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OCD, ODD and phobias


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When I brought up this list to the psychiatrist and psychologist they said the ODD can be a result of OCD and they often do go hand in hand. The ODD may result in not being able to complete something associated w/ the OCD. We just may not realize the connection. I do know that once we got the OCD more under control, the ODD went away too. So much is a guessing game. Especially since they are young. They don't know how to verbalize what is going on in their heads nor do they undertsand something is going on in their heads. To this day, my son doesn't know what he was doing was wrong or odd.

 

My son did not seem to have conflicting thoughts or obsessions. It was all actions. When you say he reacts to things going on on the outside vs inside his head...can you give an example?

 

I pulled other from another thread b/c I didn't want to derail it too bad. I am curious about the OCD and ODD b/c my son has never presented with classic OCD or tics. It's more ODD and separation anxiety. He's doing very well now but as everyone, I'm trying to be prepared for the future. He's about 90% back with remaining strepnoxious and hyper-sensitive behavior.

 

They're all under the anxiety umbrella but here's why I think it may be important to differentiate.

 

He's had a potty phobia for 2 years - since we first tried to potty train him. He got the message to not go in his pants but was terrified of the potty - what a conundrum. His solution was to just not go. Yes, a 3 year old holding it for 10-12 hours. We got him back in diapers and that finally subsided after a few weeks. Just an interesting note - about 1-2 weeks into that he threw up one morning. I took him to the dr b/c I was worried he was having some serious problem. She thought his throat looked red and rapid tested and cultured him. They were both negative. I think it's got to be related.

 

For the next two years, I had him peeing on a towel b/c he had to go to school so I needed him out of the diapers. He didn't want to be in diapers, didn't want to use the potty. He knew it was ridiculous. We couldn't get any help. I kept saying it was like a phobia. "Professionals" just wanted to talk about power struggle.

 

Finally, after finding anxietybc.com, we were able to conquer this with 73 days of a desensitization plan for treating phobias. I said it was like a phobia, when I treated it like a phobia, he could conquer it.

 

I think phobic fit him better than OCD but is that where the ODD obnoxiousness is remaining? I read a book this summer The Sky is Falling by RaeAnn Dumont. He fits a list common features to OCD and phobias: a need for clarity, decisions seem monumental and difficult; intense fear causing avoidance. She distinquished by saying a phobics fears are "out there" while OCD find the thoughts themselves fearful and unacceptable. A regular phobic may be limited b/c they can't do something related to what's happening in their world but OCD is consumed with rituals perpetuated by their thoughts. A phobic can tell what they fear and when not in the situation are not anxious.

 

Sorry this is long - he doesn't seem to have rituals but does like things a certain way. Can anyone tell me ways they treated OCD that helped ODD subside?

 

Thanks!

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When I brought up this list to the psychiatrist and psychologist they said the ODD can be a result of OCD and they often do go hand in hand. The ODD may result in not being able to complete something associated w/ the OCD. We just may not realize the connection. I do know that once we got the OCD more under control, the ODD went away too. So much is a guessing game. Especially since they are young. They don't know how to verbalize what is going on in their heads nor do they undertsand something is going on in their heads. To this day, my son doesn't know what he was doing was wrong or odd.

 

My son did not seem to have conflicting thoughts or obsessions. It was all actions. When you say he reacts to things going on on the outside vs inside his head...can you give an example?

 

I pulled other from another thread b/c I didn't want to derail it too bad. I am curious about the OCD and ODD b/c my son has never presented with classic OCD or tics. It's more ODD and separation anxiety. He's doing very well now but as everyone, I'm trying to be prepared for the future. He's about 90% back with remaining strepnoxious and hyper-sensitive behavior.

 

They're all under the anxiety umbrella but here's why I think it may be important to differentiate.

 

He's had a potty phobia for 2 years - since we first tried to potty train him. He got the message to not go in his pants but was terrified of the potty - what a conundrum. His solution was to just not go. Yes, a 3 year old holding it for 10-12 hours. We got him back in diapers and that finally subsided after a few weeks. Just an interesting note - about 1-2 weeks into that he threw up one morning. I took him to the dr b/c I was worried he was having some serious problem. She thought his throat looked red and rapid tested and cultured him. They were both negative. I think it's got to be related.

 

For the next two years, I had him peeing on a towel b/c he had to go to school so I needed him out of the diapers. He didn't want to be in diapers, didn't want to use the potty. He knew it was ridiculous. We couldn't get any help. I kept saying it was like a phobia. "Professionals" just wanted to talk about power struggle.

 

Finally, after finding anxietybc.com, we were able to conquer this with 73 days of a desensitization plan for treating phobias. I said it was like a phobia, when I treated it like a phobia, he could conquer it.

 

I think phobic fit him better than OCD but is that where the ODD obnoxiousness is remaining? I read a book this summer The Sky is Falling by RaeAnn Dumont. He fits a list common features to OCD and phobias: a need for clarity, decisions seem monumental and difficult; intense fear causing avoidance. She distinquished by saying a phobics fears are "out there" while OCD find the thoughts themselves fearful and unacceptable. A regular phobic may be limited b/c they can't do something related to what's happening in their world but OCD is consumed with rituals perpetuated by their thoughts. A phobic can tell what they fear and when not in the situation are not anxious.

 

Sorry this is long - he doesn't seem to have rituals but does like things a certain way. Can anyone tell me ways they treated OCD that helped ODD subside?

 

Thanks!

 

We also found that when we treated the OCD with ERP (Exposure & Ritual Prevention - which is also used for some Phobia, PTSD, and Panic Disorder), that all the rage and refusal to comply, went away. We initially thought she did not have OCD, as we didn't understand OCD enough. It can manifest in a lot of ways, and kids have a hard time expressing it. Also, a lot of the compulsions and obsessions can be internal/mental. So for example, my dd would fly into a rage if you asked her to get dressed, because she thought all her clothes would make her sick. The only way to "fix" the clothes, was for me to touch them first. So if I refused to help, she would NOT get dressed, or would rage for HOURS. She could not explain to me why - she did not know the words for the feeling - she just knew that really BAD stuff would happen if she touched those clothes. I saw none of this. I just saw a kid throwing unbelievable temper tantrums if I asked her to put her socks on & refused to be her "servent" to go upstairs and get the socks myself. Does that make sense? I can give you a 1000 examples - it was a bad time. Eventually, so much of her time was spent in OCD, that anything she was asked to do, she would refuse, rage, etc. AVOIDANCE in itself can be the RITUAL. It doesn't really matter what the Obsession is - although it is helpful if you can describe it - it is not necessary to the ERP therapy.

 

It's tough and slow therapy but totally worthwhile. We find OCD to be VERY sticky - I think it becomes part of their brain after a while, and we have not found a way to get rid of it altogether without therapy - but we have not done IVIG or PEX. It's sort of a catch 22 - she is not bad enough, if that makes sense. So far, we are using antibiotics, Pred, and therapy.

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We also found that when we treated the OCD with ERP (Exposure & Ritual Prevention - which is also used for some Phobia, PTSD, and Panic Disorder), that all the rage and refusal to comply, went away. We initially thought she did not have OCD, as we didn't understand OCD enough. It can manifest in a lot of ways, and kids have a hard time expressing it. Also, a lot of the compulsions and obsessions can be internal/mental. So for example, my dd would fly into a rage if you asked her to get dressed, because she thought all her clothes would make her sick. The only way to "fix" the clothes, was for me to touch them first. So if I refused to help, she would NOT get dressed, or would rage for HOURS. She could not explain to me why - she did not know the words for the feeling - she just knew that really BAD stuff would happen if she touched those clothes. I saw none of this. I just saw a kid throwing unbelievable temper tantrums if I asked her to put her socks on & refused to be her "servent" to go upstairs and get the socks myself. Does that make sense? I can give you a 1000 examples - it was a bad time. Eventually, so much of her time was spent in OCD, that anything she was asked to do, she would refuse, rage, etc. AVOIDANCE in itself can be the RITUAL. It doesn't really matter what the Obsession is - although it is helpful if you can describe it - it is not necessary to the ERP therapy.

 

It's tough and slow therapy but totally worthwhile. We find OCD to be VERY sticky - I think it becomes part of their brain after a while, and we have not found a way to get rid of it altogether without therapy - but we have not done IVIG or PEX. It's sort of a catch 22 - she is not bad enough, if that makes sense. So far, we are using antibiotics, Pred, and therapy.

 

So, maybe this has to do with my last email to you, maybe I don't really understand OCD or what is going on with DD8.... well, that's obvious anyway, no matter what it is, I don't understand it. But the behavior you describe is very similar to what we are experiencing. I'll do some more internet searching to see if I can get some more understanding of it.

 

Susan

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Meg's Mom - really helpful info! So how do you do the ERP if you don't know what the initial problem is, you just see the tantrum?

 

We have a psychologist who is next to useless. I think he thinks we have him in a tough school and he's rebelling. He goes to a Montessori school which he loves. It's not too tough, just has things available if kids want it. Danny is 5 and reads fluently and is pretty good at math, too - fits the pandas phenotype. School phobia was part of the problem last year. Psych can't seem to understand it's not really the school that is the problem. I'm searching for someone else to help us and have an appt Oct 13 with someone who sounds promising.

 

Here's Daniel - tonight playing baseball with father and brother before dinner. Dad says each gets one more hit before coming in for dinner. Brother hits home run first. Danny hits base hit last. Danny can't help clean up toys, yelling he needs another hit. Refuses to come in, yelling he needs to hit it in the bushes. Just yelling and getting himself worked up. I carry him in (b/c mosquitos eating him) and use calming techniques from The Explosive Child book. After much, I discover he's upset b/c he only got a base run and didn't want to be stuck on base all night b/c there's no one else to bat him in.

 

It's not usually so clear-cut that it's unfinished business upsetting him. Is that not completing running the bases a sign of OCD? Is the problem that he needs to be able to run home or that he can't express it properly to fix it? If he could have said it in the first place, it's not so much a big deal and he could have gotten to bat again to run home.

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That sounds so much like something my son would have done. As for OCD, phobias, thoughts, etc, the psychlogist told me that is was obvious my son's OCD was different (uh...yeah.....PANDAS). He did not have obsessions, or thoughts running the show. No odd cause and effects going on his head.

 

Definitely find a new psychologist. The first one we went to was worthless. This one doesn't do much (I do most of the work), but she listens, doesn't judge, and would help guide if I needed it.

 

btw..You did great not giving in to him tonight with baseball. That high anxiety or even a meltdown is expected when you are trying to overcome an OCD need. How long did it take for him to calm down?

 

OCD is so much more complicated than I ever thought. Then there are also OCD spectrum disorders. Unfortunately, I can see OCD in so much people do now. Maybe his ODD-like behvaiors are a result of him needing control somehow and that's his way of getting it. A control he is not getting whe he has to give in to the OCD.

 

 

 

Here's Daniel - tonight playing baseball with father and brother before dinner. Dad says each gets one more hit before coming in for dinner. Brother hits home run first. Danny hits base hit last. Danny can't help clean up toys, yelling he needs another hit. Refuses to come in, yelling he needs to hit it in the bushes. Just yelling and getting himself worked up. I carry him in (b/c mosquitos eating him) and use calming techniques from The Explosive Child book. After much, I discover he's upset b/c he only got a base run and didn't want to be stuck on base all night b/c there's no one else to bat him in.
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Hi Susan - I don't have an email from you! Can you resend? There is a very good Pediatric OCD therapist up at Exit 25 off I-77. Her name is Dr. DeeDee Russell. She did the training at the OC's BTTI course. It's not easy, but it does make going through this much easier for all of us - we sort of have our roles now. And Meg has come out of this with much more confidence. It wanes sometimes, but we all know how strong she really is. That's a silver lining.

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Meg's Mom - really helpful info! So how do you do the ERP if you don't know what the initial problem is, you just see the tantrum?

 

We have a psychologist who is next to useless. I think he thinks we have him in a tough school and he's rebelling. He goes to a Montessori school which he loves. It's not too tough, just has things available if kids want it. Danny is 5 and reads fluently and is pretty good at math, too - fits the pandas phenotype. School phobia was part of the problem last year. Psych can't seem to understand it's not really the school that is the problem. I'm searching for someone else to help us and have an appt Oct 13 with someone who sounds promising.

 

Here's Daniel - tonight playing baseball with father and brother before dinner. Dad says each gets one more hit before coming in for dinner. Brother hits home run first. Danny hits base hit last. Danny can't help clean up toys, yelling he needs another hit. Refuses to come in, yelling he needs to hit it in the bushes. Just yelling and getting himself worked up. I carry him in (b/c mosquitos eating him) and use calming techniques from The Explosive Child book. After much, I discover he's upset b/c he only got a base run and didn't want to be stuck on base all night b/c there's no one else to bat him in.

 

It's not usually so clear-cut that it's unfinished business upsetting him. Is that not completing running the bases a sign of OCD? Is the problem that he needs to be able to run home or that he can't express it properly to fix it? If he could have said it in the first place, it's not so much a big deal and he could have gotten to bat again to run home.

 

So I'm not a doc, just a mom - really I find that GOOD professional help is a lifesaver. But say you don't find someone for a minute. Then read Dr. March's book "how to help kids say no to OCD and parents say way to go" (that's not exact title). Then, read "what to do if your brain get's stuck" with your son, so he can understand the basic concepts of OCD. Since he is 5, you may have to skip some parts. Then you'll name the OCD - we call it the worryman, some kids call it the Meanie Feeling - whatever works for them. Then, you start to use this language to talk about OCD moments, all the time. For a while, you may need to guess, that is ok. So say things like "Oh, honey, is the worryman making you feel angry right now? What does he want you to do? How will he make you feel if you dont do that? I'm sorry that the worryman is causing you trouble. I'm going to help you learn some tools to fight him!"

 

The next step is to build a heirarchy of stuff & rate it. You make a fear thermometer (this is in the book "Worry Hill", but you can make your own). The idea is to ask the child to be a detective (you help) and find out what makes them feel a certain compulsive way - or just to list the compulsions. So even if you don't know WHY they must finish the bases (that's ok, it's an irrational feeling anyway!), you can still list it. The rating part is to say, ok, if you did not finish running the bases, where would your fear temperature be? Would it be a 10 (crazy, my head will explode), or a 1 (no big deal, I just wanted to). This process is about a week or more. But when you doing this work, it actually helps to relieve a lot of the pressure on everyone. We gave points for every detective item - and then had really easy dollar store rewards in the prize box. You can let him pick - or if that is too much for him, then keep the prize box secret, and you give them. Or make it a covered box that you reach down into. Whatever works - but make it FUN for him. You want to keep him motivated. So on our first night, I listed something & then if she agreed, gave her a reward. On the second night, she had to come up with one idea. I would remind her 4-5 times during the day, to be sure to be a detective.

 

THEN you can start working. Choose a heirarch item that is a 1-2 on the fear scale. Tell him ahead of time that you are going to beat up the worryman together. Give him a choice of a few low scale items that he could try first. Tell him your reward plan, and be sure that some rewards are just for trying!! You want to reward effort here. And you want to do a LOT of positive reinforcement. "you are such a brave kid, I know you can do this. This is hard, but you can beat the worryman. I was so proud of how hard you tried last night". Make this their personal story. That they have faced the worst - and won. It's about tiny baby steps. I can write more later - have to run.

 

I loved Saving Sammy - and found it really interesting that she found a similar experience to ours - that the Anti-biotic took the urge way down to a manageable level - but that ERP therapy was really important to get rid of the OCD, since it becomes habit based or habit reinforced after some time. We also find that ERP is a necessary part of the tool box. I feel like her brain "learns" OCD after a while.

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See, I tried naming OCD with my 5 year and it didn't work. He was adamant there's wasn't a problem, nothing was "telling" him to do things. Nor, did I get the chance to let him help make the heirarchy. CBT is hard when the kids won't ackowledge the problem. However, we still had sucess with getting rid of that OCD! So, to those facing the same problem I did, there can still be success....just wanted to put that out there.

 

 

 

Then you'll name the OCD - we call it the worryman, some kids call it the Meanie Feeling - whatever works for them. Then, you start to use this language to talk about OCD moments, all the time. For a while, you may need to guess, that is ok. So say things like "Oh, honey, is the worryman making you feel angry right now? What does he want you to do? How will he make you feel if you dont do that? I'm sorry that the worryman is causing you trouble. I'm going to help you learn some tools to fight him!"

 

The next step is to build a heirarchy of stuff & rate it. You make a fear thermometer (this is in the book "Worry Hill", but you can make your own). The idea is to ask the child to be a detective (you help) and find out what makes them feel a certain compulsive way - or just to list the compulsions. So even if you don't know WHY they must finish the bases (that's ok, it's an irrational feeling anyway!), you can still list it. The rating part is to say, ok, if you did not finish running the bases, where would your fear temperature be? Would it be a 10 (crazy, my head will explode), or a 1 (no big deal, I just wanted to). This process is about a week or more. But when you doing this work, it actually helps to relieve a lot of the pressure on everyone. We gave points for every detective item - and then had really easy dollar store rewards in the prize box. You can let him pick - or if that is too much for him, then keep the prize box secret, and you give them. Or make it a covered box that you reach down into. Whatever works - but make it FUN for him. You want to keep him motivated. So on our first night, I listed something & then if she agreed, gave her a reward. On the second night, she had to come up with one idea. I would remind her 4-5 times during the day, to be sure to be a detective.

 

THEN you can start working. Choose a heirarch item that is a 1-2 on the fear scale. Tell him ahead of time that you are going to beat up the worryman together. Give him a choice of a few low scale items that he could try first. Tell him your reward plan, and be sure that some rewards are just for trying!! You want to reward effort here. And you want to do a LOT of positive reinforcement. "you are such a brave kid, I know you can do this. This is hard, but you can beat the worryman. I was so proud of how hard you tried last night". Make this their personal story. That they have faced the worst - and won. It's about tiny baby steps. I can write more later - have to run.

 

I loved Saving Sammy - and found it really interesting that she found a similar experience to ours - that the Anti-biotic took the urge way down to a manageable level - but that ERP therapy was really important to get rid of the OCD, since it becomes habit based or habit reinforced after some time. We also find that ERP is a necessary part of the tool box. I feel like her brain "learns" OCD after a while.

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Especially given the age of a child - I agree - the therapy can be really varied to fit each family and child! Terrific point. Glad it worked so well for you. We are big "worryman" fighters around our house. Funny story - we went to Stone Mountain Park this summer & I am afraid of heights. So guess who was walking on ropes 3 stories in the air? Yep, Meg loved that I had to fight my own "worryman" that day!

 

See, I tried naming OCD with my 5 year and it didn't work. He was adamant there's wasn't a problem, nothing was "telling" him to do things. Nor, did I get the chance to let him help make the heirarchy. CBT is hard when the kids won't ackowledge the problem. However, we still had sucess with getting rid of that OCD! So, to those facing the same problem I did, there can still be success....just wanted to put that out there.
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Funny! You know when I get "thoughts" in my head that I have to do something, I try to "talk back" to those thoughts. That's really hard! I admit I give into the thoughts (and I guess what are compulsions) a lot. I need to practice what I preach!

 

Especially given the age of a child - I agree - the therapy can be really varied to fit each family and child! Terrific point. Glad it worked so well for you. We are big "worryman" fighters around our house. Funny story - we went to Stone Mountain Park this summer & I am afraid of heights. So guess who was walking on ropes 3 stories in the air? Yep, Meg loved that I had to fight my own "worryman" that day!

 

See, I tried naming OCD with my 5 year and it didn't work. He was adamant there's wasn't a problem, nothing was "telling" him to do things. Nor, did I get the chance to let him help make the heirarchy. CBT is hard when the kids won't ackowledge the problem. However, we still had sucess with getting rid of that OCD! So, to those facing the same problem I did, there can still be success....just wanted to put that out there.

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I think about this a lot. About what I am asking my child to do, and how hard it is for me. When something is going wrong in my life, and I start to ruminate on it, or it wakes me at 4 am, and I can't turn it off. Or when I am afraid of doing something, like a big presentation. I think that this is what Meg feels like everyday in the middle of an episode, even when she tries to do something simple - and that she has so much courage to fight back. I really admire her.

 

Funny! You know when I get "thoughts" in my head that I have to do something, I try to "talk back" to those thoughts. That's really hard! I admit I give into the thoughts (and I guess what are compulsions) a lot. I need to practice what I preach!

 

Especially given the age of a child - I agree - the therapy can be really varied to fit each family and child! Terrific point. Glad it worked so well for you. We are big "worryman" fighters around our house. Funny story - we went to Stone Mountain Park this summer & I am afraid of heights. So guess who was walking on ropes 3 stories in the air? Yep, Meg loved that I had to fight my own "worryman" that day!

 

See, I tried naming OCD with my 5 year and it didn't work. He was adamant there's wasn't a problem, nothing was "telling" him to do things. Nor, did I get the chance to let him help make the heirarchy. CBT is hard when the kids won't ackowledge the problem. However, we still had sucess with getting rid of that OCD! So, to those facing the same problem I did, there can still be success....just wanted to put that out there.

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