. Learning coping strategies like deep breathing, meditation, or progressive muscle relaxation can help to manage the distress from denying or delaying the OCD. The more access to reputable resources and supports, the better!
Below are some more visual aids and workbooks to help kids with learning about their own manifestation of OCD and identifying their specific obsessions and compulsions. There are also links to general coping workbooks for distress management. You can also check out my pinterest page for free printables under the ‘saved’ section.
