When you find yourself asking "Why is my child doing this?"
Have you recently noticed your child engaging in ritualistic behaviors or having a preoccupation with specific thoughts? Do you notice your child’s routines becoming time-consuming or differing from that of “normal” childhood behavior? It can be hard for a parent when they realize that their child is exhibiting unusual behavior or expressing uncommon thoughts and worries. It can be especially hard for a child who is living with these symptoms.
It’s common for children who have undiagnosed OCD to have reservations about sharing their symptoms for fear of embarrassment, or because they don’t fully understand what they’re experiencing. OCD symptoms can sometimes look similar to other anxiety disorders, ADHD, and autism spectrum disorders and prior to having a diagnosis can make it hard to know what kind of treatment your child needs. A good starting point is to better understand what OCD is and what it isn’t.
Most people have heard of OCD but have preconcieved notions about what it is. As a parent there's a good chance you've been doing significant research but you might not be familiarized with the many forms that OCD can take. If you’ve ever found yourself sitting down at the computer searching things like “Why is my child frequently worrying about germs?” or “Why does my child excessively check things and frequently confess/apologize for their actions?” then read over a list of common obsessions and compulsions below.
- Extreme fear that bad things may happen or that they will do something wrong
- Worries about germs, sickness/disease, or dying
- Feeling things need to be “just right”
- Unwanted thoughts/images of doing harm to others
- Unwanted thoughts/images of a sexual nature
- Excessive washing/cleaning
- Doing things until they feel “just right”
- Arranging or ordering things
- Excessive checking (ex: “Is the door locked?” / “Is the iron off?”)
- Excessive praying or reviewing things in your mind
- Finding some works or numbers to be lucky/unlucky
- Excessive reassurance seeking (“Am I sick?” / “Are things going to be ok?”)
Obsessions can occur prior to seeing them physically manifest into compulsions. An example of this might be a child obsessing about germs and worries that they will become sick or die. A compulsion that they might use to combat these intrusive thoughts could be excessive hand washing, avoiding “dirty” places or staying away from people they deem to be “dirty.” Another example might be a child that writes and rewrites over their letters when doing homework until it feels “just right” or until a “bad” thought that they had gets replaced with a “good” thought.
If any of this sounds familiar, consider having a conversation with your child. Open the door for a discussion about their worries and behaviors to take place so that they can feel comfortable sharing their symptoms. According to the International OCD Foundation (IOCDF), some suggestions for parents on how to start conversations about their child’s OCD include the following:
“You seem so preoccupied all the time, can you tell me what’s on your mind?” “All people have worries; it’s okay to tell us about yours.” “We notice you repeating the same action, do you know you are? Are you afraid something will happen? Can you try to do it only once? What happens then? Does it just not feel right?”
Consulting with a therapist who specializes in OCD treatment and uses Cognitive Behavioral Therapy (CBT) in conjunction with Exposure and Response Prevention (ERP) is the best step to take to help your child. The sooner your child can get familiar with their OCD, the better. By understanding their obsessions and compulsions, and how OCD targets them in everyday life, the sooner they can learn practical tools that they can use to combat their OCD for the rest of their lives.