jmg

Help with OCD and aggression

11 posts in this topic

Hi, my 11 yo daughter has recently been identified with OCD - she has probably had it for about 6 months now, with lots of bedtime rituals, hand-washing, hair-washing and a compulsion to have things done in a particular order. This has been really challenging but I think we could cope with this if it wasn't for the extremely aggressive behaviour that has developed alongside. She is verbally abusive to both of us (parents) and increasingly physically violent too. This is most extreme when we 'disrupt' her order, or when she is really anxious - but it is really scary. I am worried she will hurt herself or one of us. Sometimes, we don't recognise her at all - it's as if the OCD has changed her personality. She has started CBT treatment, although i'm not sure how much she's engaging with it.....early days I guess, but  I have been trying to read around the subject and can't find much that says this level of violence is linked? Hope that makes some kind of sense!

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Could it be some form of Tourettes or similar? Anxiety is a problem that involves the adrenal system, and the fight or flight response, it may come out in various ways. I know when I'm anxious or annoyed I can get quite aggressive and reactionary, also I remember when I was a kid (18) and my routines were disrupted, I'd go into a rage too. Partly because I was frustrated at not being able to do what I wanted without routine, partly because I was so scared of the consequences of not doing the routine that I'd be angry with anyone stopping me doing it. I was, unfortunately, quite unpleasant to my mother. At that age I couldn't work out what was wrong with me, and was scared. I didn't know how to handle it, or that it was treatable. I imagine your daughter could be going through some similar things.

What I can tell you is that I wish my mother had pushed even harder to get me out of the OCD then, because it would have been a short period of pain rather than a long life of still having OCD unresolved. That's just my take on it though.

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I think it's anxiety - which makes the OCD worse...and she gets angrier. I think she gets scared the routines will stop. But it's reassuring to hear you say that you wished your parents had pushed harder. We don't really know if we're doing right or wrong.

 

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Yeah, pretty much what my mum said to me. At the time, I wanted her to leave me alone, but that was so I could do the routines. What would have been better for me would have been if she'd pushed me to the point of realising I had a problem, and that it wasn't real or anything. Although I realise that could be a very hard thing to do.

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She does realise she has a problem - and we are getting treatment, although not sure it's working. I'm just scared she will end up hurting someone. Is violence quite common with OCD?

 

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Sorry to pester - but can anyone else offer any advice as to whether violence is common with OCD?

 

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Hi jmg, 

I'm sorry you didn't get the advice you were seeking before. Perhaps that's because you're asking a question which is difficult to answer without knowing your daughter. :unsure: 

The simple answer is that OCD has nothing to do with violent behaviour. Violence is not a symptom of OCD.

However, for someone who is very entrenched in their OCD thinking challenging the rituals and compulsions is perceived as a severe threat to their well-being, even their survival, and it's not unusual for the survival instinct to be expressed as verbal or physical aggression. You and I would fight physically if we felt our life was at stake too.

Some young people are aggressive because they feel threatened, some are aggressive because they lack boundaries of behaviour, some are aggressive because their role models typically act aggressively when challenged. There's no single reason that covers everybody. 

You've already mentioned that you think it might be a fear reaction and I agree that seems most likely in the circumstances. I think it's unlikely she'll deliberately hurt herself or someone else when reacting violently, but I can't say the potential isn't there as I don't know your daughter's personality or temperament the way you do.

You mentioned that her behaviour scares you, partly because it's out of character and partly from the violence itself. I think what matters is managing the behaviour as calmly as possible and for the parent to retain control of the situation at all times. You should be able to get some help on specific ways to do that from the CAHMS team, or it may be worth investing in a parenting book on managing challenging behaviour in kids. (There are several good ones available on Amazon, just google it.) 

It can be very frightening to be faced with someone acting violently, but as much as possible try to react as you would to a bully - show no fear and stand up to her without becoming verbally or physically aggressive yourself. Refuse to be intimidated.

Time out is always useful, so as part of parents taking control consider setting up a quiet space where she can be alone to breathe, relax and calm down. You may need to agree she can return to finish the ritual later when she's calmer. Remember the idea of this time out is simply to defuse the situation, reduce aggression and therefore prevent injury, not to stop her from engaging in rituals or punish her for trying. Once she's calmer, even if she does decide to complete the ritual, it should be a less unpleasant affair for all concerned. Later you can work on challenging the need to do rituals with what she has learned in CBT.

CBT cannot be applied successfully while she is distressed and reacting aggressively.  

Hope that's of some use to you. :) 

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Thank you so much - that is very helpful. I think we are struggling to understand what is her OCD and how we should support her. I think we are giving in too much and boundaries aren't as clear. She is often up to 1am completing rituals - if we intervene it leads to 'meltdown' and physical abuse from her. It's like she's a stranger and we don't know how to reach her. Perhaps we need to be more patient though - I guess we get angry and that doesn't help. I will look at books on challenging behaviour too. I wish we understood this more - she is having CBT so I can only hope that starts to help.

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jmg I am going through a very similar thing. My once charming & intelligent 14 year old daughter is almost unrecognisable currently, mainly if I don't go along with her compulsions. What makes it worse it that she manages to hide her OCD from everyone except me. Even her father & grandparents don't know how bad things are. She says compulsions numerous times (50+) times a day & if I don't reassure her the thoughts are normal she gets so very angry. From everything I have read I know I shouldn't encourage the OCD by going along with them but if I don't I end up having to lock myself away from her whilst she basically has a meltdown the other side of the door. This situation has been building for about 2 years and has lead to me now being very down. She is having treatment but it isn't going well. I am not sure the therapist is right for her. I suspect teenage hormones are not helping but I am struggling to separate or work out what is general bad behaviour from the OCD. Sorry I cannot offer advice but you are not alone in this situation. 

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I'm right there with you all. Please see my post from today. 14 year old daughter who has all sorts of anxiety and panic has terrible guilt and confessing type ocd for last few years. Last few days its increased tenfold.  

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Our son is the same. He gets very aggressive and upset when hes concerned about something.

At the moment, we're probably doing it wrong. Some things we've probably allowed him to do but there are others we can;t allow (like freaking when his little sister touches him). We dom't want to be mean to him but wonder whether we should be firm or not?

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