“Mommy, I have thoughts about killing you while you sleep. Do you forgive me?”
“I have thoughts of stabbing you to death.”
“I have the urge to push people in front of cars as I walk down the street.”
“I picture different ways of killing myself. The last time I hung myself.”
Imagine your young child or adolescent (anyone for that matter) saying these statements to you. How would you react? What would you think about your child? What would you think about yourself? Would you be scared? What does this MEAN?
No, these quotes are not something out of horror movie, but examples of thoughts from kids I have worked with. Kids with Obsessive-Compulsive Disorder (OCD).
But I thought OCD was people who like to clean and organize.
OCD is often misunderstood as someone who likes to clean or a germaphobe. Or, you’ve probably heard or even said yourself, “I’m so OCD.” The ugly truth is that OCD is a debilitating health condition that is widely misunderstood. OCD affects an estimated 1 in 200 children and 1 in 100 adults (though actual numbers are believed to be higher due to misdiagnosis and underreporting) and comes in many different forms.
We all experience obsessive thoughts and engage in compulsive behaviors from time to time, but OCD sufferers experience intensely distressing feelings in response to unwanted intrusive thoughts and images. In an attempt to decrease this distress, sufferers feel they must engage in overt and/or covert compulsions (i.e. praying, confessing, checking, rituals) that can take up hours of their day.
OCD is categorized into several different subtypes of fears and obsessions, such as contamination, symmetry/ordering/just right, pedophilia, and scrupulosity (morality). The quotes above are all examples of thoughts and images a person suffering from harm OCD may experience.
How do I know if my child has harm OCD or any other OCD?
If your child’s behavior begins to change or is out of proportion to their peers, this is a sign something more may be going on. Common signs of OCD may include, reassurance-seeking, avoidance of certain people, places, situations, or items, confessing actions and thoughts, or various repetitive behaviors and rituals (i.e. tapping, checking, praying, questions).
While everyone has ‘bad’ and scary thoughts sometimes, those with harm OCD may hide them out of fear of how people will respond or what they may do if anyone found out. By creating an environment where your child feels safe and free from judgement (even if you are scared yourself or don’t understand what’s going on), they will be more open with you about their struggles.
Will my child have these thoughts forever?
While OCD is not curable, many sufferers are able to gain control over their OCD with proper therapy or a combination of therapy and medication. Exposure and Response Prevention (ERP) is the gold standard, evidence-based treatment for Obsessive-Compulsive Spectrum and Anxiety Disorders. ERP helps sufferers face their fears gradually in a safe environment while resisting compulsions and tolerating discomfort; leading to a decrease in overall anxiety.
Unfortunately, OCD is too often misdiagnosed, and sufferers can be prescribed inappropriate treatment and medication for years before finding appropriate help. When looking for an appropriate therapist, don’t be afraid to ask questions. You are interviewing them! Inquire about how much experience they have successfully treating children with OCD using ERP (even some ERP experts don’t work with children). You can start your search for a specialist in your area through the International OCD Foundation’s (iocdf.org) ‘Find A Therapist’ tool.
To learn more about OCD and treatment:
All things OCD: https://iocdf.org/
UNSTUCK: An OCD Kid’s Movie: https://www.ocdkidsmovie.com/
Find A Therapist: https://iocdf.org/
How to Find the Right Therapist: https://iocdf.org/ocd-finding-help/how-to-find-the-right-therapist/
Parents Guide to OCD: https://childmind.org/guide/parents-guide-to-ocd/
Kids and OCD: The Parents’ Role in Treatment: https://childmind.org/article/kids-and-ocd-the-parents-role-in-treatment/
Support Groups: https://iocdf.org/ocd-finding-help/supportgroups/