Helping Children to Overcome OCD: 6 Creative Strategies for Parents

Ben Furman, MD
30
1952

This article is for parents raising a child who struggles with OCD. I begin by suggesting ways to explain OCD to your child and outlining some ineffective and often counterproductive methods that children typically use in trying to manage their worries. Then, I present six creative strategies that you can teach to your child to help him or her manage the problem.

Although I offer suggestions to assist parents in helping their children, all of these ideas are applicable to adults as well.

What Is OCD?

Obsessive-compulsive disorder (OCD) is the medical term for a disorder, or malfunction in thinking, in which a person suffers from obsessions, which are often linked to compulsions. Obsessions are intense and obstinate worries that something awful has happened or will happen. Compulsions are repetitious acts that the person performs to try to manage their intense worries. Examples of compulsions include repetitious checking, cleaning, ordering, and superstitious rituals.

OCD affects an estimated two percent of the population. It is slightly more common in females than in males, and often starts in childhood — typically at around seven to ten years old.

Obsessions and Compulsions

An obsession is an apprehension, or a distressful fear that something dreadful may have already happened or will soon happen because of something the person has done or failed to do. An obsession is an obstinate worry that preoccupies the mind of the person and haunts them even if they try their best to overcome it.

Compulsion is the term used for the ineffective methods that people suffering from OCD use to try to overcome their obstinate worries. Imagine that this thought pops up in your mind: “My hands are dirty” (even though you already washed them a moment ago). You can try to get rid of that worry-thought by washing your hands again. If you find yourself washing your hands repeatedly, the washing is a compulsion that you are using to overcome your persistent and overstated worry that your hands are dirty.

Another example: An intense worry occurs in a child’s mind that something bad may have happened to his mother while he is in school and his mother is at home. The child can try to get rid of his worry-thought is by calling his mother to make sure Mom is alive and well. If the worry reappears soon, and the child feels he needs to repeat the checking, we can say that the checking is the compulsion by which the child tries to control the worry “Something bad may have happened to my mother.”

Standard OCD Treatments

The two most commonly used treatments for OCD are medication and cognitive behavioral therapy (CBT).

Psychiatrists readily prescribe psychotropic drugs–even to children–but its effectiveness is very marginal. At best, medication may reduce or mask some OCD symptoms by reducing anxiety, but more often than not the side effects of the psychiatric drugs outweigh their possible benefits.

Cognitive behavior therapy (CBT) is considered the gold standard for treating OCD in children as well as adults. Although good results have been reported in clinical research studies, in real life, the effectiveness of CBT seems to be overrated. A large percentage of people who have undergone CBT are still suffering from OCD symptoms after having completed their treatment.

In this article, I propose a way of thinking about OCD and an approach to helping children struggling with the condition that are grounded in the basic principles of CBT. However, this approach adds a creative layer that makes it more fun and engaging for the child. My inspiration derives mainly from the traditions of brief, narrative, and solution-focused therapies.

Explaining OCD to Children

It’s not surprising that it’s difficult to explain OCD to a child, because even experts haven’t got a clue as to why some people suffer from this condition while most don’t.

pink worry monster

One possible way for you to help your child make sense of her problem is to use “externalization,” an explanation commonly used in narrative therapy with children. It means that you tell your child that there is an imaginary creature, perhaps sitting on our left shoulder, whose job is to generate worries for us. Children usually respond well to this metaphor. You can then help your child come up with a name for the creature and ask her to draw a picture of it. In this article I will call this creature the “worry gremlin.”

An alternative way of using externalization is to explain that there is a special region in the human brain that is responsible for generating worries. You can call that area our “worry generator” or “nucleus worrius.” The very same methods that I describe in this article for coping with the worry gremlin can be applied to coping with nucleus worrius just as well.

Of course, there are no gremlins sitting on our left shoulder bombarding us with obstinate worries, nor are there any specific brain regions responsible for generating worries. Yet, metaphor can be very helpful to children, not only because it allows them make sense of their distressing experience, but also because it assists them in becoming more creative and astute in inventing ways to cope with their worries.

You can explain to your child that we all have a worry gremlin and we all need to learn to come to terms with or to live in harmony with it. Sometimes, if the worry gremlin becomes excited and goes into overdrive, we need to find ways to calm it down. It is also important to explain to the child that some ways to try to calm down the overexcited worry-gremlin work better than others.

Ineffective Ways to Calm Down the Gremlin

It may be useful for you as the parent to understand some of the ineffective ways in which children often try to come to terms with their worries. These methods include reasoning, reassurance, checking, cleaning, ordering, repeating, superstitious rituals, avoidance, and distraction. (If you are familiar with these strategies, feel free to skip this section and to proceed to the next, in which I describe six creative ways to help your child become better at coping with an overexcited worry gremlin.)

Reasoning

Children sometimes try to overcome their worries by starting an internal dialogue with their worry gremlin. The problem with this method is that it’s next to impossible to outsmart the gremlin. Consider this “conversation”:

“Are your hands perhaps dirty?” says the worry gremlin.

“No, they are not. I just washed them a minute ago,” the child replies.

“But they might still be dirty,” the worry gremlin insists.

“Why would they be if I just washed them?” the child tries to say.

“You did wash them, but not properly. You didn’t wash in between your fingers, did you?” the worry gremlin points out.

“I did wash between my fingers,” the child protests.

“Did you? Are you sure? You could have been careless. I bet your hands are still dirty,” the worry gremlin now says.

“My mother says that it’s impossible to have 100% clean hands. There will always be some germs on the skin,” the child tries to reason.

“That’s right, and by touching things that other people may eat, you can cause someone to become sick. Who knows, they may even die because of you,” the worry gremlin replies, and begins to scare the child.

“OK, I’ll wash them one more time just to make sure,” says the child, giving in to the obstinate worry gremlin.

Reasoning, or logical argumentation, means debating with the worry gremlin. It’s meant to silence the gremlin, but it does the exact opposite by triggering it to come up with endless counterarguments. The more the child tries to disprove the worry, the more intensely his or her worry gremlin will defend it. It is next to impossible to beat the worry gremlin by debating with it.

Reassurance

It is not uncommon for children who suffer from OCD to ask their parents to convince them that their worry is unnecessary. Parental reassurance can offer a temporary break from anxiety for the child, but the relief is often short-lived. By reassuring a child with OCD that there is nothing to be afraid of, the parents are doing a disservice to him. Instead of calming him down, this well-meant comforting ends up stimulating the child’s worry gremlin, simultaneously increasing the child’s dependency on his parents’ reassurances.

Child: Will someone in our family die during the night while we are sleeping?

Parent: No, nobody will die during the night. I have told you that many times already.

Child: Are you sure nobody will die? How can you be so sure?

Parent: We will all sleep well and wake up fresh in the morning.

Child: But what if someone dies in the night? Please tell me one more time that nobody will die. Say it again, please!

Checking, Cleaning, Ordering, and Repeating

Some worries can be overcome by checking. If you are taking to your child to school and she suddenly begins to worry that you left the door to your house unlocked, you can go back and make sure the door is, in fact, locked. Or if your child starts to worry that you may have left the stove on, you can go together to the stove to make sure it’s off.

Checking more than once is not a good way to overcome worries. Like reassurance, it only provides the child with temporary relief while paving the way for renewed doubt and a need to check again. “Yes, it’s true that you already checked, but did you check properly?” the worry gremlin taunts, forcing the child to check again and again. Rather than helping the child to conquer her worries, checking tends to make the worry more obstinate.

If the child’s worry is related to the dirt, it makes sense that she will try to overcome her worry by cleaning. Likewise, if the child is worried that something bad will happen if things are not placed in exactly the right way, or activities are not carried out in perfectly correct order, then it is understandable that the child will try to overcome the worry by spending time placing things just so, or repeating an activity again and again until she can feel that the sequence was done in the perfectly correct way. As we all know, these kinds of compulsions can consume huge amounts of time and do little in terms of helping the child to overcome the underlying worries.

Superstitious Rituals

Human beings are a superstitious lot. We knock on wood after we say something has been going well. We know this action has no effect, but we still do it. Just in case.

It is therefore no surprise that children who suffer from irrational worries come up with the idea that they might beat their worry by performing a superstitious ritual of some sort.

For example, a child who worries that something bad will happen because he has had a “sinful” thought might come up with the idea of preventing that bad thing by performing a ritual. That ritual could be reciting a prayer, repeating certain words in his mind, or even shaking his hands in a certain way X number of times.

By performing a superstitious ritual, the child may be able to conquer his worry for a brief moment, but the method is treacherous because it reinforces the child’s tendency to develop worries. When children try to ward off their worries with rituals, they are practicing superstitious thinking and thereby reinforcing the foundation on which their problem rests.

Avoidance

Many people who suffer from phobias (extreme, irrational fears) manage their anxiety by avoiding, at all costs, any situations that provoke their fear. For example, those who suffer from fear of heights often cope with their problem by avoiding high places, and those afraid of social situations often avoid going anywhere they would have to talk to strangers. Similarly, children who suffer from excessive worries can try to manage their anxiety by avoiding situations that they know will trigger their obsessions.

For example, if a child suffers from the worry that something bad may happen to her mother while she is at school, the child may “solve” the problem by staying at home to make sure that her mother is safe. The “solution” eliminates the worry, but the price is high, as the child misses out on school and being with her friends.

Distraction

Some children are able to get a temporary break from their worry gremlin by redirecting their attention away from the worries toward something different. A child may, for example, distract himself by listening to music or by playing a video game.

Redirecting one’s attention to something else is useful inasmuch as it gives a temporary respite from anxious worries, but the relief can be short-lived if the worries become reactivated as soon as the distraction stops.

6 Creative Ways to Calm Down the Worry Gremlin

Now that you know about the ineffective strategies that children use to stifle their overexcited worry gremlin, it’s time to solutions. These strategies are more effective methods that you can teach your child to cope with her worry gremlin (or overactive nucleus worrius).

  1. Worry-Time

Worry-time is a method often recommended to people suffering from insomnia caused by excessive worrying. It means that you reserve a designated time for thinking about your worries during the day or evening before going to bed. During this timeslot, which may last from 10 minutes to a half an hour, you sit down with a pen and a paper and deliberately focus on thinking about your worries. The method is based on the observation that it is easier for people to rid themselves of bedtime worries if they have already dealt with them in advance. When a worry pops up in their mind in bed, they can then say to themselves: “I won’t think about it now. I already thought about it during my worry-time,” or “I won’t think about that now, I will think about it during my next worry-time.”

You can suggest this method to your child. Help your child set a timer and use a pen and a notepad and write down each worry that comes to her mind. Encourage the child to deliberately worry as much as she can during this period. What is the worst thing that could happen? What else (bad) can happen? What more are you worried about? When the timer signals that the worry-time is over, help your child put away the notepad and encourage her to start doing other things. Say to her, “You have given your full attention to your worries so you can now give yourself a break and let go of your worries until the next worry-time.”

You may enhance the effect of the method by asking your child to revisit her worry notes and to read her worries aloud to you. When children revisit their worries in this way, they often find that the worries have lost their grip on them and no longer trigger the kind of anxiety they used to.

  1. Putting Worries on Hold

Guatemalan worry dolls are miniature dolls made of pieces of colorful thread that usually come in small bags of four or five. Guatemalans have used worry dolls for centuries to help children to free themselves of worries that keep them awake and prevent them from falling asleep at bedtime. The child’s mother, father, or grandparent takes one of the tiny dolls from the purse and asks the child to tell the worry to the doll. The doll takes on the worry, thus releasing the child for having to think about it. The doll is then placed under the child’s pillow and when the child wakes up in the morning the doll is gone. It has defeated the worry and returned to the purse. There are several dolls in the purse so that if a child has more than one worry, each of the dolls can take on a different one.

The idea of worry dolls is based on the observation that worries tend to vaporize, fade, or lose their intensity if the worrier does not even try to get rid of the worries, but instead puts them on hold, to be attended to later. When a worry is on hold in a safe and secure place, but not preoccupying the mind, time starts to do its miracles and the worry starts to diminish until it loses its and power.

You don’t necessarily need worry dolls to teach this method to your child. Instead, you can have her write his worries on slips of paper and to put them on hold (remove it temporarily from his mind) by placing the slips in a worry box or some other special place the child has reserved for them. When an hour later — or maybe even next day — the child opens the worry box and reads what is written on the slips, he is likely to find that the worries no longer bother him nearly as much as they did at the time he wrote them down.

To help your child make sense of this method, you can explain to him that the worry gremlin does not like you to ignore its worries, but it doesn’t mind you putting its worries on hold. By writing your worries down and promising the worry gremlin to give them attention later, you can calm down the overactive worry gremlin and learn to live in harmony with it.

  1. Amending Worries with a Happy Ending

I have written an illustrated story for children about how to overcome recurring nightmares. You can find it at the Kids’Skills website (www.kidsskills.org). In the story, a boy named Nigel tells his grandmother that he has a recurring nightmare where big scary trucks are chasing him.

“Didn’t you know, Nigel, that there are no nightmares?” responds his grandma.

“Why do you say so? I have the same nightmare almost every night,” answers Nigel.

“There are no nightmares because all dreams have a happy ending,” explains Grandma.

“But mine doesn’t!” Nigel sobs.

“Of course not, if you wake up in the middle!” says Grandma.

The story continues with Nigel and his grandma imagining together a happy ending to Nigel’s dream. In their mutual fantasy, the trucks stop and drivers come out to tell Nigel that they are there to bring him presents. Nigel gets to enter the trucks, which are filled with interesting stuff, and to pick his favorite gift. When Nigel is in bed, Grandma says to him: “Remember to see the ending of your dream tonight.” That night Nigel sleeps through the night without any dreams and his nightmare never reappears.

One way to understand worries is to regard as them as waking nightmares, or nightmares occurring in a conscious state. The child’s mind generates scary fantasies during the day in the same way as during the night. This way of understanding worries makes it possible for you to teach your child to do to her worries what Nigel’s grandmother taught him to do with his nightmare: to revise the waking nightmare by amending it with a happy ending.

For example, if the child worries that something bad will happen to her parents because she didn’t put his clothes on in exactly the right order, ask the child to tell you the details of her waking nightmare. “What is your awake-nightmare like? What scary things do you imagine could happen to us?” Suppose your child now reports to a having a waking nightmare where one or both of you are run over by a car and die. You can now tell her that not only all dreams but also all waking nightmares have happy endings and proceed to help her amend his fantasy. Maybe in this happy ending, the ambulance comes to the scene of the accident and the paramedics find that her parents have survived the accident without a scratch and can return home without further ado. Or maybe an angel appears and heals their wounds and makes them happy again.

Children troubled by OCD are masters of using their ability to fantasize. If a child is good at creating scary fantasies, she can help herself by learning to create happy fantasies instead.

  1. Ignoring Worries

Imagine that when you were a child you had a big brother who took pleasure in teasing you. He teased you, for example, by saying things like “Watch out, there are monsters under your bed!” The more afraid you got, the more he enjoyed what he was doing.

As you grew up, you began to understand that there are no monsters under beds, and you learned to fight back against your brother. When he started to speak about monsters, you responded, “Stop it. There are no monsters under my bed. You are being stupid.” He stopped teasing you when he realized that he couldn’t trick you anymore. You defeated him by ignoring his ludicrous fearmongering.

Children often deliberately scare each other in this way. They project various scary images — “Tomorrow will be the end of the world!” or claim that the family’s pet dog has been hit and killed by a car — and then take pleasure in observing the other’s emotional reactions. From an outsider’s perspective, what they are doing appears to serve no other purpose but bullying, but we can also think of such interactions as a way of rehearsing an important life skill. When children play by deliberately scaring each other, they help train one another in the skill of handling and dealing with scary images and fantasies. The scaring game ends when the target learns to respond to the scaring in a way that indicates that he refuses to take the scenario seriously and instead shows an ability to ignore it by responding to the fearmonger by saying, for example, “BS!” “I don’t believe you,” or “Give me a break!”

It might be helpful for you to think about your child’s worry gremlin in much the same way you think about your imaginary big brother. Your child’s worry gremlin actively launches diverse images of danger and threats — not to pester him, but to teach and train him to become stronger; to help him develop a skin thick enough to protect him from all kinds of scary images and fantasies that threaten to ruin his happiness. Seen in this light, your child’s worry gremlin has good intentions. Its job is to teach him to respond to his worries by not taking them too seriously or simply ignoring them.

  1. Turning the Worry Gremlin into a Teacher

If you can think of your child’s worry gremlin not as a bully, but as a teacher, it becomes possible for you to take this concept up a notch.

A father told me the following story of how he helped his then seven-year-old daughter to overcome a persistent worry. The girl’s worry appeared at bedtime. When her father was putting her to sleep, she would start to doubt that the door to the house was locked, allowing burglars to break into their home at night. When she was already in bed, she demanded, multiple times, to go with her father to check and to secure that the door was indeed locked. The worry persisted no matter how adamantly the father reassured her that the door was locked and even if they had already checked the door together many times.

The father was desperate. He did not want to aggravate the daughter’s problem by reassuring her again and again that the door was indeed locked. Nor did he want to give in to his daughter’s demands to check the door one more time. He decided to try something out of the ordinary. Next evening at bedtime when the girl started to worry about the door not being locked, the father agreed to check the door with her once. When the girl was back in bed the father surprised her by asking her: “I know we just checked the door but what do you think? Is it locked, or might there be a chance that it is still unlocked?”

“It is locked,” the girl said, reassuring her father that there was no reason to think that the door would not be locked.

Instead of becoming convinced by his daughter’s reassurance, he continued doubting. “Are you sure it is locked? Maybe we didn’t check properly?” he said and continued until the girl started to become annoyed at him and demanded him to stop. The strategy worked. The girl quickly overcame her worry by having to reassure her father that he didn’t need to worry about the door not being properly locked. The father initiated a game to play where he assumed the role of her worry gremlin to allow her to practice and to learn a better way to respond to her worries.

  1. The Anti-Worry Muscle and the Worry-Tackle Game

If you can help your child imagine that her worries are generated by a worry gremlin, you can probably also help him to imagine that there is a skill he needs to be able to calm down her worry gremlin when it becomes overexcited and bombards her with unnecessary worries. You can call this skill-building the “anti-worry muscle” to help your child understand that it is a skill that can be strengthened with practice in the same way that you can strengthen muscles with workouts.

One possibility for doing this, which may seem weird at first, is to play a game with the child that helps him become better at discarding, ignoring, or laughing at silly worries. You can let your child give a name to this game, but for now I will call it simply the “worry-tackle game.” In this game, you take turns with your child to propose worries to each other and to demonstrate that you are each able to tackle these worries.

You should start playing the game by proposing silly worries that are easy to tackle and progress gradually towards worries that are more difficult for the child to overcome. You might start by proposing an absurd worry such as “your nose is going to fall off” or “the sky is going to fall.” When you are confident that your child is able to tackle such silly and easy worries, you can take the game up a notch and start suggesting each other more difficult worries.

For example, you might suggest “if you don’t touch the table three times, your bicycle will have a flat tire tomorrow,” “during the night, a storm will break out and our house will be hit by a lightning unless you turn around three times,” or even “you will get sick unless you wash your hands two times.”

The idea of the game is to ensure that your child learns, by emulating you, to tackle worries with creativity and humor. Possible responses include, among others, saying nothing and just shrugging one’s shoulders or rolling one’s eyes to indicate that one is unaffected by the worry. Another option is to say something along the lines of “Who cares?” “I cannot be bothered,” “Whatever!,” “In your dreams!” or “Give me a break!” The game should be fun for both you and your child. It should be infused with laughter, and every victory — even a small one — should be greeted with a high-five or another similar gesture.

Playing the worry-tackle game with you offers your child an amusing and non-threatening learning experience. It gives him a chance to work out his anti-worry muscle, to develop smarter strategies to respond to worries, and to learn to come to terms with his worry gremlin or her overactive nucleus worrius.

Final Thoughts

OCD is a common nuisance that countless people all over the world struggle with. It can take many forms, but it always consists of an imaginary fear, which the person tries to defend against using strategies that are not only unhelpful but actually make the problem worse.

Recovering from this ailment requires staying away from unhelpful strategies involving logic, reason, and sensibility and replacing them with creativity, inventiveness and playfulness.

 

30 COMMENTS

  1. Interesting tips. Would you have an opinion on the situation I encountered?

    A woman has a washing OCD that worsens to the point of forcing her to stop working and return to live with her parents.

    At home, the mother participates in washing rituals to “relieve” her daughter, then the daughter stops her rituals almost completely and lets her mother perform them in her place.

    The daughter feels more and more guilty of the rituals her mother performs for her, while the anxiety increases, and the rituals themselves become more and more agonizing.

    The mother is exhausted in performing the rituals.

    The father, who refuses to perform the rituals, blames the situation on his daughter.

    The family conflict is intense. In the end, the daughter is forcibly hospitalized by the father.

    This extreme case perhaps illustrates a neglected aspect of OCD. OCD seems to cover three roles: the one who dirties, the one who is dirty and the one who is washing (or equivalent). These three roles can be distributed differently in the family.

    It is not impossible that the OCD is, in a transfigured form… a triangle of Karpman.

    • That point is spot on! Unfortunately sometimes those people contributing to the anxious thoughts don’t have the insight, “can’t” or won’t change. If they do change, the pattern of thinking/responses might still persist for the child. Thus, the Gremlin analogy might be helpful for some children in breaking that pattern. Totally agree with you though.

  2. “Obsessive-compulsive disorder (OCD) is the medical term for a disorder, or malfunction in thinking, in which a person suffers from obsessions, which are often linked to compulsions.”

    Nonsense. There is not one single shred of evidence that there is any such thing as “OCD” or any other fictitious “disease” that is listed in the Bible of psychiatry.

    • The feelings come from a personality part that believes the behavior is beneficial, so like you say, it isn’t a disorder, it’s a functional part of the mind, the goal would be to be able to reason with this part and persuade it to change its beliefs about the washing keeping the person safe.

      • It does not come from a “personality part” but rather stems from anxiety. Completing a compulsion can relieve anxiety in a fleeting moment but there is an awareness that it strengthens the pattern at the same time- which creates more anxiety. People with it don’t think it’s beneficial. People with it think it’s annoying, time consuming, tend to hate it, and would describe their obsessions and compulsions as illogical. The author clearly explains why trying to use a reasoning strategy often doesn’t work and offers some practical strategies that are worth giving a try for children and adults alike.

  3. Seems to me these tips do exactly that –help children avoid therapy and risky drugs, because they come up with their own solutions to distressing worries.

    Obsessive anxiety and compulsions, by whatever name you want to call them, cause suffering…why wouldn’t you want to overcome them, especially if the sufferer decides the method themselves?

    • Once again, I think we see how the labeling process actually does as much or more harm than the drugs themselves. What if we just said, “Here are some strategies for those who want to figure out a way to reduce unwanted compulsions” or something like that. Why not just describe the problem in terms that are meaningful for the client, and work toward the client’s goals? Why do we have to ascribe some critical label to the behavior, rather than just identifying that it’s something the client wants to change?

      It is unfortunate that some good tips and ideas can be obscured by these medicalizing terms. I hope we as a community can work to tell the difference between our cultural training to use medicalized terms and the actual potential of the interventions being discussed. Some people with good ideas haven’t yet figured out the problematic nature of these terms just yet.

  4. Steve and all, here is the thing. When editing blogs and other materials for the Parent Resources section I recognize that we are operating in a world where certain terms are used and where we’re trying to reach beyond those who already share our perspectives. Thus, for the purpose of an article designed for a fairly broad audience, it makes sense to start with the easily recognizable, standard language for a specific type of distress–OCD, obsessions, compulsions–and then offer alternative ways to look at them and address them.

    A parent or child seeking new solutions will probably use the search term “OCD,” and for this article to be found, that term needs to be in the headline and to appear in the body. Such is the internet as currently controlled by Silicon Valley. So we attempt to reach people “where they’re at” and bring them around to a new perspective.

    That’s my way of looking at it (speaking for myself and not MIA). Some day, I hope we can put quotes around all conventional psychiatric diagnoses, and evenutally eliminate these constructs altogether. Right now, let’s focus less on semantics and more on what we can do to help parents and children in real distress find alternatives to business as usual.

    To the person above who wondered if developing techniques to quiet chronic worries and repetitive behaviors serves to perpetuate the underlying causes of those worries– that’s a great question! What if the “OCD” child is being abused, or something highly dysfunctional is going on within the family, school, or community? My guess is that the child is going to have limited control over their environment, but at least they can gain some control over their reaction to it.

    From the parents’ side of things: If this were my child, I’d take a hard look at what is going on around that child, as well as how I’m treating him or her. At the end of the day, I feel it would be my responsibility to take action to create change, given that I have more power to do so.

    What are your thoughts, Dr. Ben Furman?

  5. What if a label and the word disorder is meaningful to some people. Maybe some people think it helps describe the disruption that their thoughts and responses are causing in their life. To not use it or to attempt to use words in replace of it is perceived as being flippant about their experience. Is that point of view included in cultural training along the opposite point of view? I’m not saying one is better than the other. It’s easy to see the semantic war is way overdone.

    • I think there is a big difference between a person preferring a particular framing of their situation and a doctor claiming that everyone having a particular behavioral manifestation is suffering from “X disorder.” We are all entitled to view our circumstances in a way that makes sense, but doctors are claiming to have some superior knowledge of the situation. Making unsubstantiated claims of understanding situations that are scientifically inconsistent or mysterious or invalid is something no professional should be allowed to do. I see it as extremely damaging to our society as a whole to allow these false claims to be viewed as some kind of scientific truth. At the same time, I have no problem with anyone choosing to view their own problem as a “mental disorder.” I just don’t support doctors making this kind of assertion unless there is actually evidence it is true. Medical diagnoses should not be something people choose because they prefer them. They should be objectively measurable conditions that can be reliably identified and treated. OCD certainly does not meet those criteria, nor does essentially any other “mental disorder” in the DSM.

  6. I agree with your thoughts. The handful of regular commenters, however, make quick statements about how conditions don’t exist with sometimes a poor choice of words unless it’s about post traumatic stress disorder or eating disorders or something else that fits their own comfort level. At times it seems disrespectful to the authors’ efforts in addition to others that share different opinions. I agree with Ms. Spencer in that it distracts from the intended main focus of articles and it possibly shuts down conversation about them.

    • I do see what you’re saying. I think it involves a confusion about language. When people say, “There is no such thing as ‘Bipolar Disorder,'” I think they mostly mean that “Bipolar Disorder” is an invention that doesn’t have a scientific basis as a medical diagnosis. I don’t think people mostly believe that those behaviors defined as “bipolar disorder” don’t occur, or that they don’t cause distress, or that help is not sometimes required. I think the objection is that someone with medical authority is DEFINING these behaviors as a “medical disorder” without cause. But it is often intepreted by readers as meaning that people don’t have these feelings or behaviors, which leads to lots of confusion and, as you say, distraction from the key points. At the same time, I really do understand why people who have survived the system often are very strongly against using these terms, which is why I put them in quotation marks whenever I use them. These generalizations have been used to harm people, often intentionally, and if that had happened to me, and I later found out the “disorder” I was assigned was voted into existence by a committee, I’d never want to see that word in print again!

  7. I agree with Steve. The terms “OCD” like “ADHD” and “bipolar” are DSM inventions and have no scientific basis. Using them only reinforces the notion they exist, creates a self-fulfilling prophecy and is harmful to the child and parent. Parents need to be warned of the hazards of letting a teacher or doctor diagnose childhood behaviours as abnormal and requires medical or psychological treatment. Once a child is given a label, she will be subject to unacceptable risks, especially if the suggested interventions do not work. When therapy does not work, and there are always social factors at play, therapists or educators will suggest treating the child with chemicals by asserting that it will improve the child”s ability to socialize or learn. A parent’s best course of action is to avoid any professional who suggests that their child is suffering from an “attention deficit disorder” or some other vague defined conditions such as “OCD”.

    • But it is important to acknowledge that people DO suffer in various ways, and often need help dealing with their emotions and their experiences. This doesn’t make them ill, but I think it is important to distinguish that these “diagnoses” are crap, in that they are social inventions, but that suffering is real and that we need to get together as a community and look for solutions that actually help but don’t blame the sufferer for suffering too much or in the “wrong” manner.

    • “The terms “OCD” like “ADHD” and “bipolar” are DSM inventions and have no scientific basis. Using them only reinforces the notion they exist, creates a self-fulfilling prophecy and is harmful to the child and parent.”

      I agree 100%. But parents need not only to be warned of hazards, they need to alerted to consequences.

  8. Yes, I agree with you!

    Since, as I say, we are trying to reach a broad audience here — especially parents whose child has most likely received an OCD diagnosis–we use the term because it’s familiar to them and they will probably be using that as their search term. When editing, I often will phrase it as “diagnosed with” XX, rather than having XX, because the former is a fact and the latter is an opinion. It certainly is tricky, because by repeating the term OCD one in a sense reinforces it, and on the other –by conceptualizing it as an imaginary gremlin–it reframes the problem from a medical one to more of a “problem in living.”

  9. It is important to note that we are talking about ‘suffering” children and so-called OCD behaviours which are extremely rare. In all my years in the school system I came across only one boy that was diagnosed by a psychiatrist after he was put on medication. We have created an epidemic of disorders out of normal childhood behaviours. Children do not belong in therapy. Children often react to the stresses and tensions in their family and school and to treat the child alone is misplaced, ineffective and stigmatizing. See the post by Pacific Dawn on why children do not belong in therapy.

  10. “My biggest objection to “diagnoses” is that it lets adults off the hook and blames children for having “bad reactions” to adult abuse, neglect and mistreatment.”

    I agree!

    I saw this at work when I was a high school senior. This boy, a freshman, C., people were harassing him without let up.

    Then in a shop class someone proclaimed a hitting contest, and they were keeping score on the black board.

    Well that was the threshold!

    Now you know what the male teachers were saying, “Well boys will be boys, and C. just needs to learn to stick up for himself.

    If the School District Psychologists were to get involved, C. would have gotten a label. And that would have exonerated the abusers.

    So I was friends with C.’s older brother. Did the parents go to the Yellow Pages and find a psychotherapist of their own?

    They did go to the Yellow Pages, but they started under “A”, for attorneys. Soon every member of the school board received a last and final warning letter, on the attorney’s stationary.

    All of a sudden, those teachers who were impotent to do anything, now they were all places at all times. The kids got a talking to and one day off, but the high school kids never were the real problem in the first place.

    To this day I remain very impressed with who C.’s parents handled that.

    But what to do when it is the parents themselves who are the abusers, as is more often the case.

    And is there ever really anything talked about with a psychotherapist which would not be better talked about with an attorney?