If I Step on a Crack, Will I Really Break my Mom's Back?
“STEP on a crack and I’ll break my mother’s back.”
This was a mantra that Lily, a bright but reserved seven-year-old child, truly believed. Her mother became concerned about some of her “odd” behaviours after Lily, normally quite a free-spirited girl, began to experience anxiety about some of her eating and walking routines. Lily felt that she could only use certain glasses and plates at dinnertime out of fear that all others were “dirty.” She also only walked on every other tile on the floor and would avoid the cracks between them altogether. Lily explained that she did this because it was the only way to ensure that her mother would be safe from danger.
Andrew’s parents received calls from his teachers on a regular basis because he was at risk of failing a lot of his classes due to work not being handed in. When confronted by his parents, Andrew responded that he would only hand in “perfect work,” which on most days meant that he had to re-do his assignments or notes over and over until it felt “just right.” His parents also did not realize that on some nights, Andrew would wake from his sleep after a bad dream to “re-do” projects that were already completed because he feared his teacher would grade him poorly on work he had already submitted.
Obsessive-Compulsive Disorder, or OCD as it is commonly referred to, affects approximately 1-2% of children and adolescents (instances are higher now with COVID). It is a form of an anxiety disorder that impacts the way a person thinks and acts. As is evident in the above inspired examples, OCD can have a significant impact on a child’s or adolescent’s ability to function at school, with peers or with loved ones.
OCD symptoms consist of recurrent and persistent obsessions (thoughts) and/or compulsions (rituals or behaviours). Often, the child or adolescent will say that they need to engage in this cycle “just because” without being able to articulate a valid reason for doing so. It is simply a feeling that they have - usually an anxious one. In an attempt to stop the anxiety, they repeat the cycle.
However, by following through with this cycle on a consistent basis, the anxiety is reinforced and eventually develops into a “false alarm” cycle whereby their brain is hypersensitive to the anxiety response and acts in a way that it believes will decrease the anxiety.
Unfortunately, this response only increases the likelihood of fear in the future.
Take the example of someone with contamination issues about public transportation. Teens often ride the bus or subway to get to school or social events. Imagine a teen who believes that if she touches anything on the subway or bus because it is contaminated by all the people, germs, etc., she will contract a virus, illness, an STD or HIV. This teen enters the subway and because it is rush hour, is forced to stand and hold on to the handrail (a very anxiety provoking task). Someone next to her starts to cough. The teen immediately lets go of the handrail as a whole host of thoughts stream into her mind.
Some of these thoughts might include, “I’m going to get sick, this place is a pool of germs, my throat is closing up, that person is probably dying from something that I could catch, I am stuck here and can’t get out…” To control the anxiety, the teenager decides to pull out her hand sanitizer that she carries with her everywhere and uses it to clean her hands. The sanitizing brings a feeling of calm, and allows her to carry on with her day.
By engaging in the act of letting go of the rail and sanitizing, this in effect “saves” the teen from her troubled thoughts and her fears of catching a life-threatening illness from the cougher. This is until the next time someone coughs or sneezes, or looks sick, and the cycle starts all over again. In this sense, by sanitizing, the teen has stopped the anxiety and felt a false sense of safety. But this only lasts until the cycle presents itself again, leaving the teen to feel vulnerable and unsafe again, forcing her to undergo her ritual of cleansing to feel calm again.
It is important to know that is not uncommon for children and adolescents to try to find ways to hide their symptoms from others out of shame or embarrassment. This is because OCD symptoms are most often ego-dystonic, meaning that they are not in line with the person’s goals or self-image and get in the way of success. In short, a person realizes that the thoughts they are having and behaviours they are engaging in are not helping them, but they still feel the need to follow them.
For instance, a child realizes that he has checked the locks on the doors 28 times (and furthermore realizes that this is silly behaviour), but the thought that something terrible could happen to the family if the door is left unlocked burns his brain so deeply that he will need to check the lock a dozen more times until his brain is satisfied.
If you are a parent or someone trying to understand a very small snippet of what it might feel like for some children or adolescents who suffer with OCD, try this experiment.
If you are like most others that have completed this experiment, you likely felt frustrated, anxious and overwhelmed attempting to do all three tasks at once. This is often what a child or adolescent with symptoms of OCD feels like when it comes time to do home or school work. Imagine, for instance, a child who is told that she must complete a sheet of math questions with various numbers, but has difficulties looking at the number 6 because it is considered to be bad luck. It is no wonder then that many children or teens who suffer with OCD are also susceptible to feeling anxious and depressed.
Obsessive Compulsive Disorder
is no trivial matter for the
thousands of kids and teens who suffer from it.
Fortunately, there is hope.
Now for the good news— treatment works! Here’s what you can do to help.
1. Recognizing the signs and symptoms of OCD is a great first step in helping your child or adolescent find some peace.
2. Read and learn about OCD.
There is a plethora of information available to help you gain a better understanding of the symptoms that your child is experiencing. Many bookstores and libraries will carry a vast array of books that can help you understand not only why OCD happens, but ways to help you begin to understand and work with, rather than against it.
3. Be patient—and more importantly understand that the behaviours often associated with OCD are not done intentionally.
As mentioned above, many children and adolescents take great measures to ensure that their families and friends are not aware that they are struggling with OCD. Symptoms of OCD commonly cause a significant level of distress and most often sufferers are trying their best with what resources they have available to them to cope.
4. Know that children and adolescents are resilient and crafty.
It is a common reaction to want to immediately stop your child’s or adolescent’s suffering, especially when you witness the effect that it has on their school, home and social life. Know that, just as a child learns to accommodate to the arrival of a new sibling, changing schools, or successfully completing each academic year, he/she also learns how to overcome and adapt to strains put on their mental health. OCD can be treated effectively in children, adolescents and adults. Effective treatment (at any age) can leave a person feeling revived, self-confident and ready to take on new challenges.
5. Talk to your doctor and/or get additional professional support.
Witnessing your child or adolescent suffering from any of these symptoms can be heart wrenching. It can also be overwhelming for families to try and learn about and cope with OCD on their own. Often, parents end up enabling and accommodating their child’s behaviour in an effort to help them overcome the pain. If you notice any of these symptoms or have any concerns about your child’s emotional or behavioural functioning, you can start by talking to your family doctor or seek the help of another professional experienced in working with OCD.
Studies and research have found very positive results for clients who are motivated and follow specific treatment approaches in being better able to work through many if not most of their OCD symptoms.
Help is Here.
Hope is Here.
Let's Learn and Grow Together.
NB: This article has been adapted, and was originally written by Dr. Morea and published in 2012, in Vaughan Whatever Magazine Summer/Fall Edition.