OCD is a mental disorder that impacts a person’s ability to think and behave in ways that would be seen as “normal”. These often look like excessive repetitive thoughts and behaviors that impact ability to function. In children, this can be very confusing and distressing while trying to navigate school and home life. OCD in children is often misdiagnosed as other behavior based diagnoses, such as ADHD. This can be especially disheartening for a child who is affected by OCD and increase the feeling of not being understood. As a parent or caregiver, the support system you can provide is crucial to treatment.
Many children experience OCD and keep it to themselves, whether out of discomfort, embarrassment or fear. As parents and caregivers of a child with OCD there are things you can do to support your child while also building an appropriate and healthy relationship, both with your child as well as with your partner. By having supports in place, expanding skills and actively participating in treatment with your child, you and your partner can be significant champions in your child’s fight against OCD.
Develop effective and age appropriate language to encourage communication
By developing a language and effective communication style with your child, your child will feel encouraged and safe to talk about things that may be uncomfortable or different throughout treatment. Developing a consistent understanding between child and adult can level the playing field and show your child that you are on the same team together. Using some of the following skills can support you and your child:
–use of metaphors (my OCD feels like…)
–use of age-appropriate and developmentally appropriate language
–use of characterization (my OCD monster likes/dislikes when I…)
–use of externalization (OCD is something else separate from your child)
–use of repetition
Develop accommodation reduction plan with therapist
Part of treatment with your OCD therapist will include identifying ways that you as a parent or caregiver accommodate, or change, to survive living with OCD. This can sometimes look like changing chores or routine expectations to avoid a blow up or acting out or melting down. Accommodation reduction plans look at these changes that are done, with the best of intention for your child, and examine how these actually increase OCD.
It also looks at how changing these behaviors as the adult then impacts and improves the symptoms of the child. Part of planning your accommodation reductions will include monitoring and recording your accommodations, their frequencies and their outcomes. Working with your therapist you will process what actions are developmentally appropriate, your motivation for doing them and what happens if you do not do them.
As a parent or caregiver it is always the goal to limit the amount of discomfort for those you care for but in the case of OCD treatment it is the goal to minimize these changes to promote discomfort until the child has reached habituation, or becomes regulated. At times this may feel like it does more harm than good, but by challenging these behaviors you will be helping your child take the needed steps to create change.
Plan and prepare for extinction bursts/behavioral reactions
When challenged, your child’s OCD will likely fight back. This can look like a few different things. Your child’s intrusive thoughts and behaviors may increase, there may be changes in mood and attitude as well as behavior outbursts. OCD does not like to be challenged and when your child’s OCD is not getting the attention it wants it tends to increase behaviors to encourage you and your child to fall back into old habits. These habits are what fuels the OCD. Extinction bursts are what happens when OCD is starved of the fuel that it has used in the past. When this happens your child may start to act out. In this case, it is important for the adults to stay emotionally regulated, calm, and patient.
In order to best support your child it is important to anticipate that these behaviors will happen and develop a plan for how to address these. Communicate with your child regularly that you love them and that they are safe while also reminding yourself that this is true. Prepare a safety or crisis plan, making sure that you provide a space for your child and yourself to feel safe and feel whatever emotions come up. Do not be afraid to disengage from your child if they continue to escalate or if you feel yourself becoming distressed.
Communicate beforehand that sometimes adults need a break too and that it is normal. It is also important to have consequences for behaviors unrelated to the child’s OCD, which is best identified if you are in a calm place mentally and emotionally prior to or long enough after the behavior to be able to discuss it calmly. Most importantly, staying consistent between adults and between outbursts is key to change. No matter how difficult it feels, or how you may feel about your parenting skills, it is important for you to maintain participation in treatment. Remember, your child is learning from you through this process, if you lead by example they are more likely to practice the skills you show. When difficulty increases, talk to the child, your partner and therapist and work together as a team to address and adjust safely.
Take Care of Yourself
It may seem backwards and less parental, but it is okay to prioritize your health. In times of distress children look to their parents and caregivers for guidance and as a model for how to handle negative emotions. OCD not only affects the child’s life, but others in the home too. OCD can impact a parent’s ability to give time to others in the home, often prioritizing the child with OCD and preventing outbursts while taking away from other children or relationships.
Yes, your child with OCD needs your support, but your mental health and that of the others in your life is important too. None of this situation is easy, but by identifying the needs of yourself and others outside of your child’s OCD will only strengthen the support system and minimize stress. If you are spread too thin you will not be able to give your child 100%, by taking care of yourself you only increase your ability to support your child as well as maintain healthy relationships with those around you.
Activities you find fulfilling, that make you happy and that increase self worth are great examples of things to do for yourself. It can also be helpful to set boundaries and expectations for yourself and others while working with those in the home. Increasing social and family support is also a wonderful resource. There are online resources for educating yourself and others included in the care of your child as well as online groups for parental and caregiver support. Making time to focus on yourself creates a space where your child can learn to do the same.