child who denies OCD

November 5, 2000

I don't have all the answers but our situation is parallel. Our daughter has

been resistant to medications and other treatment. Consequently, she has

lost many important things including her public high school experience (in a

private school now),opportunities in music and acting (her gifts), and

friends who are fed up with her. Forget dating for now.

Our situation was complicated by a public school that was not

understanding of her problem at all and gave no good accommodations and

therapists that couldn't diagnose or treat the problem.

What we are left with is advice that when she is feeling badly enough

she will be motivated to help herself. I don't know if I believe this

entirely. I am still searching for a who is an expert inOCD and ERP and also

is sensitive to teen issues. They don't want to feel different from their

peers so they fight this thing without realizing that if they just complied,

they would be more like their peers.

Perfectionism is a tricky devil and one that is very difficult to

pinpoint. With good CBT, the therapist should be able to set up a program to

challenge it, the goal being exposure to less-than-perfect products from him

and the idea perfectionism gets in the way.

Good luck,

Mamimiz

November 6, 2000

What we are left with is advice that when she is feeling badly enough

she will be motivated to help herself. I don't know if I believe this

entirely. I am still searching for a who is an expert inOCD and ERP and also

is sensitive to teen issues. They don't want to feel different from their

peers so they fight this thing without realizing that if they just complied,

they would be more like their peers.

I'm not sure about this advice either. Sometimes when you're

feeling badly you are also not thinking very clearly. I know when

my husband's OCD has gotten out of control and he is feeling very very

badly and his attitude and behavior reflects it, part of his internal OCD

dialogue is that there is something wrong with everyone else (especially

me), not him. What has pulled him out of it (twice) were ultimatums:

get treatment or get out. He takes a lot of medication for another

disease and this sometimes interferes with his OCD medication and makes

it less effective. Once he was on meds that boosted his Paxil and

so he was on a lower dose. When he changed meds the new ones didn't

do that and so he was not taking the correct OCD dose of Paxil. His

doctor is and ID specialist but knows nothing about OCD. I emailed

the doc, told him what was happening, gave Clay an ultimatum and he agreed,

reluctantly since he was sooo sure I was the problem, to increase his medication

and go for some E & RP.

So I'm not so sure that waiting until the pain is great enough is the

right way to go: pain and insight don't always go together. I think

your comment about wanting to be like their peers was so right, and that

the more they "fight" OCD ineffectively (by giving in to it) the more unlike

their peers they become, which increases their fears about being different.

When Ava was at the doctor's last week and we were changing her meds to

Luvox the doctor asked Ava "is that okay with you?". Ava gave her

a withering look and said "why are you asking me, it's not like I have

a choice?" and then shot me a glare. Of course she does have a choice,

she could pretend to take the pill, argue (her specialty!) every time etc..

I think she has mixed feelings about being "different" and taking meds

and she expresses these feelings by making it my fault that she has to

take them but being very compliant about it, she even reminds me to give

her her pill.

The doctor (who is rather young and very nice and doesn't have children)tried

to say appeasing things to her about taking meds but Ava just waved her

hand and said, "whatever". Ava then said that she is normal,

I'm the only one who notices her OCD, she fits in fine with all of her

friends, if you saw her in a group you couldn't tell she had OCD.

She said she is NOT a weirdo. I said "Do you think Clay is a weirdo?"

(Clay is extremely cool in a very "hip" way and even she can tell).

She said, no. I reminded her that Clay's OCD is worse than hers but

no one knew it for years and even now they can't tell because people with

OCD aren't "crazy" and they can hide their symptoms but they still suffer.

So I think that in refusing treatment teens are expressing the part

of themselves that wants to be "normal" and in a way they are asking for

the parent to express the part that wants to be "well" by making

them go for treatment. Ava once got an invite to somewhere she didn't

want to go and she told the friend she had to ask her mom, she asked me,

signaling me the whole time to say no. I said no. Then she

got off the phone and argued with me about why I wouldn't let her go!

I said but you told me to say no! She said, yeah, but part of me

wanted to go so I feel better if I can argue with you.

Dana in NC

November 6, 2000

> What we are left with is advice that when she is feeling badly

enough

> she will be motivated to help herself. I don't know if I believe

this

> entirely. I am still searching for a who is an expert inOCD and

ERP and also

> is sensitive to teen issues. They don't want to feel different

from their

> peers so they fight this thing without realizing that if they just

complied,

> they would be more like their peers.

Whenever I've read this viewpoint I'm reminded of the idea in

Alcoholics Anonymous that the drinker must " hit bottom " as a

condition of beginning a successful recovery. But in addictions

treatment there is also the model of intervention, where loved ones

confront the sufferer with evidence of how the drinking is negatively

affecting his or her life. The viewpoint here is that the drinker is

sick, has poor insight as an effect of his disorder, is in the grip

of the disorder and is not making good choices.

I know OCD is not addiction and more than likely I'm naive about the

problems presented by teens, as my only child is 6. But it seems to

me that OCD also can confound good decision-making and insight into

one's situation, whatever the suffer's age. Without OCD, we learn

from our mistakes, and when we are uncomfortable or unhappy, this

motivates us to seek solutions to our problems. But I'm not sure

this normal process is intact in someone with untreated OCD. I know

Kellen's abrupt onset of OCD completly ruined parenting by natural

consequences, which worked well with her up until that point.

This may seem harsh, but I've wondered whether the idea that an OCDer

lacks motivation (is not yet " suffering enough " ) originates with poor

therapists, to blame the OCDer for treatment failure.

It seems a common idea among young OCDers that OCD treatment (meds or

CBT) is what sets them apart from other children, rather than the OCD

symptoms themselves. This may be another indication that our

children are not thinking " straight " and capable of making good

choices for themselves. As many of you know, I have been serving as

Kel's E & RP " therapist " for over a year now, because of being unable

to find a real therapist who would work with her due to her age.

According to her psych, she won't have the cognitive abilities to do

effective CBT until age 16 or so--right around the time that,

according to the experience of many of you on this list, her teen

issues may prevent her from considering this treatment!

I'm lucky in that Kel is young: she takes meds, does E & RP, turns off

certain TV shows, goes to bed at a certain time, many other things

she might not choose on her own, basically because I say so. My

heart goes out to those of you with teens, who watch your children

suffer, waiting and hoping your child will choose to comply with OCD

treatment. If Kel decides no more treatment as a teen, at least she

will have had the experience of successful treatment behind her, and

will know what it is that she is rejecting.

Kathy R. in Indiana

November 6, 2000

I agree that waiting till the pain is intense enough to cause the OCD sufferer to comply with treatment is probably not going to work most times. They are too out of touch with reality to understand the cause/effect of therapy/meds and improvement.

Judy

November 8, 2000

Dana. Thanks for your thoughtful reply. I have switched gears somewhat and

I am about to take a more aggressive stance somehow. That ultimatum idea

sounds good to me. What helped was finding the right therapist. The next

challenge is getting my daughter there somehow and I am psyching myself up to

use that ultimatum.

Mamimiz

November 8, 2000

Dana. Thanks for your thoughtful reply. I have switched gears somewhat and

I am about to take a more aggressive stance somehow. That ultimatum idea

sounds good to me. What helped was finding the right therapist. The next

challenge is getting my daughter there somehow and I am psyching myself up to

use that ultimatum.

Mamimiz

November 8, 2000

Thanks Kathy R. Everyone's support and insight is just confirming what I

have felt for some time. Therapist no good in OCD and CBT while she is good

with teen issues but the former is confounding the latter. I found a new

therapist who is a specialist and I am going to make my move soon. It is

very difficult to get the support from others, including her prior therapist

and therapeutic school, when they really don't understand this. Yet we need

these people to maximize success. I have become a real pain in the a-- and

I don't care. We are going to do this right or mom is going to do something

drastic. Stay tuned.

Mamimiz

November 8, 2000