Help Your Child Beat OCD with O.C.D.

The Acronym O.C.D. stands for Opt-Out, Consider, Decide — so when your child is faced with an obsession this gives him the opportunity OPT-OUT, and to then step back and CONSIDER two options. These two options are to help him DECIDE clearly whether to (1) step back in to the irrational moment whereby he gives into the compulsion or (2) whether to stay out and resist doing this negative reinforcing behaviour.

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What type of compulsions does O.C.D. help with?

All compulsions whether open, such as handwashing; or hidden ones which might be praying or mental reviewing.

Why is it important for my child to resist giving into compulsions?

It’s important because OCD is like a never-ending circle — the anxiety at first is relieved by compulsions, but then the ride goes around and around and never stops, and the child becomes more and more distressed but doesn’t know how to get off the big wheel of anxiety. The problem is that OCD sends incorrect messages that something is “wrong” or “doesn’t feel right” and so the struggle with compulsions is making the right decision — that is, to opt-out and stay out, or to step back in and continue gaining momentary anxiety relief.

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So what happens when my child chooses to stay out, and how can I help him?

When he decides to OPT-OUT explain that he gets the chance to stand back and see his unwanted thoughts in a way that is not influenced by his own feelings or irrational beliefs. Make him aware that opting out gives him a brief moment of awareness in which to think about this. During this brief moment tell him he has two choices to CONSIDER. Choice one is for him to DECIDE if going back in is the best choice since this will provide him with short-term anxiety relief only(going back in means giving into his compulsions); and choice two means staying out and building distress tolerance. This means he resists giving into his compulsions whilst agreeing to ride out associated anxiety until it begins to subside naturally, usually this happens within 30–60 minutes (reinforce this because it’s important your child is aware that his anxiety cannot get any higher when it’s reached a peak, it naturally comes down once it’s reached that peak). Let him know that O.C.D. is a practice strategy for helping him reach his main goal, where the anxiety wheel eventually stops and he is able to then enjoy recovery or much reduced symptoms.

So your O.C.D. strategy offers the chance to act very quickly, and before OCD wins the moment, is that right?

Yes, O.C.D. is a helping tool that supports your child through her EXPOSURE where RESPONSE PREVENTION is the aim, meaning the usual response (compulsion) is resisted for an agreed amount of time. As mentioned before, response prevention helps build distress tolerance, leading ultimately to habituation. Thus, the overall outcome during graduated exposures with ritual prevention can, and does, lead to remission?

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How can doubts and “what-ifs?” be dealt with?

When helping your child face her obsessions and she suffers the dreaded “what-ifs” one helpful thing to do is help her change her self-dialogue to mild exposure scripts. For example, “What if ______ (name fear) happens? to “Maybe ________ will happen, maybe it won’t, and I will live with that uncertainty.” Or, “I might have caused an accident; but nothing is certain, so I will ride out my anxiety until it comes down naturally.” Or, “Perhaps I left the stove on; on the other hand perhaps not, and if I did the house could set on fire, but I will live with the uncertainty of that whilst allowing my anxiety to subside.” Basically you are working with probability and for irrational fears the likelihood of something dreadful happening is so close to zero it isn’t worth worrying about, and this is something you can explain and reinforce to your child. Back on the topic of exposure scripts, initially these increase anxiety but with practice this does get better and the what-ifs and doubts start to become noticeably less.

What about magical thinking, any tips on this?

Remind your child that magical thinking gives him a sensation that makes him believe something could happen, but that a sensation isn’t evidence of this. Continue to remind him that intrusive thoughts do not convert to action. This tells him that there is actually no need to give into compulsions to “prevent” perceived danger or to “feel right”. One thing worthwhile thinking about when your child is faced with O.C.D. is that if he steps back in and does the compulsion, nothing bad will happen; and if he stays out and doesn’t do the compulsion, nothing bad will happen either. Basically, everyday occurrences happen, but not because your child had an unwanted thought about it.

What if my child steps back in and gives in to the compulsion, what then?

It’s simple. Let her try again next time. There are no failures when your child faces her fears, just doing that alone is an achievement, and so with your encouragement she has a better chance of getting through her fears and reaching her recovery goals.