Do constant, bothersome obsessive thoughts overpower your mind? Do you have to follow these horrible thoughts with a particular behavior or compulsion, or else your world might fall apart? Join us as we ask our most common OCD questions to Dr. Laura Kauffman, licensed child psychologist & expert contributor to Education.com:
AIT: Why is that when teens with OCD try to stop their obsessive thoughts, they seem to come on even more frequently or intensely?
LK: Although there are varying theories on this topic, there is a great deal of research to suggest that there is a significant physiological and/or genetic component to OCD. Several studies have shown that individuals with OCD have reduced white matter, which lies below the Cerebral Cortex, the “newest” portion of the brain typically thought to be involved with most higher order functions. Some have suggested that the cortex is involved in initiating the worry circuit of the brain. Similarly, other studies have shown those struggling with OCD have significant variation in the section of the brain related to motor inhibitory control. Of course, OCD is considered to be the result of a variety of factors (genetic, environmental), the research on brain structure variation in OCD suggests that those suffering from obsessive thoughts and behaviors are likely battling some pretty deeply entrenched mechanisms influencing their thoughts and behaviors.
When kids and teens begin work on addressing their OCD symptoms, some may encounter an uptick in their obsessions because they are more aware and focusing more acutely on these thoughts. Previously, some of the obsessions and behaviors may have “flown under the radar” because the individual was just reacting to their anxiety, but when actively trying to stop, they may be frustrated to discover that the obsessions are, indeed, very, very powerful.
AIT: What sort of relationship do you see with idleness and boredom with OCD thoughts?
LK: I hadn’t thought of it this way, but I imagine teens who are not busy (and who are prone to anxiety) might have more difficulty dealing with the obsessions and compulsions because they are not busy enough to be distracted by other things.
AIT: Are there any suggested activities that could serve as good distractions for OCD and help ease the frustration? What can a teen with obsessive thoughts and compulsions do to get their mind off of their OCD?
LK: In general, the best treatment for OCD involves a combination of exposure to the source of the obsession and a stop the ritualistic behaviors. For example, if someone has obsessive thoughts about order and symmetry, they might be exposed to a set of colored pencils in total disarray (no rhyme or reason behind color sequence, etc). Typically, they would feel compelled to organize the pencils out of fear that something would go wrong if they did not. In treatment, they would have to sit with the pencils and the obsessive thoughts without acting on their compulsion to organize them. With repeated exposure, they begin to gain control over the thoughts as a consequence of seeing that their catastrophic fears are never realized and that there is no inherent value in performing the ritualized compulsion. Eventually, their brain is “retrained” over time, and they are no longer held hostage by the thoughts and compulsions.
A trained professional specializing in the treatment of OCD can help a teen cope with severe symptoms, but teens with less severe symptoms might do well with workbooks that teach the teen to “talk back” to the obsessions and compulsions. Talking back involves cognitive-behavioral techniques that focus on reminding the teen that their obsessions are not based in evidence or fact, and that they don’t have to be beholden to the OCD pattern. A nice resource on this topic is “Free from OCD: A Workbook for Teens with Obsessive-compulsive Disorder.”
AIT: What do you suggest as long term goals for these teens to overcome OCD? Teens can eventually be completely free of symptoms and can learn positive techniques for managing anxiety?
LK: Teens can eventually be completely free of symptoms and can learn positive techniques for managing anxiety.
AIT: Do you have any other advice for teens suffering from endless, obsessive thoughts and anxiety?
LK: It doesn’t have to be this way. Get support from a trusted adult who can help you determine whether you need the help of a professional or whether you can work through the symptoms on your own. If you decide to get the help of a professional, look for someone who has expertise dealing with OCD. If you decide to go it alone, you will find copious amounts of information on the web on the topic of OCD with ideas for battling the thoughts and behaviors. You could search for terms, such as, “OCD, cognitive behavioral, worksheets.” This should take you on a path to tips for combating the obsessive thoughts and compulsions.
Dr. Kauffman is a licensed child psychologist in California who has been helping kids, teens, and their families cope with troubling feelings and behaviors for almost fifteen years. She received her Ph.D. at Stanford University and trained in a variety of clinical settings including schools, hospitals, and community mental health centers. Dr. Kauffman has a small private practice in Menlo Park, California, and participates as an expert on the website, Education.com. When she isn’t supporting the needs of families, she can typically be found on the soccer field or in the garden fighting the twin evils of snails and weeds.
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