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Saving My Son

Question:

I hope you can help us because so far nothing has worked. I feel as though I am fighting for my son’s life and everywhere I turn I hit a brick wall. My son is diagnosed with OCD and Generalized Anxiety Disorder. I have had him under care for years with different counselors and so far nothing has worked to decrease his symptoms even slightly.  As a matter of fact he gets worse everyday. I live in an area that lacks experts in the field of OCD and most counselors choose to do talk and mostly to me during sessions with my son. I find that most counseling visits are spent with me educating the counselor about OCD. Many are not trained in this area with the proven methods of EXRP or CBT so needless to say my son’s OCD has only grown and grown to the point of becoming physical and verbal. Just recently I have found a Clinical Psychologist who does treat OCD. My problem is I fear my son my be to the point of needing inpatient with the best of the best. He has horrible intrusive thoughts of me dying that he cannot get out of his mind. He is basically non functioning, he cannot go to school, and that is another story: they have been horrible through their lack of understanding and lack of education in OCD. For years he has been failed mentally and educationally.  He is to the point where our home is in distress and out of control. He is physical with his little brother who is 3 years younger. They are 12 and 9. I am looking for your opinion: is it to the point of inpatient when things become so angry? He admits it is his OCD that he has to do things or I will die. His OCD is fear based not contamination it is his thoughts. Please help. He is on meds: Anafranil. 100 mg. Thank you and GOD Bless.

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Answer:

Thank you for your very impassioned E. Mail question about your son.

I would suggest that you see the Clinical Psychologist as soon as possible. You report that the psychologist has expertise in OCD and that is good. It would be appropriate to ask the psychologist, when seeing that person, if your son needs hospitalization.

I can tell you that, unless your 12 year old son is very violent, in life threatening ways, towards others or himself, he will not be hospitalized. That is reserved for dangerous cases, at least in my experience.

It seems that your son is already on medication, Anafranil. I am wondering who is prescribing the medication? I have the idea that it is not a psychiatrist because, if it was, your son would be in the proper type of psychotherapy now. He needs to be seen by the Clinical Psychologist and, based on the psychologist’s evaluation, perhaps be seen by a psychiatrist.

What I am implying is that the diagnosis may not be correct. Of course, I have no way of knowing. However, your son has gotten so very little help over the years that, it seems to me, anything is possible. By the way, OCD is an anxiety disorder. But, sometimes symptoms can be confusing and not clear cut. Anyway, the diagnosis should be checked out and that is where the psychologist and psychiatrist come in.

You appear to understand that "talking therapy" is not what your son needs and that is probably correct. If he has OCD and it is very severe, he may need Cognitive Behavioral Therapy along with medication.

At this point, I can only say that, based on what you have written, it is not likely that your son would be hospitalized. In addition, it is not likely that hospitalization would do him much good, unless things are far worse and far more violent than what you have reported.

One last but very important thing:
You and your family seem to be extremely stressed by this and that is very understandable. What I want to recommend is that, in addition to having your son seen by the Psychologist and, perhaps, Psychiatrist, that the whole family be seen in Family Therapy. The reason would be to help all of you learn more about this illness and what things all of you can do to help.

Finally, you should discuss the school situation with the psychologist. Perhaps going to school is not realistic right now: I really do not know. Anyway, the Psychologist is probably the best person to help get the school on board with helping your son and the family.

Best of Luck

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