Guest guest Posted July 6, 2000 Report Share Posted July 6, 2000 Hi Ann: Normally people involved in CBT have homework. Have you seen your son doing homework? The best treatment for OCD is E & RP, a specialized form of CBT. Telling an OCDer to ignore their thoughts is only likely to make them obsess more. What they have to do is consider their fears are actually happening (imaginal exposure) or even better have a real (in vivo) exposure to their fears. This needs to be done in a graduated and organized fashion. Typically homework may also involve the family as many of our kids suffer worst with OCD at home where they are more relaxed as OCD comes and gets them when their defences are down. Breathing techniques are helpful for some anxiety disorders but usually not for OCD. In fact some published research uses relaxation techniques like breathing as the control group (i.e. untreated) to compare the treatment modality under study. In real life I can tell you that Steve would get pretty agitated when he was encouraged to relax and OCD was bossing him around big time. We even have customized relaxation tapes from one therapist who tried this with him (she also claimed to be experienced with OCD!). I know the March protocol includes relaxation; perhaps this is because many of our kids have other comorbid anxiety disorders, e.g. PTSD which can get in the way of doing E & RP successfully. Pure " O " OCD is considered by many docs to be a situation where if you look closely enough you find mental rituals which are engaged in to reduce anxiety. For example when reading a " bad " word they may go back and start at the beginning of the page until they get to a good word to " neutralize " the bad word. Steve has had problems with re-reading and, other than noticing he was not reading much or was not finishing his books, I would not have known it was OCD unless I knew about these common mental rituals. Keeping busy and distracting yourself is not bad advice, especially if it involves physical activity. However I noticed this was not very effective when Steve was very sick with OCD. It just consumed him and he was trying very hard to distract himself with Gameboy until his fingers hurt, since nothing else seemed powerful enough to quieten his obsessions. Do you know what thoughts your son has about reading? It would be helpful to know this to deliver some cognitive therapy. Just understanding that OCD is a no-fault disorder, giving it a name/making it separate from your child and developing his understanding and recognition when OCD is making him do/think something rather than when he is in charge are all ways of doing cognitive therapy. I am sure Dr. Chansky can make more specific recommendations. It sounds like you need to discuss the goals of therapy with your son's therapist. Why not make and appointment and ask them what their game plan is, how many sessions they need and what goals and measurable objectives they suggest for treatment? I am going through CBT right now for depression myself. I get regular homework, reading assignments, writing assignments, activities to follow through on and my therapist asked me what my goals are and we check how it is coming along. Anyone familiar with CBT/CT should be willing to do something similar with you. It is an outcome-oriented kind of therapy aimed at helping people understand how they think and behave affects how they feel. YOu cannot always control how you think nor how you feel, but you can control how you behave, including " beating yourself up " with interpreting thoughts negatively. As you change the way you behave, the way you think starts to change and then the way you feel starts to change. Sometimes we get stuck and need help. Good luck, take care, aloha, Kathy (H) kathyh@... At 11:45 PM 07/06/2000 +0000, you wrote: > I am not seeing my son's psychologist doing any Cognitive Therapy. I >ask my son what he does in his office and he says he asks him what >his thoughts are and tells him to ignore them and do his breathing >techniques and keep busey. So far that has been it! From a well known >Doctor who is suppose to specialize in OCD! > Can someone tell me with my son having obsessive thoughts no rituals >just thoughts how would a psychologist go about using Cognitive >therapy, his thoughts central around one of his favorite things and >that is reading. I would really appriciate anyones input here. Thanks! > > Ann Quote Link to comment Share on other sites More sharing options...
Guest guest Posted July 7, 2000 Report Share Posted July 7, 2000 Kathy, The only homework my son ever had was to write down his thoughts and that was at the beginning. I can tell you there has not been anything like what you explained done with my son. I was wrong saying his OCD was just from reading,I drew a blank and forgot how it when he gets upset he thinks he must discuss the incident and say I am sorry a thousand times or else something bad will happen. With reading he reads Star Wars novels and he is a christian and his thoughts tell him that if he reads the novels he is antichrist or hes not a christian,he has since then bought different books as the Doctor suggested. You are right on keeping busey. My son's OCD is very severe and the thoughts are so strong that he can't do much of anything but cry. I don't know where else to look for a psychologist if this one does not pan out. We live in a small town and we have been down this road before with Psychologist that we wonder if there is any out there that really do CBT the way you describe it. Ann > Hi Ann: > > Normally people involved in CBT have homework. Have you seen your son > doing homework? The best treatment for OCD is E & RP, a specialized form of > CBT. Telling an OCDer to ignore their thoughts is only likely to make them > obsess more. What they have to do is consider their fears are actually > happening (imaginal exposure) or even better have a real (in vivo) exposure > to their fears. This needs to be done in a graduated and organized > fashion. Typically homework may also involve the family as many of our > kids suffer worst with OCD at home where they are more relaxed as OCD comes > and gets them when their defences are down. > > Breathing techniques are helpful for some anxiety disorders but usually not > for OCD. In fact some published research uses relaxation techniques like > breathing as the control group (i.e. untreated) to compare the treatment > modality under study. In real life I can tell you that Steve would get > pretty agitated when he was encouraged to relax and OCD was bossing him > around big time. We even have customized relaxation tapes from one > therapist who tried this with him (she also claimed to be experienced with > OCD!). I know the March protocol includes relaxation; perhaps this is > because many of our kids have other comorbid anxiety disorders, e.g. PTSD > which can get in the way of doing E & RP successfully. > > Pure " O " OCD is considered by many docs to be a situation where if you look > closely enough you find mental rituals which are engaged in to reduce > anxiety. For example when reading a " bad " word they may go back and start > at the beginning of the page until they get to a good word to " neutralize " > the bad word. Steve has had problems with re-reading and, other than > noticing he was not reading much or was not finishing his books, I would > not have known it was OCD unless I knew about these common mental rituals. > > Keeping busy and distracting yourself is not bad advice, especially if it > involves physical activity. However I noticed this was not very effective > when Steve was very sick with OCD. It just consumed him and he was trying > very hard to distract himself with Gameboy until his fingers hurt, since > nothing else seemed powerful enough to quieten his obsessions. > > Do you know what thoughts your son has about reading? It would be helpful > to know this to deliver some cognitive therapy. Just understanding that > OCD is a no-fault disorder, giving it a name/making it separate from your > child and developing his understanding and recognition when OCD is making > him do/think something rather than when he is in charge are all ways of > doing cognitive therapy. I am sure Dr. Chansky can make more specific > recommendations. > > It sounds like you need to discuss the goals of therapy with your son's > therapist. Why not make and appointment and ask them what their game plan > is, how many sessions they need and what goals and measurable objectives > they suggest for treatment? > > I am going through CBT right now for depression myself. I get regular > homework, reading assignments, writing assignments, activities to follow > through on and my therapist asked me what my goals are and we check how it > is coming along. Anyone familiar with CBT/CT should be willing to do > something similar with you. It is an outcome-oriented kind of therapy > aimed at helping people understand how they think and behave affects how > they feel. YOu cannot always control how you think nor how you feel, but > you can control how you behave, including " beating yourself up " with > interpreting thoughts negatively. As you change the way you behave, the > way you think starts to change and then the way you feel starts to change. > Sometimes we get stuck and need help. > > Good luck, take care, aloha, Kathy (H) > kathyh@i... > > At 11:45 PM 07/06/2000 +0000, you wrote: > > I am not seeing my son's psychologist doing any Cognitive Therapy. I > >ask my son what he does in his office and he says he asks him what > >his thoughts are and tells him to ignore them and do his breathing > >techniques and keep busey. So far that has been it! From a well known > >Doctor who is suppose to specialize in OCD! > > Can someone tell me with my son having obsessive thoughts no rituals > >just thoughts how would a psychologist go about using Cognitive > >therapy, his thoughts central around one of his favorite things and > >that is reading. I would really appriciate anyones input here. Thanks! > > > > Ann Quote Link to comment Share on other sites More sharing options...
Guest guest Posted July 7, 2000 Report Share Posted July 7, 2000 HI Ann: I am sorry you are struggling so much to find a therapist locally. Have you considered travelling to find one? This is what we did and he then helped us find someone locally he could train to do E & RP with Steve on our island. Unfortunately not reading books that upset your son is not the best approach to this problem. It is known as avoidance and does not help the OCD sufferer to learn to control their symptoms. In a graduated way they have to learn how to cope with the anxiety they get from reading these books. It sounds like your son has scrupulosity and many therapists find this is best treated using a team approach involving a religious advisor/counselor whom the sufferer trust to be their moral compass. First they need to understand and accept that their own moral compass is not working properly due to OCD so they can trust the advisor. THe religious advisor needs to be someone who understands OCD and can work with the CBT therapist. Steve has non-religious scrupulosity and he told me he thought he was just a bad kid when he first started to suffer from OCD. Doing a bit of cognitive work with him to teach him that OCD is a brain disorder and that his brain was sending error messages and letting him know how loved he is helped. The paradoxical approach has also been helpful as it lightens up the situation and helps them reorient their perspective fairly rapidly. Also explaining that everyone gets odd thoughts flashing in and that the problem for people with OCD is that they interpret these thoughts as having meaning that they just don't can help them. Saying he is sorry is a very common ritual and you might be able to encourage your son to limit his apologizing as a start to getting his OCD under control. Do you have a copy of the March protocol? IMO every parent of a child with OCD should read this book to understand about the first-line treatment for OCD in kids. Good luck, take care, aloha, Kathy (H) kathyh@... At 02:47 PM 07/07/2000 +0000, you wrote: > Kathy, > The only homework my son ever had was to write down his thoughts >and that was at the beginning. I can tell you there has not been >anything like what you explained done with my son. > I was wrong saying his OCD was just from reading,I drew a blank and >forgot how it when he gets upset he thinks he must discuss the >incident and say I am sorry a thousand times or else something bad >will happen. With reading he reads Star Wars novels and he is a >christian and his thoughts tell him that if he reads the novels he is >antichrist or hes not a christian,he has since then bought different >books as the Doctor suggested. > You are right on keeping busey. My son's OCD is very severe and the >thoughts are so strong that he can't do much of anything but cry. > I don't know where else to look for a psychologist if this one does >not pan out. We live in a small town and we have been down this road >before with Psychologist that we wonder if there is any out there >that really do CBT the way you describe it. > > Ann Quote Link to comment Share on other sites More sharing options...
Guest guest Posted November 17, 2004 Report Share Posted November 17, 2004 My daughter has bumps in the bones on her skull, on the sides, top, back and the forehead. She wasn't born with the bones like this, it just happened over time for some reason. she's being tested for McCune Albright Syndrome because she also has cafe au lait coast of maine spots and has many signs of early puberty and her thyroid bounces around from hypo to hyper. she is supposed to undergo a full body bone scan next week and I think it will be a very hard proceedure for her to undergo. she is a 4 person hold down for bloodwork and we can't even attempt to get ecg's or echo's done on her, she rips out IV lines the moment she opens her eyes in recovery. so I think having her undergo this proceedure, while awake, will be very hard on her. They put in an IV and she has to keep it in for two hours and then she has a 90 min scan. I guess my question to everyone here is this: do any of the children here with Down syndrome have bumpy bones on their skulls that developed as they grew and do any of the kids here have McCune Albright Syndrome? Cheryl Quote Link to comment Share on other sites More sharing options...
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