What is OCD? And how do you tackle it in children?

It's important to know what OCD is before attempting to tackle it in children.

So what is OCD?

OCD, or obsessive-compulsive disorder to give it its full name, is made up of 3 components which are:

Obsessions

These are intrusive thoughts that lead to carrying compulsions.

Compulsions

These are actions that sufferers feel they need to do, over and over again, to calm anxious thoughts. They can be mental and physical compulsions.

Despite these actions being repeated over and over, they are not enjoyable. Far from it!

They are exhausting and can lead to children sleeping for long periods, which can lead to low school attendance and avoiding socialising with friends.

Disorder

The disorder bit is when intrusive thoughts become stuck and fail to release. This leads to the thought going around and around in the child's head, leading to carrying out compulsions.

The disorder part of the illness separates OCD from general anxiety because most children will have intrusive thoughts at some point or another.

However, a child with general anxiety will usually be able to resume everyday life after experiencing intrusive thoughts.

Sadly this does not apply to a child suffering from OCD. They will become consumed with the thoughts (and consequent compulsions), leading to them not being able to resume normal activities.

So how do you start tackling child OCD?

Before discussing what to DO when helping a child with OCD, here are three things NOT to do.

Offer reassurance

OCD feeds off reassurance. The more reassurance you give, the more it will demand. Try to resist offering reassurance to your child.

Provide a reaction

OCD loves to be the centre of attention. It craves an audience. Try not to react when it creates a full-blown OCD meltdown in your child.

Get recruited

You will be amazed at how easily OCD can recruit the whole family into carrying out the most bizarre rituals. After all, who wouldn't want to do anything in their power to protect their child? The problem is, once you start complying with this invisible monster (aka OCD), things will begin to spiral out of control until OCD will be controlling the whole family!

What can you do, instead, to support a child with OCD?

Here are a few things that were real game-changers for us when supporting our daughter with OCD.

Introducing exposure therapy

Exposure therapy is considered the best treatment for OCD.

It consists of introducing children to their biggest fears, bit by bit, without carrying out consequent compulsions.

It's not a quick fix.

And it's not an easy one.

But if practised consistently, it can provide relief from OCD.

How do you start introducing exposure therapy?

The best way that we found was to start by writing a list.

Writing the list

• List all OCD issues to be tackled. Using coloured cards and pens can help to make this task more fun.
• Score each item on the list out of 10, with ten being the highest anxiety and one being the least.
• Select the lowest scorer on the list. (It's worth noting that at this point, most items will probably be high scorers). If this proves to be the case, then ask your child to select an item off the list.
• This will become the FIRST CHALLENGE.

Coming up with a plan

Agree on how your child will start tackling OCD via exposure therapy.

Some suggestions to consider include:

• Delaying carrying out an exposure, e.g. delaying an exposure for 3 seconds.
• Reducing compulsions, e.g. Reducing hand sanitising from 20 times a day to 15 times a day.
• Saying the OCD fear word/thought out loud, e.g. covid.
• Putting images of the OCD fear word up on the wall and leading up to touching it.
• Creating exposure to people being avoided due to OCD via methods such as having video calls, writing letters or emails to them, or using a barrier such as wearing plastic gloves to touch the person.

These are just some of the ways that you can start introducing exposure therapy.

The next step is to decide on a time frame to achieve the challenge, e.g. one week.

Distracting the uncomfortable

Exposure therapy can be highly challenging for children and can leave them feeling quite distressed.

That's where using some form of distraction can help.

When your child is carrying out exposure therapy, try to distract them somehow.

For example:

• Try to engage in some interesting conversation with them.
• Do something fun simultaneously, like playing a board game, doing some craft, going outdoors and so on.
• Play some soothing music in the background.

Rewarding successes

When rewards were mentioned to us, we were dead against them, especially as we had other siblings to consider.

However, I must confess that offering rewards can be effective in combatting OCD because they help:

• Motivate children to get on board with therapy (and stay consistent with it).
• Provide focus (especially when the therapy is particularly tough).
• Help them to celebrate the wins.

One tip I would strongly recommend, though, is to create a reward system for siblings, too, as OCD can be tough on them.

When your child has successfully tackled the first challenge, use the same system to start tackling the rest of the list.

How to keep OCD at bay

OCD is usually triggered by extreme anxiety. Therefore the best way of keeping OCD under control is by reducing a child's stress.

Some ways that you do this include:

• Having regular chats in a calm space.
• Going for a short trip in the car.
• Creating a sensory box.
• Keeping a journal.
• Listening to music or a meditation tape.

Sadly, when it comes to OCD, there are no one size fits, as OCD has so many different themes.

It is important to find what works for your child and stick to it.

And to closely monitor your child at all times to ensure that they don't:

• Experience suicidal or self-harm thoughts.
• Develop any new OCD themes. Be on the lookout for new themes creeping in, such as eating disorders.
• Allow their anxiety bucket to overspill, as this is what can lead to OCD developing again.

I now write children's books and workshops to help parents support children with OCD.

Within my books and workshops, I share in more depth. Strategies that I used when helping my daughter to free herself from OCD's clutches.

You can find more details about my Mind Monsters books and workshops on my website.