My Way or The Highway - OCD in Children
Updated: Aug 19
Being an OCD (obsessive-compulsive disorder)/anxiety specialist and also the mom of a toddler has been an interesting experience to say the least. There have been plenty of times when my 2 and a half year old, Eli, engaged in full on obsessive-compulsive behaviors. First, it was Eli lining up his toy cars and trucks in an absolute, straight line. Then, it was wanting to take an item of clothing off whenever he got a stain on it (umm, which was pretty much always!). Luckily, I knew enough about anxiety and development to know that this was likely just a phase.
When a child has OCD, they will feel like they have to do things a certain way, or engage in some type of ritual, otherwise something bad might happen. That “something bad” might mean they would get sick, that they would get hurt, that someone else they love might get hurt, or something else - and sometimes, it just means that it wouldn’t feel okay and that, in and of itself, would cause anxiety.
If you’re concerned about whether your child’s behaviors are normal or if something else may be going on, consider the following.
Preference vs need: A preference is something that we’d like to do, that we’re in favor of doing, but something that we can generally do without if the situation calls for it. A need, on the other hand, implies a sense that something bad will happen in the absence of this need getting fulfilled. Try to test this out by seeing whether your child can roll with the punches, postpone the hand wash or other “ritual” behavior, or move onto something else rather easily. If they can, that’s a great sign that they just have certain preferences, which is normal. If they’re extremely upset, then that may point to more of a need.
Interference: Consider the extent to which these behaviors are interfering with the life of your child and the lives of others in the household. What’s the extent of the distress when your child doesn’t get their way? There is a big difference between a normal, totally developmentally appropriate tantrum and anxiety that causes the child difficulty participating in activities, schoolwork, etc.
Involving other people in the behaviors: Are these behaviors something that are generally done on their own? Or are the needs of your child so extreme that they often want other people to bend to their will? As parents, we often want to do whatever we can do comfort our children. However, by participating in these behaviors, e.g., fixing things that are supposedly “out of place” according to the child, we exacerbate these symptoms and make matters worse. This is called family accommodation and is one of the biggest issues in the maintenance and worsening of OCD, especially in children.
So what are some things you can do as a parent to help support your child?
Be supportive. This sounds like “I can tell this is really scary for you right now and I want you to know I’m here for you”. This is different from validating the fears, because we don’t necessarily want to do that. Find a way to be supportive without being judgmental about the obsession/compulsion.
Try not to engage in the accommodations. As tempting as it might be to give into your child when they are at the peak of a tantrum and they just want their freaking blue cup instead of the green one you gave them (!!!!!), try not surrender. Instead, be supportive (see #1), stick to your guns, and try to move on.
Encourage flexibility and rolling with the punches. A lot of these issues boil down to a difficulty with a child being flexible. Instead, children may tend to be rigid in their needs and desires. We need to do what we can to encourage our children to be flexible, think of other ways to do things (e.g., "I know you wanted the blue cup, but the green one is pretty cool, too - it matches Mike from Monsters Inc!”). Try to encourage your child to consider other ways of thinking about things.
Remember that we all have a little bit of these symptoms in us from time to time. That doesn’t meant that we have obsessive-compulsive DISORDER. We all have our instances when we like things a certain way. We all have safety behaviors during times of high stress and anxiety. It’s just a matter of when these things get out of control and start to interfere with our lives and the lives of others that they become problematic.
If you're concerned about whether your child could have OCD, the good news is there are lots of resources available online and in person. I recommend checking out IOCDF.org for a list of resources, as well as lots of awesome, educational information about this topic. A trusted doctor or mental health professional will be able to talk to you more in depth about your specific child’s behaviors.
Comment below if you have any questions! Or any strange child quirks you'd like to share because #solidarity. Am I right?
PS: If you enjoyed this blog post, make sure to check out my podcast "All The Hard Things" with my first episode, "OCD and Anxiety in Motherhood". I go way more in depth about OCD and share my own experience with it as a mom.