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One of my 7 yo ds's issues (as of late) is obsessional thinking and confessing. On Sept 6, a few weeks into his sinus infection (and unfortunately it correlates with him starting a new school, so I'm not sure how much "normal" nerves played a part)he began to CONFESS obsessively to me. For some reason he remembered that a little girl "made" him kiss her in 1st grade (he is unfortunately VERY easily persuaded)....and when he told me about it (a few weeks ago, he is now in 2nd) he was bawling his eyes out. He said he felt he was going to throw up, he hurt all over just thinking about it...and went on to describe that it made him sick because she had nasty, green "boogies" under her nose (his OCD is germ based/hand washing).

 

He just could NOT stop that image from coming to him. But after he told me that, he continued to "imagine" that he was kissing everything/everybody around him (kids, adults, trees, you name it) - even inanimate objects. And every time the thought would pop in his head he would "confess" it tearfully. My attempts to allay his worries by telling him it is all normal and natural and that I had had a crush on a boy when I was in 1st grade, didn't seem to stop that unavoidable obsessional thought. In an attempt to "play it down" I told him he has a wonderful imagination and not to let it worry him....so now he says "my imagination is thinking (fill in the blank)". But it's so sad because he seems tormented more or less.

 

This SEEMS to have slowed a bit in the last 2 days - but I'm knocking on wood as I say that. He has been on abx for about a week now....hmmmm....

 

Is obsessional thinking part of PANDAS for some? The majority? Am I grasping at straws here? Anythink you can offer would be great.

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Obsessional thinking can be a MAJOR part of OCD, so if OCD behaviors play a significant role in your DS's PANDAS symptoms then, yes, I think you've appropriately identified this as part of the PANDAS.

 

I assume your DS is undergoing treatment for the PANDAS via abx or some other medical means? In addition to this, I would suggest finding a good, well-trained therapist who will use Cognitive Behavioral Therapy and/or Exposure Response Prevention to help your DS learn to contend with and move past those obsessive thoughts. It is very challenging; I know from experience with my own DS.

 

You can try to "reason out" with your DS how these thoughts and concerns are an "over-reaction" or an "exaggeration," and then maybe set up a rewards system for him NOT confessing and NOT melting down over a thought. A good therapist will have some ideas and exercises for helping you and your family meet these behaviors head-on.

 

MegsMom is very well versed in most aspects of OCD, too, and her DD is closer to your DS's age, so she will hopefully chime in here, too.

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One time when my dd had strep with symptoms (pre treating PANDAS woth prophy) her doctor put her on amoxicillan and for that 10 days my dd was confessing lots of things. She confessed that she had watched the neighbor girl pee in her back yard, that she had but boogers on the couch, very innocent things that nonetheless had been stored guiltily in her brain somewhere. The amox ended up failing, with fever returning at end of 10 days and she was put on omnicef and all that confessing went away. We figured out later that PANDAS was showing its ugly head with that confessing.

 

I learned later, when we finally put all the PANDAS pieces together that confessing is a well known form of OCD. If it doesn't get better for your son, perhaps you could consider a different antibiotic and/or longer course? And then possibly prophylactic if he is not on it already?

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This is a very big part of pandas for some. Antibiotics alone did not help our dd and she had to have IVIG. You might see if you can try high dose antibiotics? We never tried that. This can be a horrifying OCD for some. It was for us. Confessions of the most horrible type and out of NOWHERE and upwards of 100,000 per day. Contact one of the pandas specialists. Good luck!

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Hey - This is actually very normal for OCD - whatever the type. If your child has PANDAS, then treating that will really help. However, we find ERP therapy to be very helpful either way. Our daughter had a lot of this kind of OCD. It falls under the subtype of scrupulosity. Often people think this is a very hard kind of ERP to do, as this seems like a mental ritual about a thought. But actually, the obsession is the thought, the compulsion is the telling of it. Have you explained what OCD is to your child? If not, you need to buy the book "what to do when your brain gets stuck" http://www.amazon.com/What-When-Brain-Stuck-What-/dp/1591478057/ref=sr_1_1?s=gateway&ie=UTF8&qid=1285796081&sr=8-1 & read that together for the next week. There are really a lot of steps to ERP, but I don't see why a parent can't take some steps at home once you have read the book. The first thing is to communicate with your child about how you are going to approach it. Let him know that OCD tries to make him worry & confess things, and that you know this is OCD. I like to spend a week or so, just defining OCD for a child. So this sounds silly, but everytime he confesses, tell him "oh hon, I am so sorry that OCD (we like to give him a name - like bossy guy) is trying to make you think you will kiss a tree. No big deal, you can beat him up when you are ready". Then I graduate to asking him - is that bossy guy wanting you to think that, or is that You? Give a little prize if they are able to tell the difference.

 

Once you feel like you have depersonalized it a little, remind him of how you read the tools in the book, and ask him if he would like to beat up bossy guy one teeny tiny time? Suggest that you will be there, and if it gets too hard, he can try again a different time. And that if he tries, he can pick a prize from the prize box (by the way, run to your nearest dollar store & spent $20 on stuff he will like - then make coupons for other things, like extra 10 min of TV, or read book with mom, or dessert for dinner, or game with dad). Next, pick the tool that you are going to use from the book - or I you can make it up. The idea is to CHANGE or CUT BACK the ritual. There are as many ways to do this as there are compulsions!

 

I have to run tonight, but here is a quick snapshot - let me know if you want more. You can spend 3 days counting (with him!) how many times he confesses. Say it is 100 times in a day on the high side (if it is more than 100, you may want to try a different tool first)! Now make a little worry box & get a jar with 110 chips in it (you can make with him out of paper if you want). Each time he confesses, BEFORE you respond, ask him to drop a chip in the box. Be sure he can see the chips in the jar, so he'll know if this starts to run out. See if he can keep confessing down to 110 times (you want him to succeed!). Then do this for 3 days or so - if successful, move the number of times down by 1 from how many he is really using. This is pretty effective as a technique, once the child sees some success & beats it up a few times (delays telling you or does not tell you) then they start to feel better about their ability.

 

Another tool is to simply delay. When he wants to tell you a compulsion, as him to do 5 jumping jacks first. You can use coupons and agree that before he tells you, he has to pick an activity out of the jar, do that (make them SHORT at first), then tell you. If he does this 5 times in a day - prize! YOu are not looking for big change at first - just want him to build confidence that he can beat up the OCD.

 

Make sense? I can email you later if you want. How bad is his exacerbation? Hopefully, the abx will help a ton - but either way, we find ERP tools are very helpful in dealing with day to day issues. Remember that your child's brain is just stuck, like a broken record - but he is still a normal great little kid.

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These are some wonderful posts--

Our d has severe confessing issues, with each exacerbation. It amazed me this summer as she was coming to me and "confessing" (really just wanting to tell me) about things that she could remember from 3 or 4 years ago. Really little things--It seemed that these things were long forgotten, but now dredged up for review (things she had read in books for example.) None of these "issues/things" were of any consequence at all -- however she felt the need to confess them.

 

Our d (12) told me this week that she was dealing this week more with compulsions then with obsessions...(I almost fell off my chair.)

 

She told me that the intrusive thoughts in her head (that previously were causing the confessing issues) were less then they had been (I knew this as the constant muttering under her breath had slowed/ended as the prednisone burst tapered.) However, she was able to identify that she was feeling "compulsions" to leave some math problems blank, or erase and rewrite due to OCD. The insights these kids have into themselves amazes me.

 

I wonder if there is a "recovery" pattern as the Ps is brought into control...such as, do obsessions go first? tics? then compulsions? just a thought--

 

Megsmom--I am going to try your idea with the "chips". Thanks.

Edited by T.Mom
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I agree - our kids are amazing. My daughter was "forged in fire" over the last few years, but her insight into herself and others, at age 9, is quite amazing now. She is a quiet leader, by example - and adults often comment on her maturity (she is a complete little goofball at the same time!)

 

Tmom, I am SO glad to hear that things are inproving for your dd12. We find ERP techniques easier to practice on the backside of an exacerbations, as they feel health returning and are motivated to help it come faster.

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Well, I have to say this is a symptom of OCD, but my oldest, who does not have PANDAS did go through a phase where he was "confessing" to me all the time, and apologizing over and over, and also plagued by intrusive thoughts. It seemed like it took forever, but then it slowly went away. Seven is an age when they start developing their conscience, and I think it's not uncommon, but probably just being made worse by PANDAS. Just try not to give it too much attention. The more you try to talk them through it, the worse it seems to get. I have found (taking my dh's advice) it's better to just give them a quick response and then get them moving, do something else, fun, etc.

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