Obsessive Compulsive Disorder (OCD)

Obsessive compulsive disorder (OCD) is often joked about or dropped casually in everyday conversation. But, OCD is no joke, especially to the people living with OCD. OCD is a mental health condition that can affect people of all ages, including children and teens. Obsessive-Compulsive Disorder (OCD) is an anxiety-based disorder that is characterized by recurring, unwanted thoughts or fears—known as obsessions—that lead to repetitive behaviours, called compulsions. If your child frequently engages in repetitive actions like checking, counting, or organizing items to cope with their anxiety, they may be struggling with OCD. In children, OCD can be particularly challenging because it can interfere with their ability to learn and socialize, and it can cause significant distress for both the child and their family.

Parents are often confused by the quirky and strange behaviours they see their children doing, while children are often suffering in silence. Before you know it, OCD has become the boss and is running the show and controlling family life. It’s common for parents not to know what is going on before it’s too late and OCD has a strong grip on the child and often the family. As a parent, it can be heartbreaking to see your child struggling with OCD. It can be difficult to understand why your child is experiencing such intense fear or anxiety, and it can be frustrating to watch them engage in compulsive behaviours that interfere with their daily life.

What is the difference between obsessions and compulsions?

Obsessions: Intrusive, distressing thoughts, images, or urges that children cannot control and often lead to significant anxiety.
Compulsions: Repetitive behaviours or mental acts performed to alleviate the anxiety caused by obsessions. These behaviours might not make logical sense but are driven by an overwhelming need to reduce distress. Compulsions include repetitive rituals, avoidance, and reassurance seeking.

There are various subtypes of OCD. Some subtypes of OCD include:

Checking OCD: Children with Checking OCD feel compelled to repeatedly check things like locks, lights, or appliances to prevent something bad from happening. This behavior is driven by fear and can become time-consuming and disruptive.
Contamination OCD: Contamination OCD involves an intense fear of germs, dirt, or illness. Children with this type may wash their hands excessively or avoid certain objects or places to prevent contamination.
Counting OCD: Children with Counting OCD feel the need to count objects, actions, or even thoughts in specific patterns. This compulsive counting is often done to relieve anxiety or prevent bad things from happening.
Existential OCD: Existential OCD involves obsessive questioning about the meaning of life, reality, or one’s own existence. These deep, unsettling thoughts can cause significant anxiety and distress in children.
Harm OCD: Harm OCD involves intrusive thoughts about causing harm to oneself or others. These thoughts are deeply distressing, and children may engage in rituals or avoidance behaviours to prevent harm. They may also seek constant reassurance from others.
“Just Right” OCD: Children with “Just Right” OCD feel an overwhelming need to make things feel “just right” or perfect. This can involve arranging objects, repeating actions, or following specific routines to achieve a sense of completeness.
Magical Thinking OCD: Magical Thinking OCD causes children to believe that their thoughts, words, or actions can influence events in an unrealistic way. For example, they might think that stepping on a crack will cause harm to a loved one.
Real Events OCD: Children with Real Events OCD become fixated on past events, often minor mistakes or misdeeds, and worry excessively about their implications. They may repeatedly analyze the event or seek reassurance that they aren’t “bad” for what happened. They also often feel the need to “confess” to every minor event that has happened.
Relationship OCD: Relationship OCD causes children to obsessively question their relationships with friends, family, or romantic partners. They may constantly seek reassurance or analyze their feelings to ensure they’re “right.”
Scrupulosity (Religious) OCD: Scrupulosity OCD involves obsessive concerns about religious or moral issues. Children with this type may fear they’ve sinned or offended their beliefs, leading them to engage in repetitive prayers or rituals to alleviate their anxiety.

Approach to Treatment

The good news is OCD is VERY treatable! In fact, it’s Dr. Lisa’s favorite challenge to work with because there is such great evidence-based treatments for it. If you and your child put in the work, your child can become the boss of OCD rather than the other way around. Dr. Lisa has years of specialized training and extensive experience in treating children and teens with OCD. Her approach to treating OCD is built on empathy, patience, and personalized care based on the latest science and evidence-based practices. She understands that children require a unique approach that takes into account their developmental stage and emotional needs. Dr. Lisa uses age-appropriate techniques, including cognitive-behavioural therapy (CBT), acceptance and commitment therapy (ACT), and exposure and response prevention (ERP), to guide children towards:

Accepting Their Feelings: We can’t control our feelings, but we can learn to make room for and accept our feelings.
Understanding Their Thoughts: Helping children differentiate between helpful thoughts and intrusive obsessions.
Challenging Compulsions: Assisting children in breaking the cycle of compulsive behaviours by gradually facing their fears and reducing rituals.
Building Coping Skills: Equipping children with practical strategies to manage anxiety and cope with distressing thoughts.
Empowering Resilience: Fostering a sense of empowerment and confidence to confront OCD triggers.

The overall goal of OCD treatment is to help your child learn to accept their obsessions and not be controlled by their OCD. We can’t make OCD go away, but we can make sure OCD has no power.

Parental involvement is an important part of treatment for children with OCD, as OCD has often roped parents into its game. Parents can learn strategies to support their child and reinforce the skills they learn in therapy. They can also help their child practice their new coping strategies at home and in real-life situations.

A Journey Towards Brighter Days

OCD doesn't have to define a child's life or your family’s. Reach out to Dr. Lisa today to learn more about how she can help you and your family regain control over OCD.