How to Recognize Signs of OCD in Children

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OCD (obsessive, compulsive disorder) is an anxiety disorder characterized by unwanted, uncontrollable, intrusive thoughts, images, or urges that cause distress, and repetitive behaviors or rituals a person feels compelled to perform in order to get rid of the distress and prevent bad things from happening. However, the signs of OCD may look different in children than they do in adults.

OCD can affect children as well as adults and start at any age, but symptoms most commonly begin to manifest between the ages of 8 and 12 or during the late teen years. The signs usually start small and intensify over time, and because of their gradual onset, may not be noticeable at first.

Are signs of OCD in children the same as signs of OCD in adults?

Signs of OCD in children are similar to those in adults, but younger children who have less developed cognitive skills are less likely to recognize that their obsessions and compulsions are unreasonable or excessive and may think that everyone else has similar thoughts and urges. Children are also more likely to have obsessive thoughts about the safety of their parents and to be afraid that someone they love might get sick or die.

What is the difference between picky behaviors and obsessions or compulsions?

Behaviors such as lining up blocks in a certain way, being a picky eater or fussy dresser, or having certain quirks or preoccupations may just be common phases of childhood. Obsessions and compulsions, however, are not the same thing. They are not a matter of personal choice, nor are they fleeting or short-lived.

Obsessions are repetitive, involuntary, fear-producing, thoughts that the child does not want to have but cannot stop thinking about or control, and that can have a paralyzing effect that prevents him or her from thinking about anything else.

These lead to compulsions, which are repetitive actions or rituals the child feels driven to perform in a certain way to stop the obsessive thoughts and prevent something bad from happening. If they are not done in a specific way, it causes the child to panic and repeat it until they get it right.

What are the diagnostic criteria for OCD in children?

According to the Centers for Disease Control and Prevention (CDC), many children are sometimes bothered by thoughts they may feel they have to do something about such as, for instance, wearing a favorite piece of clothing to avoid bad luck. For children with OCD, however, these thoughts and urges to act on them are not just occasional. They persist even if the child tries to ignore them or make them go away.

To be diagnosed with OCD, the unwanted thoughts and behaviors the child feels he or she must do happen frequently, take up a lot of time (more than an hour a day), interfere with his or her activities, or make him or her very upset.

What red flags may be signs of OCD in children?

  • Needing to have their possessions organized in a particular way according to a precise, symmetrical pattern, with everything perfectly aligned, and getting upset if anything is touched or moved.
  • Constant anxiety about making a mistake or doing something wrong that will cause something bad to happen.
  • Fear of being contaminated by dirt or germs.
  • Excessive hand washing that leaves skin scrubbed raw and bleeding.
  • Repeatedly checking in on family and needing constant reassurance that they are safe and well.
  • Needing constant reassurance that they haven’t hurt anyone.
  • Repeatedly checking things such as light switches, windows, and doors before leaving the house and getting upset if forced to leave before completing their routine.
  • Having certain rituals they need to perform exactly the same way each time to avoid something bad happening, such as counting steps a specific amount of times before entering a room.
  • Checking things over and over to make sure they are done right.
  • Worrying excessively about the neatness of their handwriting or schoolwork, and erasing, rewriting, or redoing things in a certain way over and over again until they look just right.
  • Asking the same questions repeatedly in different ways to get reassurance that everything will be okay or a particular thing is safe.
  • Having a specific bedtime routine that has to be done just so or they need to start all over again until they get it right.
  • Performing repeated movements such as tapping objects in a repetitive order.
  • Having a preoccupation with unlucky numbers, words, or colors, and linking them to bad things happening.

OCD can be devastating for a child but there are several effective, evidence-based treatment options available. The sooner the condition is diagnosed, the faster it can be treated, and the better the chance for a successful outcome.

If you would like to set up a risk-free appointment to meet with one of the faith-based counselors in Newport Beach, California, please give us a call at Newport Beach Christian Counseling.

References:

Natasha Daniels. “OCD in Children: Are You Missing the Signs?” AT Parenting Survival. anxioustoddlers.com/ocd-in-children/.

“Obsessive-Compulsive Disorder In Children.” Centers for Disease Control and Prevention. Reviewed July 26, 2023. cdc.gov/childrensmentalhealth/ocd.html.

Stephanie Rhodes. “How to Recognize Your Child Might Have OCD.” Michigan Medicine. February 18, 2020. michiganmedicine.org/health-lab/how-recognize-your-child-might-have-ocd.

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“Potted Plant”, Courtesy of Nik, Unsplash.com, CC0 License

OCD in Children: What Parents Need to Know

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When someone seems overly concerned about being clean, others might call them “obsessive.” When a person insists on specific behaviors or requires a certain order of things, words or actions, people may say they’re “compulsive”.

People may use the term “OCD” in an almost light-hearted manner to justify behaviors or rules which they themselves practice. But for anyone diagnosed with real Obsessive Compulsive Disorder (OCD), there is nothing light-hearted about their struggles. For them, the condition often brings distress and places limits on their every day lives to varying degrees.

According to information released by the American Psychiatric Association (APA), the best estimates are that about 1.2% of the American population struggles with OCD. It occurs in adults, teens, and children and it is likely that at least a million U.S. children wrestle with OCD symptoms (OCFMC, 2006).

Other studies predict that one child or teenager out of every 200 will develop OCD (AACAP, 2013). The average age when OCD begins is 19-1/2 years old, and 1/4 of all people who were diagnosed with OCD had developed obvious symptoms by the age of 14 (American Psychiatric Association, 2013).

Parents are overwhelmed and confused when one of their children develops the symptoms or begins to live under the dark cloud of the fears that are a part of OCD.

It’s difficult to know what to do when a child has an emotional meltdown or battles with someone who has (probably without realizing it) interfered with a “necessary” order of items and actions.

It should be good news to know that effective treatment is available. Parents should begin by learning all that they can about OCD with the goal of becoming better able to understand what a child with OCD is facing and how and where to find the right help.

What is Obsessive Compulsive Disorder?

OCD is a mental health issue that is diagnosed by looking for genuine obsessions and/or compulsions.

Obsession: Obsessions may be defined as urges, thoughts, or images that intrude on a person’s mind and life in a way that becomes difficult or impossible to ignore (APA, 2013). For example, someone can become a germophobe. A child may become driven to seek perfection. Another lives with the constant fear of harming themselves or others.

Compulsion: Compulsions, on the other hand, are behaviors or mental acts that a person is driven to repeat again and again. Compulsions may grow out of obsessions (APA, 2013). People with OCD find themselves compelled to continually wash their hands, perform special rituals, engage in what is known as “checking” behaviors, count things, or even pray because they believe they must.

When a person suffers from OCD, they carry out certain acts (compulsions) to try to relieve anxiety or tension (American Psychiatric Association, 2013). Often the anxiety for which the person desperately wants relief is driven by an obsession. The compulsive behavior brings a measure of relief but it’s only temporary, so when the anxiety returns, the person must perform the action again to get relief. This develops into a cycle where relief from the anxiety reinforces the need to repeat the compulsive behavior in order to experience another brief period of relief.

The obsessions and compulsions are often connected, such as germophobia and washing one’s hands. Or, a student is so afraid of failing that he or she keeps on checking and checking his or her test answers even to the point of missing recess or lunch.

In other cases, the obsessions and compulsions may not seem to be related. Think, for example, of a child who counts a certain number of cracks in a sidewalk thinking it will keep his mother from being hurt. So, a diagnosis of OCD does not always mean that the obsessions and compulsions are related. A child may have one without the other.

How OCD develops and manifests itself can also vary. Also, the focus of obsessions and compulsions shift over time. For some people, obsessions and compulsion come out more obviously and intensely when they are under stress (APA, 2013). Those same people may experience fewer or less intense symptoms in situations where stress levels are low. And often, when one obsession or compulsion is eliminated, others may change.

True OCD symptoms are not simply small irritations. They consume a major portion of the time in a child’s day. Further, they may increase a child’s level of stress, bringing layers of problems.

For example, a germophobic child may wash their hands to the point that they become dry and cracked, and may even start to bleed. Then, he or she may also become terrified of being around sick people or having physical contact with someone who has even been close to a sick person.

This can disrupt relationships, or bring on peer harassment if the fears or behaviors become known. Brothers and sisters may feel rejected by the child who struggles with germophobia because he or she may avoid giving hugs or express fear which the siblings may take personally.

OCD not only affects the person who struggles with the obsessions and compulsions, but also impacts their family and friendships. Then the OCD sufferer feels shame over their compulsive behaviors. A child’s need to carry out these compulsions often builds more shame. The emotional distress that often comes with OCD can become so heavy that depression also develops.

OCD in Children: Catching it Early

Early warnings of OCD in children may go unnoticed. Children may find certain behaviors embarrassing and may try to hide them. But parents who observe some of the following in their child’s life may have reason to seek further assistance in checking out the possibility of OCD (OCFMC, 2006; AACAP, 2013):

1. Repetitive behaviors (washing their hands over and over, touching things in a specific order, anxiously rechecking school work, or repeatedly checking doors, etc.

2. Continuous fears that become extreme (such as unusual fears surrounding germs or dirt, or anxiety about the well being of the family).

3. Often repeated statements that go beyond reasonable concern and obsessively express worry outcomes that do not necessarily follow. “I must touch [this object] 10 times so that my sister will still like me” or “When I fail to pray a certain way, our team loses.”

4. Habits and behaviors beginning to get in the way of normal life or friendships.

5. Needing reassurance too much and too often (“will I be okay if…?”; “will it be okay…?”).

6. Constantly compulsion to carry out an action until everything feels “correct.”

7. Often driven to confess bad thoughts, like sexual imagery or thinking unkind thoughts about other people.

8. Avoiding more and more activities not connected to obsessions or compulsions

9. Always seeming to be behind (because obsessions and/or compulsions demand time).

10. Increased physical symptoms of anxiety, such as headaches and stomach aches.

What Causes Obsessive Compulsive Disorder?

As is typical of much of the world of mental illness, the exact causes of OCD are still largely a mystery. In fact, a number of different factors acting in combination, including environmental and biological factors, may be behind a child’s OCD.

The Diagnostic and Statistical Manual of Mental Disorders, 5th Edition (DSM-5), states that for those individuals who have a member of their immediate family that has OCD there is a 200% greater likelihood that they will develop OCD over those whose first-degree relatives are not OCD (APA, 2013).

What’s more, they also found that when the immediate family member has experienced childhood-onset OCD, the likelihood of developing OCD increases by 1000%. Other possible causes of OCD include significant life transitions (divorce, changing schools, etc), abuse, and loss (AACAP, 2013; APA, 2013).

Whatever the cause may be in a given instance, it has become clear that OCD has a significant effect on the brain. Brain scans have shown differences in brain activity between people who have OCD and those who do not (Scharwtz, 2016).

OCD may also have physical causes, so an evaluation by a medical professional is always a good idea. Physical causes may be addressed to help reduce contributing factors. For example, Pediatric Autoimmune Neuropsychiatric Disorders Associated with Streptococcal (PANDAS) can trigger a sudden and severe onset of OCD or tic disorder symptoms (National Institute of Mental Health, 2016). In these cases, the streptococcal infection would require medical treatment.

Helping Your Child

If your child exhibits symptoms of OCD, there are a number of ways to find help and give good support.

  • Get immediate professional help and counsel. There is no reason for you to try to handle this alone!
  • Don’t fall into the trap of merely using reassurance as your tool to try to calm your child. This is not an effective way to reduce the symptoms nor does it teach your child to fight and manage them.
  • Don’t try to avoid everything that your child fears or is obsessed by since this only tends to reinforce their symptoms.
  • Give your healthy coping skills, like memorizing relevant Bible verses, relaxation techniques, evaluating the rationality of their thoughts, soothing activities, and learning to live in the moment. Stress tends to trigger and magnify symptoms, so being able to use effective stress management tools makes a real difference.
  • Demonstrate how to set proper boundaries. These can help your child handle stress.
  • Teach your child how to take care of themselves, like eating healthy foods and getting enough sleep,
  • Teach your child to recognize their obsessions and compulsions. Knowledge is a power.
  • Do not shame! There may be no logic behind OCD symptoms, but they are quite real and your child is not to blame.
  • Provide a time and place for your child to express and process negative feelings, like embarrassment and shame, that go along with OCD symptoms.
  • Find support for yourself and a place to process your own feelings about your child’s OCD symptoms. You may experience frustration and fear, along with any number of other difficult but typical emotions. Learn to take care of yourself so that you can take care of your child.

Treatment for OCD in Children

To confirm a diagnosis of OCD in children, parents should seek an evaluation by an experienced mental health professional. The DSM-5 states that OCD left untreated unlikely to go away and the symptoms will fluctuate as time goes on (APA, 2013).

Several different therapies exist for treating OCD in children. Cognitive behavioral therapy (CBT) is one of the most recommended. One kind of CBT applied quite often is known as Exposure and Response Prevention (ERP).

Much like it sounds, ERP is a type of therapy where a patient is taught not to act on any compulsion in order to ease their anxiety. Counselors will then teach a child various tools to deal with the difficult emotions.

Though the idea of asking a child not to use his or her compulsive behaviors in the face of anxiety may sound frightening, therapy can be paced so that anxiety does not become unmanageable.

Other methods of CBT, include “imagined exposure” and learning to overcome negative and illogical thinking patterns. For some children, play therapy may be a part of treatment.

Along with counseling medical, evaluation is crucial. A medical professional can help determine whether medication might help.

It may also be necessary to ask your child’s school for any help or support they may be equipped to offer. You should talk to your counselor about this.

Remember, you need not try to parent your OCD child alone! Reach out to a counselor today to ask questions and discuss the many options available.

There is hope and healing!

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Obsessive-Compulsive Disorder: Signs and Symptoms

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Obsessive-compulsive disorder (OCD) is a mental condition that is becoming increasingly widespread. Fortunately, however, so is the research being done on the condition. Behavior Therapy is available and the best thing about it is that it works.

OCD can manifest itself in a number of ways and tends to manifest specific to the emotional and/or neurological structure of the individual who is suffering from it. It is characterized by a feeling of being stuck within repeating cycles of behavior and/or thinking.

Over a period of time, the individual begins to feel they have little or no control over their behavior and/or thinking. Feelings of depression and anxiety may arise and escalate. Not stepping on cracks on sidewalks, constant washing of hands, and checking and rechecking to make sure the stove is turned off are all examples of OCD behavior.

The condition of OCD is complex. Being diagnosed as having Obsessive-Compulsive Disorder warrants a visit to a mental health professional to discuss concerns and to explore solutions. If you feel you have symptoms where your OCD behavior is affecting yourself and/or your loved ones, it is crucial that you reach out for help.

Because the symptoms may be behavioral, neurological, or somatic, it’s vital to discover the root cause so you can find the treatment that best suits you. If you’ve received an OCD diagnosis from a professional in the mental health field, depending on the causality and severity, it may be able to be treated by Behavior Therapy.

Behavioral Therapy Help for OCD

As a rule, Behavioral Therapy, also known as (BT), embraces the use of operant conditioning as a tool to alter the sufferer’s behavior. It is through interventions that are structured especially with the patient in mind, sometimes employing the use of a reward or punishment or even extinction which is the abrupt halting of an unwanted, undesired behavior. Individually tailored treatment plans strive to make use of the interests and strengths of the person in order to optimize the effectiveness.

The following are some BT practice examples that are fictitious in nature, but whose scenarios ring very true to life where the condition is concerned:

  • A. is a male who is 24-years of age and is still residing with his parents. It has proven to be difficult for the young man to make it out the front door and arrive at college on time because he gets stuck sitting in his bedroom, obsessing over things that might go wrong throughout the day. His professional therapist has recommended that he pack his school things in his backpack the night before and set it beside the door, put a copy of his daily schedule on the refrigerator, and set his alarm before bedtime. In addition to these suggestions, A’s counselor is working with him to redirect his thoughts away from possible negative outcomes.
  • K. is a female who 32 years-old is. She was promoted in her job six months back but suffers from a touch of OCD, mainly the action of touching a light switch three times prior to turning it on. No other OCD actions were significant, however. Within the past few weeks, though, she has caught herself continually vacuuming her floor to the point where she is consumed with doing so any time she is at her house. Her therapist has recommended that she not vacuum after seven in the evening and suggested that her vacuuming should not go on longer than thirty minutes each day. She is to tie a ribbon on the doorknob of the closet that the vacuum is in to remind herself of the suggestion.
  • B. is a male who is 28-years-old who cannot get thoughts of a girl he had been dating out of his mind. She ended the relationship abruptly, without any explanation and refuses to return his phone calls. He is obsessed with her and constantly wonders what she is thinking, what she is doing, and why she ended things with him. He has not even been talking to his friends during this time. His therapist suggests that he pick a friend and set up an interaction such as going for coffee or to a movie. The counselor also tells him to put a rubber band around his wrist which he is to snap each time he finds himself thinking of the girl in order to distract his thoughts.

The above examples show how a therapist can use BT to help alter a patient’s thoughts and behaviors. These types of intervention may be helpful, depending, of course, upon the pathology that lies behind the behavior

If behavior modification worsens the situation or doesn’t work, other options will be explored such as psychodynamic psychotherapy for the purpose of finding the root cause, brain testing for possible neurological issues, and/or use of medication.

Underlying Structure

We are virtually completely emotionally unstructured at birth. Birth is generally the first traumatic experience that takes place and our response to it is typically to desire to control the trauma. Since infants, and even children, are helpless to control what is going on around them, they begin to create defense structures in order to protect themselves.

Since the very young don’t have the capacity to think it all through because the neocortex is not mature enough to understand and reason, a child who has experienced great trauma may become catatonic or may disconnect from the feelings that are just too overwhelming to deal with.

Among the number of possible trauma responses are ones that have to do with OCD. Repeating actions can, in some strange sense, make us feel as if we have control over what is going on around us. When we reach our adult years, those behaviors and thoughts are actually hardwired in our brains. Thankfully, neurological studies reveal that we can rewire providing we’re willing to go through the effort and time it takes to do so.

Brain Rewiring

When we are dealing with our typical ways of thinking, awareness and identification are about half of the battle. Our system defenses are automatic so they don’t necessarily need to be in the forefront of our thoughts in order to be used, which ultimately means that if we want to make changes in our modus operandi, we must make a purposed, conscious effort.

For instance, if just seeing your neighbor causes you to be anxious, you may, unconsciously, distance yourself from him. If you take it a step further and explore why seeing him might may you feel nervous and anxious, much may be discovered by exploring such a question. Does he remind you of a relative who was abusive? Maybe you are intimidated by him? Perhaps you waved to him once and he didn’t wave back?

Once you figure out that your emotional response isn’t realistic, the next time you see him, you can remind yourself of that fact. With each and every breath, remind yourself of what is and isn’t the reality of the situation and become consciously aware of the goal of working through the anxiety rather than adding to it.

It is amazingly easy to take a perfectly normal situation and make it into a vendetta which is imagined. Picture a family reunion. Your cousin is there with her new husband who is an attorney. In the back of your mind, you are thinking of years ago when you actually had to hire an attorney to represent you for a misdemeanor that stemmed from a case of bad judgment.

You are introduced and reach out to shake his hand but he does not reciprocate the gesture. You immediately assume he thinks you are beneath him. For years, you carry the intimidating feelings and when you see him, you feel very anxious.

Later, when attending a relative’s funeral, you learn that he suffers from a phobia of germs and never shake hands with anyone. Your anxiety and feelings of insecurity were never legitimate but years have been wasted by your assumptions.

The truth of the matter is we can’t really know what anyone thinks or feels, even in the event that they tell us. We can decide to believe them if they tell us, but we can never know for sure. A child who has a father who is abusive may be apologized to, time after time.

Can the child believe that the father really was sorry? It is normal in such an event for the child to look for signs of sincerity or evidence otherwise. That’s why our defense mechanisms are always sending out feelers to second guess others and to go into defensive gear if things seem out of order.

Abused children are often pros at reading people in a room. They can immediately see who is emotionally stable and safe and who is not. This type of hyper-vigilance can be temporarily effective because it gives the illusion of being in control, able to control social setting and to choose who to talk to and who not to.

It also causes problems. It becomes exhausting and your thoughts can be way off track. Having your defenses up can interfere with relationships with friends and family and even with intimacy. When your defenses are always up, it is difficult to have meaningful relationships.

But when we start to develop internal awareness, we can stop and ask ourselves such things as, “What was that response all about?” We can dig down inside ourselves and figure out the roots of our feelings. That is where a therapist shines.

A therapist is trained to work alongside you to explore and discover and then to reach solutions that will free you from the bondage of OCD behaviors and OCD thoughts. If the BT route is not productive, your therapist will present other solutions to you.

Unprocessed trauma narratives don’t just go away. You may rearrange the thoughts and tuck them away for a time, but they will always resurface. When you reach out to a therapist, together you can work through, not around the issues and put those traumas into the past so you can move on without the OCD symptoms that are controlling your life. It will involve some work (there’s no denying that) but in the end, you will be happy that you chose to get help.

As we begin to recognize things that are emotional triggers, we can reflect on the situation and what is going on around us. We can pinpoint why a song makes us sad or why a neighbor makes us anxious. We can then work through it, separating the two.

Just as defenses have become the natural way you go about your life, so can the learned behaviors of dealing with OCD. Soon, you will be able to put an end to the destructive behaviors and thoughts like clockwork and replace them with constructive ones that promote mental health, life, and healing.

Recognize, Reflect then Redirect is a useful tool when it comes to relatively mild traumatic triggers. The more severe the trauma is, the more possible it will be for it to take professional help and time in order to work it through.

Behavioral Therapy has the potential to be a very valuable tool in the management of thought and behavior patterns that are undesirable. While it can be tempting to self-diagnose OCD, it is not wise.

It’s best to seek a therapist and to acquire a diagnosis from a professional standpoint so that if it is present, you can begin with a tailored treatment plan. Working through to experience health and emotional growth is very possible. Don’t put it off another day. Your new life awaits you.

Photos:
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OCD Definition: Signs of Obsessive-Compulsive Disorder

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Are you plagued by fear? Do you engage in rituals motivated by superstition? How do you know if these are normal or are symptoms of a clinical disorder?

The general public is grossly uneducated when it comes to understanding obsessive-compulsive disorder. The acronym OCD is tossed about flippantly today, being used to describe behaviors as innocent as eating only blue M&M’s to more stereotypical rituals such as excessive hand-washing. This article provides some much-needed clarification.

OCD Definition

Individuals with obsessive-compulsive disorder may exhibit just one symptom (i.e. they experience obsessive, intrusive thoughts but do not engage in any compulsive behavior), but many sufferers exhibit both. Examples of single-symptom sufferers might include individuals characterized as workaholics or those with anal-retentive personalities.

Those who fall under the more common dual-symptom category experience obsessive thoughts and attempt to resolve their discomfort by performing the compulsive behavior. These people are usually cognizant of the fact that their thoughts and behaviors are not rational; the impulse to act on the thought is just too strong to resist. Newport Beach Christian Counseling offers support to help individuals manage these challenges effectively.

OCD Examples

Obsession

Descriptions of those experiencing obsessive thoughts might surprise you. According to Michael Maccoby, “[Obsessives] are self-reliant and conscientious….They look constantly for ways to help people, listen better, resolve conflict, and find win-win opportunities. They buy self-improvement books…and they like to focus on continuous improvement at work because it fits in with their sense of moral improvement.”

For those who are deep thinkers (e.g. philosophy professors, poets), obsessions are not always answered with compulsive behaviors. The nature of these obsessive thoughts, however, is quite unlike ordinary daydreaming. These individuals spend a considerable amount of time mentally running through scenarios, arguments, and ideas.

The philosophers of the ancient world are a classic example of thinkers who spent hour upon hour pouring over moral debates and ruminating over unanswerable questions. Not what many would call “normal” behavior.

In her book Psychoanalytic Diagnosis: Understanding Personality Structure in the Clinical Process, Nancy McWilliams illuminates the personality differences that delineate the obsessive individual from the compulsive. The former feels no compulsion to act upon their continual, intrusive thoughts (p. 290).

Individuals with this obsessive personality structure are characterized as stubborn, tidy, prompt, thorough, thrifty, rigid, cerebral, persistent, and prone to arguing over semantics. McWilliams adds that “[t]hey are generally dependable and reliable and have high standards and ethical values” (p. 291). Their internal standard of excellence, while admirable, is often unachievable.

Unable to measure up to their own ideals, individuals with obsessive-only OCD battle shame and attempt to cope with it by rationalizing, moralizing, intellectualizing or compartmentalizing their intrusive thoughts. In tandem with shame, anger plagues these individuals who interpret negative emotion as inadequacy.

Rather than deal with this anger toward self for what it is, people with obsessions direct the anger toward “legitimate” targets to protect themselves from further shame (p. 293). This tendency to self-protect from negative emotions prohibits these individuals from expressing their emotions effectively.

Those who struggle with obsessive-type OCD not only have difficulty expressing emotion, but they also have difficulty making decisions as well. The thought of making a wrong choice often paralyzes them from making any choice, leading these individuals to vacillate between options until they eventually refuse to choose.

McWilliams gives a poignant example of this trait by illustrating how it would impact an expecting mother. In this illustration, the pregnant patient selects two obstetricians with different treatment philosophies from which she would choose one to deliver her baby. She deliberates so long, wavering between the two options, that she eventually goes into labor and has no other option but to have her baby delivered by the resident on duty at the nearest hospital.

Compulsion

Individuals with compulsions also self-protect against the shame of making a wrong decision, but instead of vacillating between options, these individuals impulsively choose one without any deliberation. Becoming sexually active with any individual with whom one has sexual chemistry is an example of this type of impulsivity.

What characterizes the behaviors as compulsive has little to do with whether the activity is beneficial or even logical; what makes the action compulsive is its irresistible nature. Interestingly, people with compulsions prefer manual tasks (i.e. woodwork, needlework) that do not involve much thinking.

Compulsive individuals do not hold a monopoly on ritualistic behaviors that have little bearing on outcomes. It would be difficult to find a person who has not acted compulsively at one time or another. Athletes perform rituals before or during their competitions, people “knock on wood” when a friend forecasts favorable results, and gamblers slide one more quarter into the slot machine for good measure (p. 301).

The ritual is motivated by a desire to prevent an unwanted event, such as a man with a compulsive personality who buckles and re-buckles his seatbelt four times to avoid a car accident. What makes these thoughts and behaviors a clinical issue is the amount of distress experienced by the individual as a result.

Obsession and Compulsion Together

While it is possible to experience one symptom or the other, as discussed previously, it is common to experience both obsessions and compulsions together. Clinically speaking, the compulsive behaviors aim to resolve the anxiety produced by the intrusive or obsessive thoughts. Ultimately, the two battle with each other for control.

A&E airs a show called “Obsessed” (available instantly on Netflix) which chronicles the struggle of sufferers with OCD. One episode follows Karen, a woman battling a fear of death after spending years in an abusive relationship. The constant anxiety and fear for her life that she experienced during this relationship metastasized into a pervasive terror even after the termination of that relationship.

Her obsessions involve thoughts of strangers lurking behind corners waiting to kill her, other drivers swerving on the road to hit her head-on, and earthquakes opening the ground to swallow her. Her compulsions involve repeatedly checking under her bed and in her closets for fear that an intruder entered her apartment since her last check. While she knows how irrational these obsessive thoughts are, her fears and anxiety compel her to act.

Christian Counseling for OCD

Individuals with OCD do not have to be enslaved to their obsessions and compulsions. Your struggle is not a sign of weak faith or disobedience to God’s exhortation to “fear not.” Obsessive-compulsive disorder is a clinical condition that requires professional treatment. The hope of Matthew 6:27, 31 and Philippians 4:6 is that He offers us the antidote for fear!

If this article resonates with you or sounds like someone you know, there is help. No one has to struggle alone. Contact a professional Christian counselor in Newport Beach who can come alongside those battling OCD and start the journey of recovery. Using research-based treatment techniques in a faith-based setting, these professionals can help you discover the roots of your thoughts and behaviors and help you learn to manage your symptoms. There is hope for you – freedom from fear awaits!

ReferenceMcWilliams, N. (2011). Psychoanalytic diagnosis: Understanding personality structure in the clinical process (2nd ed.). New York, NY: Guilford Press.

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