Worried about DD's rituals

[Jourdain11]

I feel a bit bad for posting here, as it seems unfair on DD, but I am worried that I am overreacting and making an issue out of a non-issue.

DD8 lately seems to have developed all these little "rituals" - touching things, going to the toilet multiple times in a row, making little lists. I work in MH (albeit in another area and not with children) and I feel like, over the last few weeks, it's become quite disruptive to her life. A few days ago, she got quite upset and agitated at DH rushing her out of the house because (I think) she hadn't done her things. She also generally seems quite anxious and I've tried to get her talking about it, but she obviously isn't keen.

I don't want to make the mistake of labelling her behaviour as something when it isn't, nor do I want to make her self-conscious, but I feel she's showing OCD tendencies and I am really concerned not to let things get out of control. If she needs help, I want her to get it in a timely way so that this won't take over for her.

DH thinks we should let it be, because it might just "fade away", but my feeling is that it is escalating.

On the other hand, I know it is normal for kids to have some ritualised behaviour, and I am worried about overreacting... which is why I'm posting here, I guess for a neutral and non-involved opinion! Although I appreciate it is difficult when you haven't seen / don't know DD.

As a family, we've had quite a lot of changes and stress recently (who hasn't?) so I guess I am concerned about how this may have affected her.

Thx in advance.

It's teaching your dd that your brain plays tricks on you and you need to "boss" it back and tell it off for tricking you. Giving it a name to "tell off"

Also knowing and accepting that when resisting rituals, stress will initially increase as the brain panics because its usual coping strategy isn't working so it tries harder to make you do what it wants you to do. Realising that going through that initial increase in stress and knowing that it will pass and will soon lead to a much lower stress level, makes it much less frightening. Rather than trying to resist it all in one go, it's advised to split things into tiny segments and then reward/bribe each tiny baby step.

Good luck.

I don't think it's that uncommon - when I was worried about changing schools, I had to do things equally with both sides of my body. So if I accidentally brushed something with my right hand, I had to do it again as closely as possible (same pressure, angle etc) with my left. For me, it just went away after a couple of months, partly because at school I couldn't always 're-balance' and nothing bad would happen, and also I got used to the school and was happy there. So maybe as things get more back to normal, and if she's kept busy and distracted, she might realise that she hasn't completed the ritual but everything was still ok.

Other than that, I've never really had any mental health issues. I'm still not massively keen on change, and am a bit cautious in new situations, but the feeling never came back after that time (but I still remember it, because the feeling of compulsion and worry about what might happen was really quite scary). So hopefully it'll will just be a one-off for her.

This might sound a bit airy-fairy, but before you go to hospital would you consider getting your DD a worry doll? It's a tiny doll that you tell your worries to before bed, then sleep with it under your pillow, so during the night it looks after your worries for you rather than them giving you bad dreams. My parents bought me some and it helped me know it was ok to worry. I think having to think of how to verbalise what I was worried about helped too because it gave me a chance to organise my thoughts, rather than panicking.

Obviously it isn't a full solution, and in the long term CAHMS is probably a better option but it might be something immediate you could do? I hope your hospital stay is OK, it must be a very difficult time for all of you.

I think you're right to look into OCD.

My daughter has elements like this and has been diagnosed with pans/pandas which triggers OCD from the immune system. So her OCD gets worse when she's sick, but also in times of stress.

Just wanted to mention that there can be a strong biological/medical/genetic component that causes OCD.

Thanks again for all the help and advice!

DD finally talked to me a little bit this morning. She was supposed to go to tennis today (she is doing it all week - we tried to sign the kids up for lots of activities to keep them busy while I'm in hospital) but once again, it for forever for her to get ready. I asked her if she was doing extra things because she felt anxious and she said no, she wasn't doing anything, and got quite agitated. I maybe pushed it a bit and said "I've noticed you doing some extra things" and she got upset and said she has to do it to stop anything going wrong. Then she got very upset.

I tried to reassure her and said that nothing she does or doesn't do will make anything go wrong, but she was in floods of tears and kept hitting at her legs and saying, "I don't feel safe!" It was horrible and so, so sad. And I can absolutely understand why she feels like that.

I tried to stop her from hitting herself (because she was punching at her legs really hard and I was afraid she was going to hurt herself badly) and I just tried to comfort her and said that she shouldn't have to feel like this and her dad and I will help her to feel safe again.

She calmed down a bit after that, but she was a bit too worked up to go to tennis, so we said she'd go after lunch. (She's now having a nap, I think she exhausted herself, poor thing.) I hope it will be good distraction for her.

I just feel awful, that maybe I've really pushed her too much and made things worse. I hope not!

I think it's better that she's acknowledged it, as now it will be easier to use the books - some of the ones recommended are CBT based, and it sounds like she is ready for that, being open about things not feeling safe etc, and ready to talk about how that's just a feeling.

I still have similar feelings lurking in the background, but they never got to the point that I got so distressed if I couldn't do various rituals. I used to do things like pull my hair out instead! but it did eventually improve as I got older and more able to acknowledge it. I do still have these odd feelings of not wanting to 'jinx' things by being too happy about something in case that makes it all go wrong, but that's all it is now.

Hi OP

I was diagnosed with OCD as a child and was similar to how you've described your daughter. She will definitely be reacting to the uncertainty around your illness.

I was then diagnosed with autism as a young adult - autism presents itself differently in girls than boys, and girls are quite often misdiagnosed with OCD. I don't want to say I was misdiagnosed with OCD, but the OCD was a manifestation of autism in my case.

Nothing you have said indicates autism but like I said - no doctor picked up mine until I was 20, I present differently to the 'stereotypical' (male) autistic person. So I recognised the behaviour as similar to mine as a child and wanted to share knowledge in case there are other things that might indicate this. Being diagnosed earlier would have made a significant difference to my life.

Good look with your chemo

I think it's actually a good thing that it's come to a head and that you're talking. Although it will feel pretty wretched for you both right now, this needed to happen and it does open the way up to talking about it, understanding it better and feeling happier.

I just tried to comfort her and said that she shouldn't have to feel like this and her dad and I will help her to feel safe again.

This is perfect and has now given you both an "in" to read and use the techniques suggested in all the books.

Thank you - it does feel terrible at the moment, but you've given me a bit of hope that things can get better.

I also made a tel appt to speak to the GP this afternoon, just to see what she can advise. It may be that we don't end up going down the CAMHS route, but I'm guessing we can always ask about the referral and if we end up not needing it DD could just be taken off the waiting list.

Jourdain, probably best to get on the CAMHS waiting list now. It can take a while. And like you said, you can always come off it, if things improve. OCD does have a way of waxing and waning.

Oh OP, I've nothing useful to add, but I just wanted to say that you sound like a really lovely Mum with a lot going on.

Sending lots of unmumsnetty hugs your way, I hope it all works out.

Thank you! The GP was great... she has put DD on the CAMHS waiting list, but said at the moment try to get DD to talk about her worries as much as possible, try to challenge some of the rituals one at a time, distract. We'll see how it goes!

I'm off into hospital today and (unsurprisingly) DD was very anxious last night and this morning (as were the other two, DH was grumpy, I was naturally sweetness and light!) but she has the tennis again today. Hopefully they'll keep busy and it'll all be fine.

Hope all goes as well as it can do in hospital

Also, just remembered this, a close friend recently had some counselling for OCD and one thing that her counsellor recommended in terms of stopping the rituals was weaning off them gradually. So for example, if one ritual is tapping the coffee table five times, try tapping it just four times. And then reduce it to three, and then two etc etc. So this method might help your DD a bit possibly.

I hope that everything in hospital goes as well as it can

Thank you, it is all going as well as it can! I think DD1 is very anxious though and the younger two are running riot, so I'm trying to video call a couple of times each day to reassure that all is okay. Poor DH is a bit harassed though!

A little update... for advice as much as anything else! DD is on the CAMHS waiting list and DH and I have been looking at the books and trying to use some strategies to help DD cope. It comes and goes a little bit, but in general I've noticed things building up over the last week or so. She has been very stressed and nervous the last few days and the rituals are starting to become quite disruptive (tapping things, going up and down stairs, going to the toilet over and over again). DH told her she needs to stop yesterday evening and she had a bit of a meltdown and starting hitting her head on the floor and screaming. It was quite distressing for everyone, but I imagine especially her. I just hope the waiting list won't be too long.

The only advice I can think of is to make a fuss with cahms, highlighting the new more severe behaviours. Make sure they know about your illness too. "He who shouts loudest" might be worth a try.

It is distressing isn't it.

Keep healthy and keep plugging away.

My now teen DD has suffered with OCD (not diagnosed) and anxiety. She is a deep thinker and sensitive to others emotions. It got very bad last year and she said she wanted help. After a useless GP referral to a cafe where she might access someone who could do “a bit of CBT” if they were available we found our own private practitioner.
After a joint chat she felt 6 weeks exploring her anxieties and worries and general talking therapy would be good to start without ploughing full into CBT.
It really helped and she is doing well although those issues will never go away the therapist explained to her they are a normal reaction to the worries in her life rather than trying to treat and stop the OCD if that makes sense?
Anyway just a little insight and perhaps a short course of some mild talking therapy to explore her worries? I wouldn’t leave it we had years of the mild issues until it was making her severely unhappy.

Sorry I should add I appreciate private can be costly our lady was £45 for around 45 minutes which was quite good and had worked specifically with children and teens in the Local Authority.

Thanks for this! I have been looking into private options, but it's tricky to figure out what sort of approach is going to be suitable. DD is a little resistant to the idea also, and I feel like it is going to be easier to persuade her to go if the doctor is sending her rather than her parents... if that makes any sense!!

Jourdain, I mentioned it before, but you may want to look into pans/pandas.

It sounds very much like it with the meltdown and hitting her head.

I have looked up the website and there are things which seem like it... but I'm not sure if the onset was sudden with the OCD type issues, at least, I didn't become aware of it suddenly. She certainly seems very anxious and tearful, lots of outbursts of shouting and crying and screaming (which is very uncharacteristic), and she seems very anxious around food (not wanting to have certain foods). Not sure about urinary frequency, because I don't know how much of it is needing to go to the toilet and how much is "just making sure".

She had another very upsetting episode tonight and was just screaming uncontrollably and hitting at herself and neither DH nor I could calm her down for what felt like hours. It's obviously very scary for DD2 and DS too, since they just don't understand and find it very upsetting.

Honestly, I just don't know what to do and I'm constantly afraid that I am just doing the wrong thing!

I'm even starting to worry about her going back to school, but maybe she'll be better once she's there.

Hiya, well we have a pans diagnosis and didn't have sudden onset. It crept on gradually over the years. Think they are really revisiting the abrupt onset in the diagnostic criteria no.

She always had problems with infections when she was younger.

You can trial her on full dose ibuprofen for a few days. If it's pans/pandas, the behaviour and OCD usually improves, as the symptoms are caused by inflammation.