OCD in children

[Molly357]

I am looking for some help in tackling OCD in children. These are some of the things I am noticing.
-ritualistic bedtime routines
-repeating set phrases at bedtime
-liking things to be odd or even
I should add that none of this is noticeable to others yet or even dad. However, I would like to make sure that this doesn't develop, especially given lockdown. We have spoken before about it and I feel that it is quite controlling in their head but not always verbalised. I am not sure what steps to take next.

Don't think about or talk about managing OCD- the last thing the child needs is attention drawn to their 'routines', it just entrenches the behaviour.

Think instead about managing stress, encouraging relaxation etc.

Build regular routines that diffuse stress, play breathing games, do kiddy yoga, light a candle, all sorts.

Help DC find words to describe how they are feeling, so they know how to ask for help. Model good habits.

Eg. Light a candle before dinner, talk about what felt good today, what felt difficult but you managed it (and how you managed it). Go around the table so everyone does it together.

Blow your worries into a balloon, then let the balloon go with that silly noise and spiralling action. Maybe even copy the balloon yourself!

Write the thing that bothers you on a slip of paper, post it in a worry box.

Get worry dolls to tell your troubles to.

If you can manage the underlying anxiety, the various tics will go.

Thanks for replying. They aren't particularly worried about any one thing and they dont think anything will happen if they dont do it. They just find these behaviours reassuring. Not a particularly anxious child more than any other. V Confident socially but finds chasing games etc stressful. I am going to look at B vitamins as know these can increase anxiety. Just wondered if any one had experienced something similar.

I don't know specifically about children but as an adult, OCD therapy makes you think about the fear behind the ritual and face it head on. E.g. a ritual could be lining up things (toys?) in an even number only. If they are not an even number, a member of your family will be seriously harmed.
During therapy you would be asked to purposely line the toys in an odd number and then sit with the fear that someone you care for could die. Doing this regularly causes the fear to slowly go and the ritual to be broken. You will see that the number of toys in a line has no impact on the health of your family.

Read up on this.
Performing the rituals brings brief relief but ingrains the 'need' for the behaviour.
Anxiety is at the root of OCD. Maybe a start would be to make time to talk about anything worrying them. Bedtime is a real trigger for worry for my DD.

They are managing anxiety using rituals, though. Address the anxiety, nips the behaviours in the bud.

I agree that the root of this is anxiety. However, he is really open and aside from monsters under his bed, he isn't feeling anxious-that he can verbalise anyway. He is happy and confident and very sociable. How do you tackle anxiety when there is nothing he can verbalise?

biblio.co.uk/book/what-do-when-your-brain-gets/d/558795969?aid=frg&currency_id=2&gclid=Cj0KCQiA0fr_BRDaARIsAABw4EvEkj0bZFKOH0ZA0RdJo95rhpxgrL8dKNy1gN2MRptf06nxKHyednUaAnWwEALw_wcB

have a read yourself.

My DD had CBT at 12 for OCD. You are vigilant to spot the rituals so early. DD was doing stuff like this and it just ramped up to at the end about 34 ritual maybe more. only looking back did we see the bedtime ones as the start.

DD's therapy was amazing but the main help was having the courage to do the opposite. The belief was something bad would happen if rituals not followed eg would die in our sleep. The thought made her do the act to feel safe and it took courage to do the opposite and trust we would be ok, but doing to opposite broke the strength of the thought.

Thanks MegCleary . I have been keeping an eye on him as he started
talking about needing to do things in even numbers last year. He likes to look at words and see if there is a central letter with even numbers each side. I feel like they are developing more recently and I now think I need to step in to stop it escalating.

By doing relaxation exercises, age appropriate meditation, mindfulness etc. Stress and anxiety are physical and emotional and mental. Small children tend not to be self aware enough to notice stress, it's just expressed through their behaviour.

Massage, age appropriate meditation, yoga- they teach us to become aware of the physical elements of our stress (muscle tension etc) and actively choose to release it. I've been doing a class for 18 months, where she specifies to relax and let go of any tension etc etc. A couple of months ago she mentioned the buttocks in passing and I realised that I hold huge amounts of tension there. Locked in. I was totally oblivious to it. It's hard to believe such huge muscles can be locked tight, without you being aware of it. But there you go.

On the superficial level of his mind, he has no stress and anxiety because he's got everything under control. He's in a leaky boat, but his toe is jammed in the hole, so everything's fine, enjoy the sunshine. He needs to learn to examine the boat!

These kinds of exercises aren't something you do a few times, identify the source of the issue and shout 'hurrah'! They teach you to relax physically, release tension, do a quick self check for pockets of tension/worries etc. You get better at it the more you practice. You may sit for 5 minutes and notice nothing, then a troubling thought drifts to the surface.

Obviously, children don't sit gazing at a candle in silence for 10mins, chanting 'om'. They need more active relaxation- things like knitting, repetitive soothing activities.

Have you ever walked a labrynth? You could make one together out of string or papers. Walk the twisting path, concentrating on putting one foot in front of the other and staying on track. When you get to the middle, pause, turn around and come back. It's soothing. It unwinds the mind.

I know I'm not explaining very well. I've done a lot of work on trauma and therapeutic play. Try looking up therapeutic play, see if anything floats your boat! It's about building security and safety in the child, and for some, releasing past stresses and traumas.

Thanks picklemewalnuts. I have googled therapeutic play but a lot of the ideas involve talking about emotions which he will probably laugh at. I like the idea of the paper labyrinth though. Do you have more ideas or can recommend a website to look on? I think some activities before bed would be good as I think his mind is often whirring. He isnt allowed any screens after 5.30.
MegCleary I have ordered that book as it looks good .

When he "needs" to do a ritual ask him well want will happen if you don't?

This is "magical thinking" and a type of faulty thought that should be challenged (supportively of course).

I would be asking the question above and then discussing why magical thinking is unhelpful in an age appropriate way. With adults what's often used in therapy is would you think the same about a positive thought? Eg would you think you are gong to win the lottery because you thought about it?

Read up on CBT and incorrect thinking. It's all about challenging the incorrect thoughts by finding evidence that supports the opposite viewpoint or why the thought can't or is unlikely to be true.

Good you are tackling this now before it becomes a bigger issue.

Mindfulness practice may also help. This helps create healthier neural pathways in the brain (tackling MH issues sideways on rather than head on) and encourages healthy MH practices such as acceptance and gratitude.

Ok, quick a brain storm..... I don't know your boy, so it's hard. When you play these, you'll feel how it works, and get ideas that suit you better. See what he likes and responds to.

Bed time wind downs
Give him a foot massage, or ask him to give you one. Feet are a long way away from the heart or head so aren't emotionally threatening... but do give an opportunity to talk about what feels nice, soothing, relaxing, smells good, tickles, etc. Also, like talking on a car journey or while doing the washing up. You are both stuck there in companionable silence, so things tend to get said. You can do head or hand massage too.

Make a sock maze together- lay out a line of socks on the bedroom floor and make it wiggle or spiral about. Walk inside the shape or on top of the sock line (depending on the shape).

Ask him to help you put cream or talc on your feet- they are sooo far away and he is young and bendy! Talk about the smell and feel of the lotion.

Get some essential oils- safe, soothing scents, lavender, geranium, rose etc.. do a scent test. Every evening choose one to put on a handkerchief or tissue one his radiator.

Self care. Show him how to smooth out his pillow, pick a good book, choose comfy pyjamas, make a warm milk (add honey, spices, see what he likes- the choosing is part of the activity). Brush his hair, if he has enough! Choose an audio book. Try and find some ways of babying him, without it feeling silly for him. Take opportunities to coddle him where you can. Touch is so important.

Silly games
Make a [child's name] pizza. You announce you're turning him into a pizza, squash out the dough (firm pressing movements), smooth on some pizza sauce (stroke firmly and smoothly), plop on some toppings (gentle poke, poke, poke) sprinkle some cheese (fingers sprinkling onto him).

Ask him to hide a cotton ball or similar on himself. Tucked into a sock or a pocket, not in the areas covered by a swimsuit. Then pat pat pat all over him trying to find it.

Try blowing a cotton wool ball with a straw. Move it around the table. Make a maze for it and try and blow it through. If you both have straws it's teamwork to try and keep it on track.

Eat a strawberry lace- at the same time! Start at opposite ends, eat till the middle! Maybe make a silly face as you get to the middle so he giggles and let's go.
Put hula hoop crisps on your fingers, and feed some to him.
Eat a chocolate mousse each- but you have to spoon it into the other person's mouth not your own!

Laughter is a great stress buster, as is physical touch.

Have only read the OP, not the comments so excuse me if repeat something.
I am wondering whether your child may be on the autism spectrum? I understand you've not detailed anything else that would suggest this, however getting comfort from the routine makes me question this.

If they have OCD they will have fixed beliefs around their behaviors, not just the behavior itself i.e if my books are not in the correct order my mum will get Covid etc.

I am a CAMHS nurse so feel free to shoot me a PM if you like, but it is likely that with everything that is going on they are anxious and trying to create a sense of control and authority for themselves. Allow it, but monitor it. Continue to talk to them, give them a "worry box" etc