Often times, individuals diagnosed with OCD can involve their family members in their obsessions and compulsions.
According to John March (2007) one in every 200 children and/or teenagers suffer from Obsessive-Compulsive Disorder (OCD). These children and teenagers suffer from intrusive unwanted thoughts, images and/or urges (obsessions) that they often know are irrational beliefs but cause significant anxiety that forces the child into carrying out repetitive bizarre behaviours and/or mental rituals (compulsions). These obsessions and compulsions can cause the child/teenager significant distress and can impair their daily functioning.
Often times, individuals diagnosed with OCD can involve their family members in their obsessions and compulsions. This is particularly evident in children/teenagers with OCD and their parents. The parent sees the fear and distress that their child is undergoing and decides that it is best to “buy-in” to their child’s demands to “help” with their OCD rituals. The parents may believe that by doing so they are helping their child rid themselves of the distress and in turn the OCD. However, this may only have the reverse effect and can maintain and/or exacerbate the OCD symptoms the child is experiencing.
A medical professional is often the first port of call for families with mental health problems. The medical professional can therefore play a significant part in guiding the family in the right direction. As a medical professional, it may be evident how stressed and/or frustrated a parent of a child with OCD may be. These parents may present with low mood, irritability, and possible burn out. These emotional reactions the parents experience can therefore be reduced or eliminated once their child’s OCD symptoms are under control.
Below are some basic tips that the medical professional can impart to the parents of a child with OCD. These tips are used to help the parents react to their child’s OCD in an effective way:
Encourage parents to educate themself on OCD
A good place for medical professionals to get information or to point the family to get information may be the South African Depression and Anxiety Group (SADAG) website (http://www.sadag.org) and/or the International OCD Foundation website (https://iocdf.org). The more educated the parents are about OCD the more they can calm their child down with correct facts and the easier it is to understand why their child may be thinking and acting in the way they are. I would suggest a book called Talking Back to OCD by John March and Christine Benton. However, there are many other books that are recommendable such as What to do when your brain gets stuck by Dawn Huebner as well as What to do when your child has Obsessive-Compulsive Disorder by Aureen Wagner.
Help the parents to normalise OCD for their child
A mental illness such as OCD can seem out of the ordinary. The medical professional may therefore be in a perfect position to explain to the parents that many children and teenagers suffer from this disorder. This will not only allow parents to normalise OCD for themselves and their family but they will also be able to comfort and reassure their child by explaining to him/her that they are not going insane, are not strange/different to others, are not a bad person, and that they are not brain damaged.
Explain to parents that OCD is no one’s fault
Many children with OCD may believe that having this illness is a punishment and the disruption they cause in their family due to the OCD is their fault. In the same breath, many parents believe their child’s suffering may be due to the way they raised their child. The medical professional can elaborate that OCD is regarded as a brain or neuropsychiatric disorder. This suggests that OCD is a disorder that lies in the brain and is therefore not the parent’s or the child’s fault. Relaying this to the parents and the child may reduce a significant amount of guilt in both parties and allow for a more harmonious household.
Help externalise OCD
It is important for both parents and children suffering from OCD to know that their child is not OCD. Rather their child suffers from OCD. A medical professional may ease this concern by suggesting that the child with OCD does not deliberately have obsessions. They also do not want to carry out these time consuming compulsions. The obsessions and compulsions are due to the OCD. The best way to make this known and to remember it is to externalise the OCD. Giving OCD a nickname can do this. The nickname can be something funny (e.g. Mr Clean) and/or it can be the medical name (E.g. Mrs OCD). This externalisation helps make OCD the problem and not the child. The child may then feel less threatened and it may also make it easier for the parents to talk to their child in a more supportive manner throughout their OCD journey.
Explain to the parents that OCD is progressive but it can be reversed
It is imperative that parents understand both the course and treatment of OCD. What they will gain from this information is that if OCD is left untreated it will most likely get worse with time. However, research suggests that through both medication and in particular Cognitive-Behavioural Therapy (CBT) the child can gain control over this disorder. This is crucial as it gives the parents and the child hope that they can get this OCD under control. It also highlights the importance for parents and children to seek treatment as early on in the disorder as possible.
Help parents avoid becoming a part of their child’s rituals
Most parents want the best for their child, which includes trying to protect them from any harm. It is therefore understandable and not uncommon that when the child with OCD presents to the parents with severe distress, the parents will do anything to avoid or reduce that distress for the child. In families with children who have OCD, this includes parents helping children to do their rituals as the parents realise that by doing the ritual the child’s distress and pain decreases even if only for a short while. However, in the long-term this only helps to maintain and even exacerbate the child’s OCD. A medical professional may help reduce the family’s distress by explaining that it is crucial for parents to avoid taking part in the child’s rituals in any way. This may cause distress in the short-term but in the long-term it will benefit the child in getting the OCD under control.
Embolden parents to encourage, not give advise
OCD can be frustrating for both the child and parents. It may often lead to parents screaming and shouting at the child to “stop washing your hands”. This advice giving does not help the child with OCD but rather brings upon more anxiety leading to exacerbations in the child’s OCD behaviour. The medical professional can therefore suggest that parents adopt an encouraging nature with the child and rather say something such as “I can see Mr. Clean is getting to you today and really wants you to stay at the basin. Could you possibly try to resist Mr. Clean for a little bit and leave the basin”.
Encourage parents to be kind to their child and teach their child to be kind to him/herself
It is imperative for parents to realise that the child is in a battle with OCD. There are times when OCD will ask the child to carry out a ritual and the child will win by being able to resist but OCD is powerful and there will be times when the anxiety and distress will just be too much and the child will give in to doing rituals. The child can feel quite despondent when OCD does win but it is essential to acknowledge that this is part of the course and treatment of OCD. It is therefore important for the child to be kind to him/herself and for the parents to take on this same attitude. This, however, does not mean giving up. It means that this time OCD won but next time the child is encouraged to win by being brave enough to resist the ritual.
As can be seen from the above discussion, OCD is a challenging topic. This is true not only for the child with OCD, the child’s parents and family, but also for the medical professional. The above is a taste of some of the skills the medical professionals can impart to the parents of children with OCD, that the parents can adopt to help their child beat OCD. Please be advised that this is only a taste and it is imperative to advise the parents and child to seek treatment from a mental health professional trained in OCD. Once the child gets the help they require they may be able to get their OCD symptoms under control and in turn reduce their parents’ stress.
March, J. S. & Benton, C. M. (2007). Talking Back To OCD: The Program That Helps Kids and Teens Say “No Way” – And Parents Say “Way To Go”. New York: Guilford Press.