Son 13 with OCD - how to cope

[paulfoel]

Always been a bit of a quiet lad. For some time,. we noticed issues with excessive hand washing, Its just got worse...

We had a talk to him and he seems to stress about dirty bathrooms etc. Also it seems to have moved onto other people - he wont go near people because they are dirty in his eyes.

In the past hes got school to call us saying hes ill - now looks like it was a toilet issue and this was an excuse.

Hes got worse recently. He wont touch his little sister (4) which upsets her a lot. LAst night he freaked because she touched him and lathered anti-bac gel on his whole arm.

We've tried to tell him he cant do that. Also, hes been a bit strange walking in certain rooms - he walks around the edge and jumps over  bits. But hes bare foot and wont wear slippers! Think this is a cat pee issue in his head.

Conversely, his bedroom is a complete tip. Standard teenager I guess but that doesnt bother him! Also, his personal hygiene could be better- again standard teenager but that doesnt bother him either.

Anyway, GP has now referred him but theres a waiting list. However, we're planning to pay for counselling also.

We've bought anti-bac gel for the bathrooms, we've spoken to school and he can use disabled toilet in the future (well its summer hols now). I know you're not really supposed to validate his behaviour but these seemed like small things. With regards to his touching other people, well its not a problem for us his parents but his little sister doesnt understand so we're going to have to stop that.

We're going on holidays in 5 weeks. So thats 8 hours sitting next to someone on a plane, toilets on the plane, villa, public toilets when we get there. Its not going to be easy!

Advice gratefully recieved? Do we pander to him and give him some slack or do we not allow him to be like this? Some of the things we can be a little flexible on but some its just not going to be possible.....

Edited July 25, 2017 by paulfoel

[PolarBear]

The therapy he needs is Cognitive Behavioral Therapy. Accept nothing less or any other form of therapy.

Buying him the antibacterial gel was a step in the wrong direction. It validates the thoughts he's having  and it's one little step to having the family participate in his compulsions. Let it go but don't let yourself get hoodwinked into doing more compulsions.

I suggest you get a good OCD book, like Break Free from OCD. It's important that the adults in the house understand the disorder and what he's going through.

[paulfoel]

5 hours ago, PolarBear said:

The therapy he needs is Cognitive Behavioral Therapy. Accept nothing less or any other form of therapy.

Buying him the antibacterial gel was a step in the wrong direction. It validates the thoughts he's having  and it's one little step to having the family participate in his compulsions. Let it go but don't let yourself get hoodwinked into doing more compulsions.

I suggest you get a good OCD book, like Break Free from OCD. It's important that the adults in the house understand the disorder and what he's going through.

Thanks PB. I have heard that you're not supposed to validate the things that someone with OCD does.

OK, maybe incorrectly, we thought, it is worth helping with the little things that are no problem. After all, a lot of people like to use things like alcohol gel and are perfectly fine.

However, we've realised that some things are just impossible. To be honest, we don't know how to handle. Examples:-

1. Worse thing is he wont let other people touch him. OK personal choice but he freaks if it happens and pretty much scrubs his hands/arms.

2. He now wont let his little sister touch him which is upsetting her because he says shes dirty - but she doesn't understand and gets upset.

3. He spends ages in the toliet. You just can't get him out. Not so much of a problem at home but when we're out (e.g. restaurant) it means the whole family is waiting for him.

Its all well and good not validating but how do we stop this behaviour? Do we tell him to cut it out? Do we get angry? Its difficult sometimes especially when he upsets his little sister.

At the back of our minds, theres always the thought that some of this is just bad behaviour from him and just being awkward for the sake of it. Who knows.

Going on holidays in 5-6 weeks. 8 hour plane journey, strange villa, days out. Its going to be tough...

[snowbear]

Hi Paul. Welcome to the forum. 

In my opinion OCD behaviours in a child are never bad behaviour or done for the sake of it, even when it looks that way coming from a 'rebellious teenager'.   They distress and inconvenience him far more than they distress you and he's not going to choose to do them for the sake of it. Getting angry and telling him to cut it out doesn't help and often only increases the stress of the situation, making the rituals worse. 

Staying calm and being supportive of him in his distress without supporting the OCD thinking or behaviours is key. (Sounds so simple when you say it!)

It can be a bit of a minefield trying to work out the best approach without guidance, so Polar Bear's advice to get him CBT and arm yourselves with a self-help book in the meantime is spot on.

Helping with the little things that seem no problem is one of those minefields. Buying antibac soap tells him his fears are justified and only encourages the behaviour (it's debatable whether people who routinely use alcohol gel are mentally as fine as they think!) but an example of letting-the-little-things-go which can help might be say before bed and you allow him to finish his ritual undisturbed thus reducing his stress level. It's a balancing act where you're always trying not to accommodate the OCD, but not being so rigid about it that you can't apply a bit of practicality to make life tolerable when necessary.

I'd like to congratulate you for your attitude on allowing him his personal space and viewing not liking being touched as 'personal choice'.   The idea that our behaviours are a choice is an important one, particularly for teenagers and adults with OCD. In therapy he may be given difficult choices and have to choose the worst option because it is also the best or right option. Understanding the boundaries between what is free personal choice and when our choices affect others and can't be just what we want may help when it comes to how he copes with his sister touching him. 

Which comes back to supporting him in his distress but not supporting the behaviour. It's not acceptable for him to upset his sister, so a compromise has to be reached. Helping him to understand why he has to control his behaviour around his sister also teaches him that his beliefs are personal to him but not 'facts', not something everybody believes or has to follow.

Similarly, compromise is a key word for toileting while outside the home - you may need to be firm at the time but on the promise he can get as clean as he wants to be once he gets home.

I suspect the upcoming holiday will be a mix of pandering and strictness with some difficult moments  but as best you can aim for normal family life and fit the OCD in round that rather than fitting family life around the OCD. Some private CBT before the holiday may help if you're thinking of going the private route anyway. Just be sure it's CBT he gets and not 'counselling' and perhaps discuss with the therapist the possibility of concentrating on the cognitive belief side as a priority, so he begins to get his head around the idea that the dirt he fears is just his view of the world and not a genuine threat from a dangerous and dirty world. 

Let us know how you get on.  

 

[paulfoel]

Thanks all. Well, he agreed to go to a counselling session with someone who specialises in teen OCD. Not sure if its CBT based though :-(

On the plus side, he agreed to go and seemed a lot happier when he came out. If nothing else, I guess its someone to talk to things about because he wont talk to us because we're his parents.

Its difficult, as you say, to decide how to do things. Be supportive but not support the OCD thinking. At the moment, we're at a stage where certain things we are letting go, but others we are being a bit stricter on.

The anti-bac gel - I hear what you say but that seems a small thing to make him happy and, as you say, lots of people do this. BUT, we won't let him be off with his little sister - shes only 4 and doesnt understand and gets upset.

I must admit its difficult for us to understand. He now won't walk through a certain doorway (two doors into the kitchen), and will walk long way around. He will then skirt around the edge of the kitchen (not sure why the middle is an issue). Same with living room - he wont stand on the rug.I think some of it may be due to our cats - they do tend to pee on things like curtain sometimes....

BUT his bedroom is still a tip. Its borderline health hazard. For some reason hes gone from 30 min showers to not having a shower at all. To be honest, hes filthy and we've got to force him to wash now. I dont understand this.

Problems I can see on holidays are mainly toilet related. Its going to be difficult if he decides he doesnt like the toilet on the plane. Or when we're in the park, we can't let him take 45-60 mins in the toilet (hes done this before). Or when we're in a restaurant. Should we be firm here? In the past we have been and have literally had to go into the toilet to get him out. Ends up in a massive argument when he refuses.

 

[paulfoel]

One other thing. Counsellor says sessions are private. Not sure about this. Hes 13 (and a very immature 13).

I'd have liked to know how things are going. Is this normal that sessions like this are private?

[Ashley]

1 hour ago, paulfoel said:

One other thing. Counsellor says sessions are private. Not sure about this. Hes 13 (and a very immature 13).

I'd have liked to know how things are going. Is this normal that sessions like this are private?

I think that is right.  Every case should be different and individual of course, but sometimes if the OCD is around the family the young person needs freedom to talk.  But, usually the family will be brought in for the last 10 minutes or so.  We would normally encourage family involvement in this last 10 minutes because the family need to know what to do during the week, what homework is being set etc. 

[paulfoel]

Thanks Ashley. Yes I understand that but we'd also like to know whats going on.

Difficulty we're finding at the moment is how we should handle things at home. Should we be telling him he can't do these things or letting him do it?

[snowbear]

7 hours ago, paulfoel said:

Should we be telling him he can't do these things or letting him do it?

Forbidding completely and letting him do what he likes are the two extremes and, as I'm sure you're aware, neither is helpful. You're aiming for a middle ground where you encourage him away from rituals, discourage OCD beliefs and support his return to normal thinking rather than setting rules about what he can and can't do. 

Although the therapist must keep your son's sessions confidential, you can ask the therapist for advice on applying the same kind of support he gets in sessions at home. This will give you some idea of 'what's happening' and boost your confidence that you're taking the right approach.  

[paulfoel]

14 hours ago, snowbear said:

Forbidding completely and letting him do what he likes are the two extremes and, as I'm sure you're aware, neither is helpful. You're aiming for a middle ground where you encourage him away from rituals, discourage OCD beliefs and support his return to normal thinking rather than setting rules about what he can and can't do. 

Although the therapist must keep your son's sessions confidential, you can ask the therapist for advice on applying the same kind of support he gets in sessions at home. This will give you some idea of 'what's happening' and boost your confidence that you're taking the right approach.  

Thanks SnowBear. I guess you're right. Finding it really tough though.

Its not so easy when its all combined with a terrible teenager "bad attitude" to everything. Any attempts to "encourage him" end up with him losing his temper. Some things fair enough, can be sorted out in time (e.g. hand washing etc), some things are a bit awkward, but then there are other things which have an affect on the family (he won't go near his little sister - whos 4 - and often tells her to get away from him). This is difficult because she doesnt understand and gets upset.

Also, things are not helped because his attitude seems to be, so what, I'll go to counselling but his attitude seems to be "well if I dont like doing x then I wont do it, no big deal". He seems to be making very little effort at all to help himself. Know for a fact that counsellor gave him "homework" to do and he hasnt bothered. 

On holidays in three weeks. Challenge is going to be toilets when we're away. Were staying in villa so we should be ok - he can have his own toilet (or should we discourage that?) but theres hotel at airport and 8 hours on a plane. Then we've got toliets in restaurants/Disney.

In the past, this has been a real problem - we've had to literally drag him out of the toliet in the past when we've waited outside (in the 90 degree heat) when hes been in there for up to an hour. How do we handle that? In the past no amount of us being nice to him and explaining that he needs to be quicker or telling him hes in trouble if hes not quciker have done anything - he just does what he wants regardless of anything else.

I think thats the problem at the moment. I appreciate he has a problem but Im still not convinced that part of it is not him being awkward because he can. The toilet thing always get worse when we ask him to be quick. Its as if hes proving to us that he has the power and can stay in there as long as he likes. Hes never apologetic about it and never seems hurry. In the past hes been in the toilet for some time and even when he gets out we've seen him meandering along back to where we are as slow as you like. Always his attitude is "tough luck it takes that long".

 

 

 

[snowbear]

29 minutes ago, paulfoel said:

we've had to literally drag him out of the toliet in the past when we've waited outside (in the 90 degree heat) when hes been in there for up to an hour. How do we handle that? In the past no amount of us being nice to him and explaining that he needs to be quicker or telling him hes in trouble if hes not quciker have done anything - he just does what he wants regardless of anything else.

I guess it comes down to how willing you are to create a scene in public and what sort of behaviour/respect you expect from him when its about non-OCD behaviours. I think you're very patient to wait for him that long! It's difficult for someone of my (older) generation to imagine parents being held to ransom by their child in that way, but you're his dad so you'd know better than me if he's playing you, just being inconsiderate, or struggling extra because of the time pressure.

Disney is a pretty safe sort of holiday zone isn't it? Would you consider simply telling him 'We'll be at such-and-such a place when you're finished' and leave him in the toilet while you go off and enjoy yourselves? Shame to let his OCD spoil the holiday for everybody and he's surely old enough to find his way back to the hotel to wait for you there if worst comes to worst? Then you can smile, relax and tell him if that's how he wants to spend his holiday it's fine by you, he can take as long as he needs/wants. 

Of course if you take that approach you mustn't spend the time apart worrying about him, or fuss over how he fared in your absence! Cool as cucumbers on the outside even if you're sweating it on the inside.

Perhaps this holiday is just what he needs at 13. An opportunity for him to learn about taking some responsibility for himself.  

[paulfoel]

Bore Da Snowbear. Shwyd ych chi? :-)

Its difficult in public. I guess you can't physically drag a 13 yr old out of somewhere.

To be honest, hes been doing the toilet thing for years. Of course, we didn't realise he had problems before with OCD. To be honest, its a mixture of all three things I think. He needs extra time but he makes no effort to think about anyone else and Im sure sometimes does it on purpose to prove a point.

In the past, we've had to miss things and spent a long time just waiting around because he was in the toilet. Hes got a 4 year old sister so its not so easy for her to understand.

Yes this year. we're all going to have mobile phones to use so we do plan to just leave him and say call us when he tries it this year. Its a big place but we go every year so hes been probably 10-11 times so "should" know his way around. As I've said hes not the most mature 13 year old though so he probably will get lost because he hasn't got the sense to look at the park map or something.

Not so easy in a restaurant or when somewhere is closing.Number of times we've waited and waited after paying the bill.

Worst ever was in a theme park sort of place called Folly Farm (in west wales) a few years ago. It was the end of the day and closing - he decided he needed to go. We sat outside in giftshop. After 15 mins went inside to find him - one cubical with a queue building. Of course, place was closing so all these kids wanted to go before leaving. Kids were hopping around, parents were glaring at me. No matter what I said to him, told him people were waiting, he point blank refused to come out until he was ready. In the end, it was over an hour. I spent the time apologising. Everyone had left - the park manager and cleaner were standing there too not impressed.

Spoke to him about it and his attutude was pretty much don't give a monkeys and  if I need to spend that amount of time in there then thats whats going to happen and not my problem about everyone else.

Of course, at the time, we didnt know he had this problem but still...