OCD is a mental health disorder which has two components; 1) obsessions, and 2) compulsions. Obsessions are often repetitive and intrusive thoughts, images or urges which can cause significant distress, anxiety and/or shame. Compulsions are behavioural routines, rituals and activities that are done repeatedly in an attempt to manage or reduce the anxiety/ obsession. People who engage in compulsions often say they feel they ‘have’ to do these activities ‘just right’, or until they ‘feel right’, even if they seem not to make sense, take a long time, interrupt daily life, or cause significant distress.
Obsessions and compulsions can vary in their frequency, intensity, and duration on a day to day basis. It is important to note that obsessional thoughts and images are not necessarily reflective of someone’s true beliefs, values or desires, which is in part, why they cause a significant degree of distress. People rarely act upon thoughts and urges they may have.
What you might see, or a young person might report:
Strong unwavering beliefs that something bad might happen, or that there is danger which they are responsible/ accountable for in some way;
Repeated, intense and overwhelming “what if” thoughts that are catastrophic in nature
Thoughts and beliefs are rigid, and cannot be challenged or thought about from a different perspective (eg, 100% belief that something bad will happen);
Thoughts and images may be graphic, frightening, or distressing. They may occur without warning and cause preoccupation;
May become distressed or agitated when facing fear, or even thinking about facing the fear;
May become agitated, distressed, oppositional, or aggressive towards others when in a situation they are particularly fearful of;
May experience shame or guilt as a result of certain obsessions, thoughts, images, urges or compulsions;
Repeated patterns of behaviour or routines which seem to help the young person, but don’t make sense to others (eg, repeated checking or counting);
Repetition of routines or rituals if these are interrupted, or if the young person still does not ‘feel right’, regardless of how long these take, or what impact they have on other commitments, and other people;
Demanding things be done in certain ways, or requesting others to do things for them.
May appear forgetful, distracted, or preoccupied. You may see mumbling or murmuring (as some young people may recite, count, or engage in mental or verbal ‘counteractive’ compulsions.
Things to try, support, and next steps:
Normalise that we all have random, intrusive, unusual, upsetting, or confusing thoughts, images and urges, from time to time. Just because we have a particular thought, image or urge, does not make us a bad person, nor does it mean that thinking about the thought will make it come true, or that we have to act upon it. Be open to listening, and try not to judge the thoughts and worries that the young person may be struggling with;
Normalise that anxiety is a natural emotion. The physical sensations of anxiety can be unpleasant, but it’s OK; it will pass, and won’t cause any harm.
Be patient and kind, even if the obsessions and/or compulsions do not make sense to you, they are real, and likely to be distressing to the young person;
Whilst you make want to help and support a young person, it is important to try not to get involved with compulsive behaviour (eg, helping them with routines, rituals, following rules or offering persistent reassurance). This will inadvertently reinforce the belief that doing the compulsions are the only way to manage the anxiety. Instead, agree on how to support and manage anxiety and the urges to behave in a compulsive way together.
Encourage, reward and praise a young person not to avoid situations where they fear their obsessions or compulsions may occur; the more a young person avoids, the harder it becomes, and the more anxious a young person will become. Instead, encourage the young person to face their fear – the more they face it, the easier it will become
Use coping techniques (please see videos below)
Role model and demonstrate that you can do things, even when you’re anxious
Supporting a young person to problem solve any obvious triggers
Watch a parent/carer workshop on coping and resilience skills (below)
Watch a parent/carer workshop on how to support anxiety (below)
Watch a parent/ carer workshop on Getting good sleep (below)
Watch a video on Teenage Turmoil (understanding why being a teenager is so difficult) (below)
Watch a video on: Maslow’s Hierarchy of Need (Understanding the needs of young people) (below)
Watch a video on: The Window of Tolerance (understanding why we can/ cant cope) (below)
Share concerns with your child’s school/college, and identify whether additional pastoral support is available
Depending on the context and/or the origins of the anxiety being experienced, other services may be helpful, eg, family guidance if there is family breakdown, or conflict
Seek advice, guidance and support from Young Minds Parent Helpline: 08088025544