By Dr. Cecily Anders
When people have Obsessive Compulsive Disorder (OCD), they often engage in rituals or compulsions that help them to immediately decrease their anxiety. These compulsions might include cleaning, straightening, checking, or movement rituals (such as opening and closing a door multiple times). Often a child with OCD will have a thought such as, “If I don’t wash my hands right now, I will die.” So the reasons that children engage in the rituals are quite terrifying to them. Many parents believe that compulsions or rituals help to decrease their child’s anxiety in a helpful way. In the short term, a compulsion or ritual can be highly rewarding for the child, especially in the beginning when the ritual doesn’t take too long to complete. However, over time, the rituals may become more elaborate and time consuming. Once the rituals become more time consuming, then the child and parents are able to see the down side of this coping mechanism.
With OCD in particular, working as a team with your child is a great way to help him or her better manage the symptoms. Together, you and your child can make an agreement to eliminate compulsions. If you see your child engaging in a compulsion, gently encourage him or her to try a different way to manage the anxiety using coping mechanisms that are frequently taught during therapy. If you also learn these helpful coping behaviors, then you can help better coach your child at home. Even though your child has made an agreement with you, frequent reminders will still be needed because the emotions and urges experienced by your child will be intense, thus making teamwork an essential part of OCD therapy.
Children and teens have a difficult time behaving in ways that will benefit them long-term. A helpful role for parents in this situation is to think about the long-term benefits for their child. Each opportunity to sit with anxiety, rather than engage in the compulsion, will teach your child that the anxiety is tolerable and that these scary future events will not actually happen to him or her. The short-term management of anxiety after a distressing thought appears will lead to better long-term management of your child’s OCD symptoms.
A lot of parents find it difficult to watch their children suffer. Resisting the urge to act on a compulsion will feel unpleasant to your child, especially in the beginning when the compulsions are easier. You may also want to “fix” a situation for your child so that they don’t feel an urge to engage in a compulsion, such as you are always the person to open a door so that your child doesn’t feel the urge to open and close the door multiple times. However, once one urge is “fixed”, another will pop up until you are overwhelmed with having to “fix” a number of previously smaller situations. Again, your role is to think long-term, rather than short-term. Everyone would prefer a quick fix for his or her child that does not involve any suffering. However, treatment often does feel uncomfortable at first. For example, we give our children vaccines, which involve a painful shot, so that they don’t develop life-threatening diseases later. Remember, that you are a team and you can also share your feelings about how hard it is to change and try out more helpful behaviors that have long-term benefits. Together, teamwork can help your child.