We all have our own ways of wanting things done; I’m obsessed with symmetry and no-one is allowed to pack the dishwasher but me! However, if your child is showing patterns of obsessive behaviour which  seem to dictate their day, take a great deal of time, or cause them to feel excessively anxious, then it’s time to talk to them. It may be part of a wider issue, which needs addressing or it could be a phase your child is going through. Either way the advice and strategies outlined here will help you give your child the support they need to work through their challenges.

Obsessive Compulsive Disorder is an anxiety disorder, which is characterised by intrusive and obsessional thoughts, which can be followed by repetitive compulsions, impulses or urges.

An important first step is to explain to your child experiencing stress / anxiety is normal. It is adaptive and it is our body’s way of alerting us to possible danger, so we can keep ourselves safe. The activation of our alarm system sets off a physiological chain reaction which prepares our body to fight or ran away from the danger. Stress / anxiety becomes an issue when our body’s internal alarm system is triggered and there is no real danger.

Keeping this in mind at all times is key, as all the strategies outlined either focus on ‘standing down’ the false alarm and reducing the body’s heightened physiological response, or they focus on changing your child’s perception of the threat and their ability to cope with it.

1. Name the ‘alarm’ system
I often make the analogy that our body’s alarm system is an ancient warrior which is woken to fight on our  behalf and our job is to tell it to ‘stand down’ as it’s a false alarm. Another analogy, which, works particularly well for OCD is to think of it is as a bully, which is trying to control you. Giving the warrior or bully a name takes the perceived shame away from your child and gives them the vocabulary to have an open dialogue with you dialogue wth you about keeping the warrior or bully in check.

2. Press ‘pause’
Encouraging your child to delay their rituals or ‘press pause’, even if it’s for 1 minute helps them regain control of the warrior or bully. Your child is likely to find this particularly difficult at first so it’s a case of short pauses in the beginning and then make them lengthier as they grow in confidence. Also encourage your child to ‘play around’ with the ritual, for example if they typically have to do something with their right then left hand, ask them to do it the other way around sometimes.
Pausing, and playing around with the ritual not only gives back control to your child but it also serves as evidence that bad things do not happen when the rituals are not performed.

3. ‘Take-three’
Encouraging your child to practice taking three deep breathes as soon as they notice their warrior or bully has started. This serves as another way to pause and reflect before acting. To help your child make the take-three a habit it is best to encourage your child to do this regularly throughout the day, whether they are feeling anxious or not.
The idea is to take a deep breath in through the nose, expanding your diaphragm, rather than puffing out your chest, and to then take a longer slower outbreath through the mouth. I have found visualising a mug of hot chocolate with marshmallows and cream on top can really help. The deep in-breath is to smell the deliciously sweet marshmallow and cream, and the out-breath is to slowing blow and cool the hot chocolate so it can be drunk.

4. Challenging their negative thoughts
It is really important to start by explaining to your child the thoughts we have are not always true or that they will happen, for example we might think a dog will bite us because they are growling as we walk past but this might not actually happen. It is therefore important to teach your child to challenge their thoughts to make sure they are not falling into a ‘thought trap’.
They might ask themselves these questions:

• Have I fallen into a ‘thought trap’?
• How do I know this thought is true?
• What is the evidence that this thought is not true?
• What would I tell a friend if he or she had this thought?
• Am I 100% sure this will happen?
• How many times has this happened before?
• What is the worst that could happen?
• If it did happen, what can I do to cope or handle it?

5. Changing their internal dialogue
Sit down with your child and create a number of positive / coping statements which your child can use when they find themselves thinking negative thoughts. Encourage the words to come from your child, not you. If the statements make use of their own language they are much more likely to be effective.
Here are some possible examples:

• I can do this
• I am much stronger than I think
• I will take some deep breaths to help me
• Only I decide what I will or won’t do
• I’m in control
• 90% of the time I do well in tests
• I have lots of friends

6. Daily practice of gratitude
Whilst this strategy doesn’t directly target the anxiety associated with OCD it has been shown to improve mental health, which is turn is likely to reduce your child’s anxiety and increase their perceived ability to cope.
I find it is best to use a diary or notebook, as it formalises the process, and allows your child to reflect back on their gratitude when things become challenging. I also find it best to do this in the morning as it sets a more positive intention for the day than doing it at night. However, it can be helpful for your child to reflect on what they have been grateful for in the evening also.
The practice asks your child to write down three things each day, which they are grateful for. This doesn’t necessarily have to be anything substantive, just something impactful. For example, they may be grateful for the sunshine as they had a games lesson outside, their friend sat next to them in a lesson, and so on.

7. Daily mindfulness
Encourage your child to take 5-10 minutes each day to practice mindfulness. There is a very useful app called HeadSpace, which is free for the first 10 sessions, allowing your child to trial it and experience the benefits. The key benefit of mindfulness for OCD is that it teaches children that thoughts come and go all the time and to sit back and observe, rather than chase after them. This can help the ‘pressing pause’ strategy work more effectively and give back control of the warrior / bully to your child.