What you may want to know about Obsessive-Compulsive Disorder
Obsessive-compulsive disorder (OCD) is often misunderstood. We hear people say “I’m so OCD” or “that’s so OCD” or someone is “obsessive” in describing everyday habits. But is it actually OCD?
Well, let’s start with what OCD isn’t.
OCD isn't simply being neat, organized, picky, or a perfectionist. Someone can love order or cleanliness without having OCD.
It isn't a child's fault or a parenting failure. OCD isn't caused by parents being too strict, too permissive, or not teaching their child the “right” habits.
It isn't attention-seeking or deliberate defiance. A child may resist a compulsion while at the same time feeling extremely distressed about not performing it.
It isn't just “overthinking.” OCD can involve powerful cycles of intrusive thoughts, anxiety, compulsions, and temporary relief.
It isn't always about germs or handwashing. OCD can involve fears about harm, mistakes, morality, relationships, sexuality, illness, losing control, or many other themes. Some forms are mainly internalized and without the compulsive behaviour may not be obvious to other people.
It isn't helpful to simply tell a child to “stop thinking about it.” Intrusive thoughts aren't usually something a child can switch off through willpower.
So what is it?
OCD is characterized by obsessions and/or compulsions: Obsessions are the unwanted, intrusive thoughts, images, urges, or fears that repeatedly show up and cause significant distress; Compulsions are the behaviours or mental acts a person does in response to the obsessions. They can temporarily reduce anxiety, or a person may think that by doing them they can prevent something bad from happening, or make things feel “right.”
The thoughts are often unwanted. A child with OCD may be frightened, disgusted, embarrassed, or confused by what their mind is telling them. Having an intrusive thought does not mean they want it, believe it, or will act on it. Often times, it’s this disconnect that causes the most discomfort - “how can I have a thought that is so counter to who I am as a person?”
Compulsions aren't always visible. They can include washing, checking, reassurance-seeking, repeating, arranging, avoiding, mentally reviewing events, counting, praying, or silently repeating phrases.
OCD can interfere with everyday life. It may affect sleep, school, family routines, friendships, eating, activities, or the amount of time a child can spend doing things they enjoy.
Children may not recognize OCD as OCD. They may be unable to explain why they feel compelled to do something or may worry that something terrible will happen if they don't.
If you think that your child may have OCD, here is something important to know and keep in mind - parents can sometimes become part of the OCD cycle without realizing it. For example, your child might ask “are you sure I didn’t hurt someone?” and a parent may repeatedly reassure them. While this reassurance can provide immediate relief, it can also become part of the compulsion cycle.
This doesn’t mean you should ignore your child’s distress. But, to the above-question, you could consider saying something like “that sounds like a hard question to be wondering about” instead of “no, of course not!” The most important message for a child is often, “you are not your thoughts and we don’t have to listen to OCD.”
There are lots of strategies available to help a young person with OCD and effective treatments (like cognitive-behavioural therapy and exposure and response prevention).
If you are worried, need ideas, or want to talk more, please reach out.