Waxing and waning of OCD

[Guest guest]

Sheila wrote: My son is 22 and was diagnosed a year and a half

ago. His ocd appears to be waxing for the past couple of weeks,

from what I understand about the nature of the illness. What I want

to know is how he can get it back under control? How long does waxing

last before waning begins?

To Sheila and other parents who deal with waxing and waning of OCD symptoms:

As you noted, waxing and waning is part and parcel of OCD. OCDers are

particularly prone to waxings during stress and transition. What I suggest to

my patients and families is:

1. EXPECT it and PLAN for it. When you expect it, you are not surprised. When

you are not surprised, you are not caught off guard. You can then take control

of it.

2. Put it in perspective: It's just a slip, not back to square 1. It's normal,

it does not mean I'm a failure or that the therapy is no good for me, and I'll

never overcome OCD. If you don't put it in perspective, you get demoralized,

when you're demoralized, you don't have resolve or energy, and your self-talk

turns into a self-fulfilling prophecy.

3. Have faith, optimism, resolve to overcome. DON " T QUIT--its the only way you

can really fail.

3. Have the same strategy you would if you slipped and fell on the sidewalk

(metaphorically speaking): What would you do if you fell on the sidewalk? If

you could, you would try to get up, dust yourself and get going. If you find

that you can't move or that your ankle hurts, you would ask for help. If

necessary, you might have to get medical help of varying degrees, depending on

the nature of the injury. Eventually, you would be back on your feet again,

although, depending on the nature of your injury, it might take time. However,

if you sat on the sidewalk and did nothing about it, you'd be there forever.

4. Face your fears more than ever: If your son is familiar with Exposure and

RP, it should be used with greater vigor than ever to confront the fears that

are creeping back in. The idea is to take charge and not let the fears take

charge. Be systematic about identifying which fears are an issue, making a

heirarchy and going after them with a vengeance.

5. Scale back: Deal with only the necessary things in life during times of

stress and waxing. Cut back on everything but essential responsibilities until

things settle, then gradually work your way back up.

6. Plan for future slips: When things have settled, do " preventive " ERP

exercises--like preventive dental care. Identify tough areas and intentionally

seek out exposures to toughen oneself for future relapses.

7. Go have yourself a party to celebrate and enjoy the good times.

Hope this is helpful.

Aureen Wagner, Ph.D.