Re: Son diagnosed with OCD. Not sure if diagnoses is correct... I am

May 11, 2012

OCD shares some symptoms with other disorders, so that can make diagnosis

complicated. It is based in anxiety. And our social worker often helps us to

sort out behaviors that we think are OCD because they are anxious. His baseline

is that OCD has a fear associated with a compulsion. " If I DON " T do this,

something bad will happen " , even if they can't name WHAT the bad thing is.

You may want to get a second opinion from someone who has worked with several

kids with OCD, using exposure response therapy.

In the end, I think parents intuition is powerful, so if you are not convinced

then you either need someone to give you a better explanation about why this is

OCD, or keep looking for a diagnosis that clicks with what you are observing.

Good luck,

Tara in Chicago

May 12, 2012

Our son, who is doing quite well right now still MUST have either the number 2

or 11 on his sports jerseys. This year as the only freshman on the varsity

lacrosse team, he got last pick of jerseys. 2 and 11 were gone. He came home

all upset because the remaining numbers were assymetric. He picked 8 because it

was " the least bad' since it matches top to bottom. I pointed out that if you

lie it on it's side it is infinity. That seemed to help! Who knows. " Just Right

" ocd and obsession with certain numbers of times of doing things repeating

things, touching or tapping is very common.

May 12, 2012

I am responding to this statement-

" I find myself wondering if I have the right shirt clean, the bowl he is going

to want for breakfast... etc. It is exhausting. "

I remember being there and it IS exhausting. All your parental instincts tell

you to make sure you do have the 'right " stuff and things are arranged in a way

to not get them upset. The issue with this is, that in this case, all your

parental instincts to protect your child and arrange the enviornment so they

wont freak out are all wrong. By making sure everything is " right " you are

actually unknowingly helping the OCD get stronger. You are telling your child "

I believe your OCD too " The goal is to talk back to it and begin exposing them

to the stuff that WILL make them freak out in a controlled enviornment. To say,

that is not dangerous and your OCD is lying to you and I am not going to help it

lie to you and I am going to fight back BECAUSE I DONT BELIEVE IT. This

involves CBT/ ERP with a good therapist experienced in CBT/ ERP for OCD if

possible. If not, it involves doing a lot of reading and becoming an expert

yourself, or going to an intensive ouptatient program specializing in OCD in

kidsfor a short time to learn how it is done (both for parent and child). I

would strongly encourage you to seek out some good help and start CBT/ERP as

soon as possible. Good luck

May 12, 2012

the book by PInto Wagner called something like what to do if your child has OCD

has a great section on common rituals and types of OCD. Worth looking through

at a bookstore or library if you cant buy the book. Another really interesting

book is " the boy who couldnt stop washing " which is side by side chapters

written by patient and psychiatrist for several different patients with several

different types of OCD

May 13, 2012

i agree that ERP should be started soon. Maybe 3 or 4 visits in after meeting,

explaining the process, making a fear heirarchy, and a reward system. This

should take no longer than 5 visits. All the rest of the coping skills etc is

just a waste of your time as far as getting a handle on the problem. Learn that

stuff LATER as a life skill. But it is not good treatment for OCD, AND IN FACT

the number one mistake with CBT/ ERP as I see it is that people try to get the

patients to use the relaxation stuff during ERP. You actually dont want to use

relaxation during ERP- You wnat to use anti relaxation and get them as anxious

as possible about whatever particular fear it is you are working on. For

example, when we were working last, we had to do ERP on " food spots " on the

counter and in the car etc. Part of the exposure was giving a jar of pasta

sause to my then 5year old (younger brother of OCDer) and telling him to do his

worst in the kitchen with it ( talk about making mom anxious). Then when that

got boring, leaving the pasta splattered around the kitchen and telling stories

about ants and maggots coming and invading our house and crawling into bed with

us etc- just trying to make him imagine all the WORST things that could happen

from pasta sauce).ERP is about being anxious and tolerating it and seeing that

nothing bad happens and it goes away on it's own.

Some kids need meds to do this and others dont. My son was already on meds the

last time we did real exposures but he did not need to increase his dose to do

them. That is individual, but I think giving CBT/ERP a try first to see if they

can engage is the standard of care ( or should be). It they cant engage, then

meds may be appropriate too

ERP is a lot of miserable work- the hardes thing I have ever done and I am sure

the hardest thing my son has ever done. But boy does it feel good to slay the

monster!

May 13, 2012

Just jumping in with some thoughts on your post....

Where to begin with ERP -

Start small, something manageable - ask your daughter to list her O/C and assign

each a number between 1-10. You would start with a 1 and build up to a 10. Not

sure if your doctor has done a hierarchy already?

Ask your daughter what she wants to start with. Or you might have something

that is problematic for you that you'd like to work on, but still ask your

daughter if she is willing.

Re frustration directed at you... Since you are the " cause " (in her mind) of

things that will trigger the OCD for her, she will vent her anger/frustration on

you. Try to direct her back to the OCD, remind her it is the OCD that is the

bully/bad guy.

It is hard to be Mum and " therapist " with the ERP. Impossible set up really,

but the nature of it. As has already said, you have to go against your

natural instinct to protect your child and instead actually provoke anxiety and

suffering. Hard for your child to not see that as against them, even when they

understand the process, and yes, I would think confusing for your 7yr old.

Ideally your dr. will cover this with both of you. Saying something like, " Mum

will be doing x to work on the OCD with you " , and make sure your daughter

understands this is what needs to be done. That the ERP causes more suffering,

but there is a purpose to it, and you end up " beating " the OCD - you win against

Mr. Wrong.

Our son is 20 and it is still an issue. In the moment, when OCD is triggered,

they really are " locked in " and are completely irrational. They will say and do

just about anything to get you to do what they feel they need you to do. What I

find helpful, is to remind myself it will subside and my son will be back,

eventually. You basically have to learn to not take anything they say or do to

heart, or react in anyway, ie. hurt, because that can give them something to

play on and " use " to get what they want, ie. you to accommodate their OCD need.

It's good to talk about it after, and go over what is happening, how the OCD

takes over and you understand this, but .... and plan for next time, go over

boundaries. However, if you are in the early stages of this, it may be

necessary to accept that boundaries will be crossed, and just do your best to

stay calm and wait it out, and try to help her contain her own emotions -

perhaps saying things like " make a good choice " re behavior/words - not sure if

this would be helpful or not, depends, just trying for some kind of cue to

remind.

You can boss back the OCD yourself. Many a time I yelled at it to leave my kid

alone - he liked that!

Keep externalizing the OCD, telling your daughter how much you love her and

don't want this to be happening to her. Our son responded well to empathy and

needed to be heard, before we could address anything at all.

They suffer so much and can feel so alone, and with the ERP, feels like you are

against them. Our son felt the whole world was against him, everywhere he

turned OCD was triggered, and there I was not helping, but making it worse. So,

it's really important to have those warm and fuzzy moments - and can be almost

impossible to feel warm and fuzzy towards them when they are acting in a way

that you want to get as far away from it/them as you can! Or maybe that's just

me

It's really hard to feel like your child thinks you are against them. With

time, as she learns to use the tool of ERP herself, she we be more able to

accept the whole process - never easy though.

Hang in there.

Barb

Canada

Son, 20, OCD, LD Plus

>

> very helpful response!!! If my daughter has several rituals and rights

in her head where do you begin with ERP? She is highly frustrated at me I think

mr wrong (our name for OCD) doesn't like me which causes me concern for our

relationship. Maybe ERP is harder because she's only 7? I need to talk with dr

>

May 14, 2012

I would agree with Barb on everything she said. My son was dx at age 3 and try

explaining it to a 3 year old. Sobbing and wailing " I know you say it is safe,

but I feel like Im going to dieeeeeeeeeeeeeeeeee! " Yes harder in a younger

person but the theory is the same. You can tel lher how much you love her and

you hate Mr WRong and you are going to help her get rid of him, because you love

her and hate what he is doing to her. But she needs to know that getting rid

of him hurts. You could use the analogy of a splinter in the finger or

something she might understand- it hurts to have it in, and it hurts to take it

out but when you are done it feels MUCH better. Also Know that anything " she "

says to you is not her talking. It is Mr Wrong saying all that stuff and you can

feel free to just ignore it emotionally even if you do try to set bounderies

around it at other times ( dont try to set bounderies during an exposure unless

there is physical danger to someone in which case the exposure is probably too

hard or you neeed meds or a med change to try).

Contrary to your worry that it will ruin your relationship I am CERTAIN that

doing ERP has strengthened our relationship (in hindsight mind you). My son

knows I have his back through the hardest job in the world.

Start with the easy stuff on fear heirarchy and have a good reward system in

place. Do exposures as many tims a day that you have the time to set aside (1-2

hrs a day is probably a realistic goal). Have daily rewards, weekly rewards and

" big reward " at the " end " when you have met your goals.

Working with an experienced therapist is great but hard to find one esp for a 7

year old. If I had one thing to do over, it would be to have uprooted my life

and taken him to an intensive outpatient therapy program out of state for

several weeks where they actually have expertise in dealing with this in young

children rather than wasting YEARS on sub par therapy or " anxiety reduction "

techniques. Once you learn how to do it, then you are an expert. But someone has

to teach you because as I said before, it goes against every parenting instinct

I have.When we finally got good therapy in Florida( we live in Vermont) over

Scype it changed his life and things have been much better since. I am still

unable to find a good therapist here, but I truely feel that I am as good at it

as anyone in the country at this point and see no reason to pay someone else who

wont do as well as I can. If he ever gets bad again, I will opt for short term,

intensive outpatient back in florida. I do know they are running several ultra

short trial IOP studies there ( 1-2 weeks I think) which essentially teach you

to do it yourself. Kind of like ERP for dummies in a crash course. Happy to

discuss the program at USF with you offline if you would like. I guess my big

moral is dont wast time and energy and money on ineffective therapists who dont

know what they are doing and arent man ( or woman) enough to admit it.

May 15, 2012

" Just right " OCD is treated jsut the same. Having said that usually when you

get to the bottom of why it HAS to be that way there is fear or anxiety. I think

that is part of the defenition of OCD.

> > >

> > > very helpful response!!! If my daughter has several rituals and

rights in her head where do you begin with ERP? She is highly frustrated at me I

think mr wrong (our name for OCD) doesn't like me which causes me concern for

our relationship. Maybe ERP is harder because she's only 7? I need to talk with

dr

> > >

> >

>

May 15, 2012

" Just right " OCD is treated jsut the same. Having said that usually when you

get to the bottom of why it HAS to be that way there is fear or anxiety. I think

that is part of the defenition of OCD.

> > >

> > > very helpful response!!! If my daughter has several rituals and

rights in her head where do you begin with ERP? She is highly frustrated at me I

think mr wrong (our name for OCD) doesn't like me which causes me concern for

our relationship. Maybe ERP is harder because she's only 7? I need to talk with

dr

> > >

> >

>

May 17, 2012

My daughter has rages/temper tantrums (less now thank goodness) when we don't

cater to her OCD. I think that's fairly common. There's no reasoning with her

when she's in that state & no point discussing anything with her then. We

handle it by isolating her (sending her to her room or outside or away from the

family) until she calms down. She has gotten better with ERP & we are better at

recognizing when she's starting a tantrum & act immediately rather than letting

her ramp up to a full blown tantrum. We don't tolerate any physical or verbal

abuse though & now she knows it. So far this has been enough to deal with her.

Good luck to you.

Dot

>

> Hi,

> The anger toward my husband and I when things aren't feeling right or they

are not how she wants them, is more of a concern than the rituals at this point.

Her angry is disruptive to the family and i can't get a word it to even help

her. Anyone have this frustration/anger attached to their rituals or rules? I am

at a loss as how to handle that behavior.

>

May 17, 2012