The first and most important step in dealing with OCD/OCPD is to be aware of its presence. Most kids who suffer with the disorder don’t even know they have a problem, and most ignore the debilitating effects. Many parents of OCD children simply deny that the condition exists, but this can allow a child’s disorder to shape the entire household’s way of life. The key to correcting the problem is to get help as soon as you recognize the associated behavioral patterns.
It’s best, of course, to seek professional assistance if at all possible. Meanwhile, there’s also a great deal you can do to confront the issue at home. The important thing is to help your child see that the thoughts she’s experiencing are merely an intrusion or an obsession, and she doesn’t need to listen to them or act on them.
It’s crucial to help her replace the intrusive thoughts by redirecting her attention to some more positive form of behavior.
If you have a child whose brain is locked into some kind of compulsive, repetitive, and ritualistic behavior, you can help break the pattern by questioning the false reality that stands behind it. At every opportunity, do what you can to help her reframe her perceptions and reevaluate her thoughts.
For example, let’s suppose you have an elementary-age daughter who refuses to go to bed until she’s checked the front door at least ten times to make sure it’s locked. When she’s on her way to check the door for the fifth time, lay a hand on her shoulder and say, “You don’t need to do that again, honey. We already know the door is locked.” Don’t get angry if she contradicts you. Instead, gently hold your ground and show compassion by empathizing with her emotions: “You may feel as if it’s still unlocked, and I understand that those feelings make you anxious.
Step 1: Be aware. The first step is to recognize the disorder for what it is. When problematic thoughts arise, tell your child (or yourself), “This thought is an obsession; this urge is a compulsive urge.”
Step 2: Relabel. Realize that the intrusive obsessive thoughts do not reflect reality, but are rather the result of OCD. Rename it as such: “You’re having an intrusive thought that is false.”
Step 3: Reattribute. Recognize that the intensity and intrusiveness of the thought or urge is caused by OCD. It may be the result of a biochemical imbalance in the brain.
Step 4: Refocus. Replace the obsession with a positive thought. Shift your child’s attention by having him do some constructive activity.
Step 5: Re-evaluate. Help your child refuse to take the OCD thought at face value. Disarm it by saying, “This is your OCD. It has no meaning.”
But there’s really no reason to be afraid.” Then prove your point by taking her to the door and trying the handle yourself.
If she comes back again, simply repeat the process. If you think it’s appropriate, you could try making light of the issue by turning it into a joke, saying something on these lines: “Don’t tell me—did that door just unlock itself again?” Adults with OCD often realize that their fears are unreasonable even though they find them irresistible. It’s not so easy for kids to make that distinction. Humor can sometimes provide the objective point of view that’s needed to break the chain.
It can also help to objectify the OCD by separating it from your daughter’s personality. In the case of a fairly young child, you might do this by selecting a stuffed animal from the toy box and dubbing it Mr. Annoying. When the child says, “Do you think I should go back and check the door?” you can respond, “No, that’s Mr. Annoying talking. You don’t need to listen to Mr. Annoying anymore.” With an older child, you can simple say, “You know that those worries aren’t valid. They’re the voices of your condition or disorder, and you have the power to tell them to go away and leave you alone.”
OCD/OCPD is almost certain to have a negative impact on a child’s academic performance. It can even disrupt his social life at school if the condition alienates his friends or leads to peer rejection. If you have a child with OCD, it would be a good idea to work closely with teachers, school counselors, and school administrators to come up with a plan best suited to address his needs.
Keep in mind that some kids with OCD can do a fairly good job of holding themselves together in the classroom all day long only to fall apart when they get home in the afternoon. If that’s your child’s situation, see that she’s given a safe place and some quiet downtime after school so she has a chance to safely fall apart, then pull herself back together again before joining the family’s activities.
If all else fails, medication can be another option in the treatment of OCD, but only after a thorough psychiatric evaluation. Counseling—both individual therapy and a family-systems approach—can be effective, so consider it a necessary first step before you look at more intensive drug-based types of therapy. Whatever you do, make sure both of you as parents are working together toward the same goals. And don’t get upset or worried if things don’t change overnight. There are many forms of therapy that can help your child overcome his obsessions and compulsions, but it’s likely to be slow going for a while.
Here’s the good news: individuals who struggle with OCD/OCPD can learn to recognize intrusive and obsessive thoughts and feelings for what they are and come up with an active plan to resist them. With patience, repetition, and perseverance, your child can even change the chemistry of her brain through this life-affirming action. The result is liberation: true freedom from a pattern of behavior that might eventually turn self-destructive if left unchecked.