Tips to handle the reassurance questions?

[airial95]

After almost 2 monhts of AMAZING results after our son's T&A in November - he backslid and alas, tested postive for strep about 2 weeks ago. (As a side note - I am in the market for a giant plastic bubble to keep him in if anyone knows where to find one )

 

My PANDAS daughter was still on abx at the time, and we've gotten her tested 2x since, she managed to avoid catching it, but she's still having a mild reaction just to the exposure. She's been very emotional and sensitive - which are hallmark symptoms for her.

 

About 3-4 days ago she started asking questions about the house burning down. She was very concerned the house was going to catch on fire. In the past, we've gone over fire safety, let them hear what the fire alarms sounded like (this was important during my son's early episodes when he was VERY sensitive to sound), and even worked on the emergency plan of what to do if they hear the alarms go off (fire or security). So our kids are fairly in the know on safety for a 5 and 4 year old.

 

I explained to her the safety precautions we have in place, as well as things to do to prevent fire (not playing with matches, turning off lights and appliances when you're not using them etc...) This doesn't help. She wants me to say that our house would NEVER catch on fire.

 

I know that it's likely the OCD pushing this, but I have a hard time saying the house will NEVER catch on fire, because although its statisitcally unlikely - it could happen.

 

We have had the "the house won't catch on fire" discussion close to 30 times over this weekend, and she's woken up every night with nightmares about the house burning down since this started late last week.

 

Any suggestions on how to respond?

[MomWithOCDSon]

After almost 2 monhts of AMAZING results after our son's T&A in November - he backslid and alas, tested postive for strep about 2 weeks ago. (As a side note - I am in the market for a giant plastic bubble to keep him in if anyone knows where to find one )

 

My PANDAS daughter was still on abx at the time, and we've gotten her tested 2x since, she managed to avoid catching it, but she's still having a mild reaction just to the exposure. She's been very emotional and sensitive - which are hallmark symptoms for her.

 

About 3-4 days ago she started asking questions about the house burning down. She was very concerned the house was going to catch on fire. In the past, we've gone over fire safety, let them hear what the fire alarms sounded like (this was important during my son's early episodes when he was VERY sensitive to sound), and even worked on the emergency plan of what to do if they hear the alarms go off (fire or security). So our kids are fairly in the know on safety for a 5 and 4 year old.

 

I explained to her the safety precautions we have in place, as well as things to do to prevent fire (not playing with matches, turning off lights and appliances when you're not using them etc...) This doesn't help. She wants me to say that our house would NEVER catch on fire.

 

I know that it's likely the OCD pushing this, but I have a hard time saying the house will NEVER catch on fire, because although its statisitcally unlikely - it could happen.

 

We have had the "the house won't catch on fire" discussion close to 30 times over this weekend, and she's woken up every night with nightmares about the house burning down since this started late last week.

 

Any suggestions on how to respond?

 

Unfortunately, there's no reasoning with OCD. You could even tell her until you're blue in the face that the house will NEVER burn down, and that will not be sufficient. Or her fear will move on to something else . . . tornado, hurricane, etc. . . . because that's just what OCD does.

 

I think DCMom will probably have some great suggestions for you; she and her girls did a lot of work at USF in Florida this past summer, and she's got some great strategies for combatting out-sized fears.

 

I might suggest a few things along the lines of exposure therapy, but only you can guage what your DD is capable of handling. If you have, for example, a fireplace in the house or a fire pit in the back yard, I would suggest maybe having a family "party," set a fire, sing some songs in its presence, roast some marshmallows, make some smores -- basically turn the fire from a threat into something that can be managed and maybe even a little fun.

 

You might also try to get her to write a story about fire . . . turn it into a character in a story. Or, as some moms have done here very successfully, especially with younger children, make up a silly song about the fear and the object of the fear. Did you ever hear the song about thunder when you were little? Maybe you could morph it into a song about fire:

 

Mr. Thunder, you can't scare me,

I'm as brave as I can be.

So shout and clap, and you will see,

All your noise, can't scare me!

 

Good luck! And if DCMom doesn't check in soon, PM her. I know she'll have some good ideas, as probably would MegsMom and LLM.

[LNN]

I'm not the resident expert on ERP for OCD -DCmom, Meg's Mom and Nancy are my "go to" ERP people. But we've done a lot of CBT for the irrational fears. We use 3 tools - color therapy, the "so what" sword and the "I'm not arguing with a Fairy" chip.

 

Color therapy is when I tell my kids to imagine a happy color (say, yellow) and to dip their toes in an imaginary bucket of yellow. Then tehy have to breath in deeply, pretending their toes are straws and they need to suck the yellow up into their bodies. They hold it to the count of three, then blow the gray, black and brown worry colors out of their bodies. They keep sucking yellow in until it reaches their heads and until the dark colors are blown out. It's basically deep breathing for relaxation.

 

Once they feel energized/empowered from the breathing, we do battle with the "What If" fairy, which as Nancy says, can never lose an argument. There will always be one more "What If" out of her. So the only weapon that works is the "So What" sword. Every time the What If fairy says "but what if the firemen don't come in time?" or "what if..." you tell the fairy "So what? If the house burned down, we'd still all get out safely and get a new house. Things can be replaced". "What if the smoke detector doesn't go off?" "So what, then the smoke detector down the hall would go off and wake us up." You counter every "what if" with a "so what" - it doesn't stop the endless "what ifs" but it does take away some of the power. By using the words "so what" in front of your counter argument, you deflate the impact of the bad thing behind the worry. You frame it as something you could handle.

 

But eventually, you know you won't have the last word. So when I've done about 3 rounds of this, I stop and say "You know, I've taken your worries seriously and told you there's a plan. Now I'm done arguing with a fairy. I'm done giving her my attention. If you want to waste your playtime giving her your attention, I think that's a poor decision, but I don't have control over that. But I do have control over who gets my attention, and the Fairy isn't the one who's going to get it." And that's as far as I'll go.

 

Now, behind all this is the work we've done on ERP and CBT. So it's not like I'm hanging them out to dry without tools and practice. But it eventually tosses the ball in their court and I disengage. They then have to decide to get serious about doing some of the work without relying entirely on me to "make it all better".

 

Ultimately, they have to participate and stop the thoughts. You can use the book "What To Do When Your Brain gets Stuck" and modify it for younger kids or use the book "Tiger Tiger Is It True" and use it for ERP, tho it's not specifically written for ERP. But both help you make the concepts something they can relate to.

[dcmom]

Hi Airial-

 

I don't have a lot of time this afternoon, but wanted to chime in. I will review my post and add more (if needed) tonight.

 

I feel like only this summer did I start to get a tiny tiny bit of understanding of ocd. I feel like I am at the beginning of my learning/understanding, and that is mostly from spending 30 hours with someone who is extremely gifted in working with our kids, this summer.

 

So- I will try to channel my inner Dr R (this is what I tell my kids).

 

First-I think your daughter is younger, so you may have to rework my thoughts a little for her age. Our dr would say that our kids really know inside what reality is. Your daughter on some level knows her fear is not "normal"- yet her brain is stuck. SO- while it is important to address the fear with some conversation, this should only be done once, she is smart, she will hear you and get it. Addressing the fear with correct info, will do nothing for her ocd. So you should talk to her about fires- Yes houses catch fire. NO it doesn't happen that often, but I cannot promise you it won't. But what I can promise you is that Daddy and I have a plan that we have taught you, and if our house did catch fire, we all (including you) will handle it.

 

Apparently, some of the fear in ocd is not the fear of the thing, but the fear of "handling" it. Of course you couldn't promise her there won't be a fire, but you can promise her she will be able to handle whatever would happen.

 

I think you need to dig in with her and find out the fear. There may be more to it- the house will burn down- where will I live? I will lose my toys? My mom will die? I am thinking there is kind of a second part to this fear, that might be key to working on it.

 

Then I think you need to tell her, the fact that she thinks of this over and over is something called ocd (have you discussed that with her?). That yes, everyone is afraid of things, but they let it go. That you will no longer answer her questions with a discussion about fires, because you just had one. In the future, if she asks, you probably need to say something like, we already had this discussion- remember what I told you - I am no longer answering these questions because it will not help your ocd.

 

Then you need to work on exposures- these will need to be tailored to the second part of the fear (if you can find that out) - but I will run down a list of thoughts to the house on fire:

 

say "our house is on fire"

 

look at a photo of a house on fire

 

watch a video of a house on fire

 

ask her to draw a picture of your house on fire

 

have your daughter write a story about your house being on fire

 

re read the story she wrote to several people- dad, grandma, etc (either have her read it, or you read with her there)

 

spend a little time every day with her visualizing your house on fire- be detailed - what would start it, where would burn, it would be hot and scary, mommy would grab you and go to the neighbors, lots of stuff would be ruined, the whole family would have to live in a hotel for a while, etc

 

THis is the best I can do for now. My kids are 8 and 11- this is how "my inner Dr R" would handle it. If it is not hard, and she is not somewhat resistant- it is not the right exposure and will not work. At the same time, you need to start with the easiest and move to the hardest. I would discuss with her the list of things she will have to do, and have her put them in order from easy to hard. Then I would do one every other day, practicing them a few times every day.

 

It is not easy. The biggest thing I learned from our therapist is that he was very blunt and up front. He didn't hide anything from them- anything he could discuss with me, they would be in on. So IMHO it is important that our kids know they have pandas and ocd, we like ocd to diabetes- it sucks, for sure, but lots of kids have "stuff" to deal with (divorced parents, poverty, illness, learning issues). We "normalize" it in this way. The treatment for OCD is ERP. It is not optional, just like insulin would not be optional for a diabetic child. (we were lucky in that one of my daughter's bf's is diabetic and cannot eat anything and takes multiple shots daily- my dd would rather have the ocd).

 

My disclaimer is that my daughters (well at least one) responded way better to this with a therapist than she would have to me- so I think it might be important to find a great ERP therapist (although for us we had to travel from NJ to FL for that...)

 

Good luck- feel free to pm me if I can help in any way.