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for those who know OCD and recovery -- if you have a contamination fear of food and begin with excessive washing hands to clean off all germs, but the root of it is contamination fear, with intense avoidance of touching food -- then move into still having the fear but drop the excessive hand washing -- still finding other ways to avoid touching food --- does that show a step in the right direction of shedding the issue?

 

how do you determine when you're moving in the right direction vs. just replacing one dsyfunctional behavior with another?

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We're just one case and others may disagree but in our house when he drops a behavior and picks up another, the new behavior is usually slightly less restrictive. Historically, that trend continues and eventually all behaviors dealing with the fear are dropped. Mine has the food contamination fear, too.

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That's a tough one to answer. I have always witnessed a decrease in the rituals first and then they would stop comletely. At times one would replace the other with the latter one much shorter in duration. Take notice if the anxiety level is low that is always a good thing.

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Unfortunately, we see a lot of "shape-shifting" of behaviors, and, in our experience, ceasing one and focusing on another doesn't always indicate improvement. It can all come down to the kid's ability to "generalize," accepting that if this issue isn't of concern anymore, then a related one isn't of concern anymore, either. Some kids though, like our DS, aren't inherently wired to generalize; so, were he to have your son's issue, he might articulate, for instance, "Well, I don't have to wash as much because I'm using both sides of my napkin better and my hands are feeling okay when I leave the table, but I can't touch that food because it is sticky/greasy/smelly/icky, and if I did touch the food, then I would definitely have to wash my hands afterward."

 

Also, just one thing to maybe keep an eye out for: hand-washing isn't always a sign of "contamination OCD." It can also be "just right OCD," which is what our DS primarily presents with. He's not afraid of germs, or consequences because he's touched something that might be dirty or germy. Rather, he doesn't like the texture, the stickiness, the greasiness, etc. of various things and just flat out considers them "gross." He washes because he wants his skin to feel "just right" and dislikes the "extra frictiony feel" they get after handling certain things.

 

Also, I'm not sure I agree with this, but we've had more than one therapist/psychologist tell us that "contamination OCD" is frequently sort of OCD's "last hurrah" before receding into the dark recesses, i.e., taking a holiday and leaving the kid alone. I'd be interested if anyone else can speak to this from experience.

 

All that said, if your DS is washing less, I'd definitely comment on it and praise him and encourage him. Not only should the praise buoy his spirits, but then he'll know you've noticed and you're watching, and it might help him stick with dropping that particular behavior for good.

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for those who know OCD and recovery -- if you have a contamination fear of food and begin with excessive washing hands to clean off all germs, but the root of it is contamination fear, with intense avoidance of touching food -- then move into still having the fear but drop the excessive hand washing -- still finding other ways to avoid touching food --- does that show a step in the right direction of shedding the issue?

 

how do you determine when you're moving in the right direction vs. just replacing one dsyfunctional behavior with another?

That's an interesting question I have often asked myself. Is he actually getting better, or is he just learning to deal with it better?

Last visit with Dr. L she did a scale and it was very clear that the obsessions were stronger than the compulsions. That is, he still has the thoughts, but does not always act upon them. Which maybe means the obsessions are still there, but not as strong, so he can refrain from handwashing. He'll even bunch up all the things that would make him wash his hands, do them all one right after another, and THEN he'll wash.

 

So it's hard to tell, maybe he's just dealing with it better. It's just not right for him to be spending so much mental energy on this :(

 

But what am I saying! Either way it IS a step in the right direction. "Changing the ritual" is one of the tactics to deal with OCD. Simply by changing the ritual you are weakening the OCD grip. Yes, change is good! :)

 

Isabel

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My son had contamination, germ, dirt fears along with excessive hand washing and eating problems. When he was overcoming his OCD, he did not overcome all the OCD at once. It was like peeling away layers of some of his tendencies. Some of these tendencies are so much more elaborate than you would think. The fact that he has dropped the excessive hand washing is great! Celebrate that! Is he using a lot of hand sanitizer, wiping hands on clothes, using sleeves as "gloves"? Will he eat with utensils? You ask about replacing one issue for another. Yes, that happens sometimes. If I saw that happening, that new issue would be dealt with quickly so it didn't become ingrained in him. Has your son replaced it? Will he touch food that he does not plan to it?

 

for those who know OCD and recovery -- if you have a contamination fear of food and begin with excessive washing hands to clean off all germs, but the root of it is contamination fear, with intense avoidance of touching food -- then move into still having the fear but drop the excessive hand washing -- still finding other ways to avoid touching food --- does that show a step in the right direction of shedding the issue?

 

how do you determine when you're moving in the right direction vs. just replacing one dsyfunctional behavior with another?

Edited by Vickie
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