OCD Does my child need help?

By Emily Hanna, LLMSW & Suzi Naguib, Psy.D.

Lisa is a light-hearted and bright 9-year-old girl who is very talkative with friends and family. However, Lisa has recently turned inward and become overwhelmed by thoughts that feels are “stuck” in her head. These thoughts started when she saw a used medical glove on the ground while at a playground. Since then, she has been overcome with thoughts that she is contaminated, and seeks constant reassurance from her mom, asking whether she will get sick from touching benign objects (such as railings, fences, pill bottles, and soccer balls). She has also started showering for one hour a day, scrubbing each part of her body in a particular order. If the order of her shower is interrupted, she becomes extremely upset and must start over. She is now avoiding activities she once used to enjoy, for fear that she will become contaminated. Lisa’s parents are confused by these recent changes in Lisa, and by the distress it is causing her.

What is Obsessive Compulsive Disorder
Obsessive Compulsive Disorder (OCD) Is a mental health disorder characterized by the presence of obsessions and/or compulsions. Obsessions are unwanted, intrusive thoughts, images, or urges that cause distress and anxiety. Compulsions are the behaviors an individual engages in to attempt to rid themselves of obsessions and/or decrease experienced distress. In the example above, Lisa’s obsession is contamination, and her compulsions include seeking reassurance, showering in a ritualized manner, and avoiding activities and situations that increase her anxiety.

Common Obsessions in OCD

  •   Contamination
  •   Unwanted sexual thoughts
  •   Fear of losing control
  •   Religious obsessions (scrupulosity)
  •   Exaggerated hear of harm
  •   Perfectionism (often experienced as needing things to be “just right”)

Common Compulsions in OCD

  •   Washing and Cleaning (washing hands in a certain way, cleaning household items, etc).
  •   Checking (checking that you did not/will not harm others, checking parts of your body)
  •   Mental Compulsions (replacing “bad” words with “good” words to “cancel” them, etc.)
  •   Putting things in order or arranging until it feels “just right”
  •   Asking for reassurance or confessing
  •   Repeating (body movements, rereading or rewriting, repeating routine activities, etc.)
  •   Avoiding situations that might trigger obsessions

When should treatment be sought?
Many people have obsessive thoughts and compulsive behaviors at some point in their life, but treatment should be sought when obsessive thoughts and/or compulsive behaviors consumes a significant part of your child’s day, and/or it causes your child (or family) significant distress.

Treatment for OCD
In addition to medication, an effective, evidence-based treatment for OCD is a subtype of Cognitive Behavioral Therapy (CBT). This treatment is called Exposure and Response Prevention (ERP).

The E in ERP refers to exposing oneself to the thoughts, images, objects and situations that cause anxious thoughts and/or triggers one’s obsessions. The RP refers to response prevention, which involves making a commitment to not engage in the compulsive behavior that one feels compelled to do once they experience obsessive thoughts. Feelings of anxiety decrease over time when exposure and response prevention is implemented consistently with the help of a professional. This decrease in anxiety is caused by the process of habituation.

Sunfield Center psychologists are available to help evaluate and treat anxiety disorders in children and adolescents using evidence based, research informed treatment protocols.

Resources
What to Do When Your Brain Gets Stuck: A Kid’s Guide to Overcoming OCD (2007) by Dawn Huebner and Bonnie Matthews

Freeing your Child From Anxiety: Practical Strategies to Overcome Fears, Worries, and Phobias and Be Prepare for Life—from Toddlers to Teens (2014) by Tamar Chansky, Ph.D.

References

International OCD Foundation