Childhood OCD: The Invisible Disorder

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I looked at my son from across the room. “What do you want for breakfast?” I asked. “I’ll have my usual,” he said. I don’t know why I asked. Of course, he’ll have his usual. It’s been over six months since he’s said anything different. His small, skinny frame swallowed up by the dining room table as he carefully places one small goldfish in his mouth at a time.

It seems like a blur when I think about how this happened. How my healthy, growing boy put his growth on pause. How his thoughts started to dominate his life – our life and put his health at risk. I remember the days when I would tell myself it is just another phase. The days when I thought I was letting all the horror stories from my work as a child therapist distort my perception of a simple issue of “picky eating.”

It started with a question. An innocuous question, or so it seemed. “Where does bacon come from?” At first, It warmed my heart that he cared so much – that he thought so deeply. Maybe he was destined to be a vegetarian I had thought to myself. But soon enough the questions took a concerning turn. “Do carrots hurt when we eat them? Can food watch down from heaven as we eat it?” And slowly I watched in horror as plates of food remained uneaten, as bones on his tiny body started to protrude where they shouldn’t.

OCD is an insidious disorder. It slithers its way into your life, remaining quiet, unnoticed until its omnipresence cannot be denied any longer. Until it is so large and well fed it can no longer hide. I know this. I should know this. I treat OCD. I specialize in OCD. Trust me, the irony is not lost.

I also know that people don’t understand OCD. Not friends. Not family. Sometimes not even well-intentioned doctors and mental health professionals. How can a disorder that impacts roughly 1 out of every 200 children be so misunderstood, so invisible? How can it sneak by us, by our ever watching, ever caring parental eye?

OCD hides in the shadows of our home because we don’t know where to look. Our culture and media like to bombard us with images of neat freaks, germophobes and symmetrical-rule followers who go around lining up and organizing the world. OCD hides in our ignorance, relishes in our simplistic understanding of such a complicated disorder.

I see this in my therapy practice. I saw it in my own home. The denial is deep. Even when OCD is brazen enough to show his ugly face, we quickly make excuses for what our mind does not want to see. Maybe it’s a phase, maybe he’ll grow out of it, maybe it’s just a quirk, a tic, a habit…anything but the invisible disorder we don’t want to see. We don’t want to believe.

“He has bad thoughts.” She barely whispers as she squirms uncomfortably on my office couch. She looks embarrassed, concerned, vulnerable. I know where this is going before she even begins.

“Every day he has to tell me things. Horrible thoughts that make me squirm. Why would my child think these things? I try to make him feel better, but nothing seems to work.”

Moral OCD hides in their home, feeding off the reassurance a mother is sure to give.

“She has quirks.” The couple tells me as I write down her history. “It is always something,” they say. “We have learned it is just part of who she is.” They shrug.

I meet her. I see her “quirks” and I see what no one else wants to see. The patterns, the compulsions, the magical thinking. The look of stress and embarrassment on the little girl’s face.

“It’s okay,” I tell her. “Other kids have this problem too.” Her eyes widen as she looks up. “They do?” She whispers. And with one comment I have made her feel more “normal” than she’s felt in years.

OCD hides among us. It hides in our children. It hides in our ignorance.

Kids with OCD live with shame. They live with guilt. They develop an internal dialogue that they are strange, different - that they are freaks. Social media doesn’t help. We don’t help. But we can…

OCD isn’t just about germs. It is about an obsessive thought – a thought that is so relentless it drowns out any happiness. A thought that is so damaging, you would do anything and everything to make it stop. Even if it means tapping three times as you walk through a door or doing and redoing your shoes until it feels just right.

OCD isn’t just about orderliness. It is about compulsions ― compulsions that take over your schedule and eventually your life. Urges that are so intense, they cannot be ignored. Urges that make no sense, not to you, not to anyone, but you do them anyway. Wiping until you bleed, checking and rechecking until it makes you late.

OCD does not make sense. You cannot rationalize your way out of an irrational disorder, even though some parents try. OCD hides. It hides in your child’s need to do everything in three’s. It hides in your child’s need to tell you “one more bad thought.”

As parents, we don’t have to conspire with OCD. We don’t have to help it find the dark shadows of our home. Turn on the lights and take a look around. Look in the shadows. It is impossible to fight something we cannot see. It is impossible to fight the invisible.