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Children, Rituals, and OCD

Janet Singer's son Dan suffered from obsessive-compulsive disorder (OCD) so severe he could not even eat. What followed was a journey from seven therapists to ...Read More

When my older daughter was about two or three years old, she had a bedtime ritual where she lined up ten of her dolls and stuffed animals on the floor. They had to be in the right order, at the right angle, touching or not touching each other in a specific way. If these “friends” were not arranged just so, she would get upset, have a tantrum, and then need to adjust each and every one of them until she got it just right. Only then could she go to sleep.

And she doesn’t have obsessive-compulsive disorder (OCD).

The fact is that rituals are a normal part of childhood, and they play an important role in children’s overall development. Rituals create order for children as they grow and try to make sense of the world around them. For example, a bath, story time, and cuddles every night before bed give children structure and a sense of security. They feel safe; they know what to expect. Everything is as it should be. Here, rituals are a good thing.

But if you’re suffering from obsessive-compulsive disorder, the rituals you feel compelled to perform actually help perpetuate your OCD. How is it that something that can be so wonderful in one situation cause so much suffering in another?

Typically, children without obsessive-compulsive disorder will be soothed and comforted by their rituals, whereas a child with OCD will experience only a fleeting calm. Anxiety and distress will always return, and the child will feel, once again, compelled to complete the ritual. This is a hallmark of OCD; that feeling of “incompleteness” that causes sufferers to perform rituals over and over again. Over time, the original rituals become “not enough” and more elaborate rituals need to be developed. It becomes a never-ending vicious cycle.

If you think your child might be suffering from OCD, you can note whether rituals are soothing for more than a few minutes. Also, it’s a good idea to pay attention to the amount of time your child spends ritualizing, as well as how much it interferes with his or her daily life. Typically, spending an hour or more a day completing rituals should raise some red flags.

Diagnosing OCD in young children is not always easy, as there are many ways the disorder can manifest itself. And OCD is tricky. Just when I was really starting to worry about my daughter, she began to care less and less about the arrangement of her “friends.” On the other hand, my son, who appeared to have no use for rituals in his life whatsoever, developed OCD.

OCD often begins in childhood. I can’t tell you how many times sufferers have told me, “I’ve had symptoms of OCD for as long as I can remember.” I believe this is something all parents should be aware of, because the earlier OCD is properly diagnosed and the correct therapy is put into place, the less likely the disorder will spiral out of control.

If you suspect, for any reason, that your child might be suffering from obsessive-compulsive disorder, I’d suggest taking him or her to a doctor who can do a proper assessment. If your child doesn’t have OCD, you will have peace of mind, and if your child does have the disorder, he or she can benefit greatly from early therapy.

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