Guest guest Posted June 11, 2004 Report Share Posted June 11, 2004 Kathy, Thanks for the response. Lexi's battle is with bad thoughts and doubts about God. How do CBT and ERP address this. Her only compulsion is to 'dialogue' with me, but since she's been on klonopin that has waned considerably. So my question is how does therapy help when there is no real compulsion? TIA, cristey On Fri, 11 Jun 2004 09:49:48 -0500 " Kathy " writes: > Hi Cristey, the first SSRI my daughter tried caused bad side effects > and > made OCD *worse.* The next two just did not do much to reduce the > OCD. > She was on each of these meds three months or more which means that > first > year following her abrupt onset was very difficult to say the least. > With > Zoloft, although there was no dramatic, early-on reduction of > symptoms, over > three months or so her symptoms reduced significantly, perhaps by > 30% or so. > This made the difference between constant, severe OCD and being able > to > function, spend some time *not* doing compulsions, not have > constant > anxiety, etc. Later when I was able to find a suitable therapist, > CBT/ERP > reduced the remaining symptoms by at least that much again, and for > some > time now my dd's OCD has been low-level and stable--no more > " roller-coaster " > where we nor she ever knew when there would be a big flare. This > makes all > the difference in the world in being able to plan activities, and > live life > comfortably day-by-day. > > All SSRIs take a long while to take effect, and the five-week mark > is early > days yet. Though there is that occasional person who has > significant relief > early on, in most cases it is not until the person has been on a > therapeutic > dose for a couple of months or more that you can accurately assess > the med's > effectiveness. (Therapeutic dose=effective treatment dose, which > depending > on the titering schedule, might not be reached for a few weeks.) > That your > daughter is experiencing significantly reduced anxiety already must > be > encouraging! The Klonopin your daughter takes is probably to help > her > through this period before Prozac takes its full effect? > > I'm sorry I don't have any personal experience with any of the > generics...I > don't think any of the SSRIs had gone off patent yet back when my > child was > trialing the different ones, and I don't think Zoloft is yet. I > have also > heard of people not doing as well on the generic versions as they > were on > the name-brand, and also the opposite. When Zoloft goes off patent > I will > probably pay the extra to keep my daughter on the brand drug since > she has > done this well with it this long--don't want to rock the boat! > > Take care, > Kathy R. in Indiana > ________________________________________________________________ The best thing to hit the Internet in years - Juno SpeedBand! Surf the Web up to FIVE TIMES FASTER! Only $14.95/ month - visit www.juno.com to sign up today! Quote Link to comment Share on other sites More sharing options...
Guest guest Posted June 12, 2004 Report Share Posted June 12, 2004 Hi Cristey, CBT/ERP can work on obsessions too, not just compulsions. The exposure would be to the idea that the thoughts are true, she does really hate God or God hates her or whatever her obsessional worries are. (The CBT part would be around the idea that these thoughts are coming from the OCD and not God or her.) With repeated exposure to the idea, it loses its " punch " and she loses her fear of the obsessions, they no longer worry her and give her anxiety, and fade away. My daughter had an obsession that really, she hated us and would kill us (parents). For ERP we had silly/weird conversations about how, when, and so on she would do this. What would it feel like, what would she think next--sort of made stories up about it. We also tried to work the obsession's content into general conversation where we could, keeping it at a level where she was mildly triggered but not over the top. For example, once when the house was a total wreck and I didn't want to clean the next day, I asked her to " Kill me now so I don't have to do this work. " (Paradoxical humor.) She avoided knives because of this obsession that she would kill us, so I challenged her to use knives, first a butter knife to spread butter on rolls we were having for dinner, later a paring knife to help me make salad, and so on until she could comfortably use a knife and this did not trigger the obsession. (Working on the knife avoidance also reduced the strength of the kill parents obsession itself.) A child with obsessions such as this sometimes has avoidance as their main compulsion. Does your daughter avoid certain topics, places, activities, etc. to keep from triggering the obsessions? If so this avoidance, gradually becoming acclimated to whatever thing she has been avoiding can reduce the obsession. Also a child may have difficult to notice compulsions--does your daughter silently pray for example, when she hears a bad or wrong word, or is otherwise triggered? She could have any number of these types of compulsions that she uses to lower the anxiety of the bad thoughts. Anyway, any good child therapist with experience in CBT/ERP for OCD will know how to treat primarily obsessional symptoms. Good luck! Take care, Kathy R. in Indiana ----- Original Message ----- > Kathy, > Thanks for the response. Lexi's battle is with bad thoughts and doubts > about God. How do CBT and ERP address this. Her only compulsion is to > 'dialogue' with me, but since she's been on klonopin that has waned > considerably. So my question is how does therapy help when there is no > real compulsion? TIA, cristey Quote Link to comment Share on other sites More sharing options...
Guest guest Posted June 15, 2004 Report Share Posted June 15, 2004 We have not found a good therapist--they seem elusive. Did your dd ever feel like 'she wanted her OCD thoughts'? Lexi really feels like these are 'her thoughts' and that 'she's pretending to have OCD' and that she 'wants these thougths' If she wants this monster, she certainly isn't gleeful about it! When I told her she didn't appear to be having fun, she said, " Mom, I feel like I " m pretending. " This OCD is one big fat liar!! In the midst of this, we've had some laughs...thank God. Bless our little children, cristey On Sat, 12 Jun 2004 11:18:32 -0500 " Kathy " writes: > Hi Cristey, CBT/ERP can work on obsessions too, not just compulsions. > The > exposure would be to the idea that the thoughts are true, she does > really > hate God or God hates her or whatever her obsessional worries are. > (The CBT > part would be around the idea that these thoughts are coming from > the OCD > and not God or her.) With repeated exposure to the idea, it loses > its > " punch " and she loses her fear of the obsessions, they no longer > worry her > and give her anxiety, and fade away. > > My daughter had an obsession that really, she hated us and would > kill us > (parents). For ERP we had silly/weird conversations about how, > when, and so > on she would do this. What would it feel like, what would she > think > next--sort of made stories up about it. We also tried to work the > obsession's content into general conversation where we could, > keeping it at > a level where she was mildly triggered but not over the top. For > example, > once when the house was a total wreck and I didn't want to clean the > next > day, I asked her to " Kill me now so I don't have to do this work. " > (Paradoxical humor.) > > She avoided knives because of this obsession that she would kill us, > so I > challenged her to use knives, first a butter knife to spread butter > on rolls > we were having for dinner, later a paring knife to help me make > salad, and > so on until she could comfortably use a knife and this did not > trigger the > obsession. (Working on the knife avoidance also reduced the > strength of the > kill parents obsession itself.) > > A child with obsessions such as this sometimes has avoidance as > their main > compulsion. Does your daughter avoid certain topics, places, > activities, > etc. to keep from triggering the obsessions? If so this avoidance, > gradually becoming acclimated to whatever thing she has been > avoiding can > reduce the obsession. Also a child may have difficult to notice > compulsions--does your daughter silently pray for example, when she > hears a > bad or wrong word, or is otherwise triggered? She could have any > number of > these types of compulsions that she uses to lower the anxiety of the > bad > thoughts. > > Anyway, any good child therapist with experience in CBT/ERP for OCD > will > know how to treat primarily obsessional symptoms. Good luck! ________________________________________________________________ The best thing to hit the Internet in years - Juno SpeedBand! Surf the Web up to FIVE TIMES FASTER! Only $14.95/ month - visit www.juno.com to sign up today! Quote Link to comment Share on other sites More sharing options...
Guest guest Posted June 18, 2004 Report Share Posted June 18, 2004 Hi Cristey, yes my daughter felt she wanted and needed the thoughts--one of the cruel things OCD does is create doubt or confusion about whether the thoughts are real, a child's own, or a product of the disorder. OCD is sometimes called " the doubting disease " because of this common symptom of being unable to feel sure or certain about things. This doubt can encompass all sorts of things, not just whether a thought is coming from OCD or not. Yes, depending on what area you are in, expert child therapists experienced in treating OCD are scarce with daunting waiting lists. That's why I so frequently encourage parents to get right on the task of lining up a therapist, it can take quite awhile. If you have networking skills, it sometimes comes down to following up leads, and leads generated from those leads, until one bears fruit. If you have a university-affiliated med center somewhat near, call their psychiatry department to see if they have appropriate therapists or can suggest names in the area. Don't overlook the phone book, your insurance's list of providers, and perhaps even personal recommendations from friends/family who you know have accessed the mh system and might be able to give you the name of someone good. Even if that person doesn't work out, he/she may be able to give you the name of someone who will. HTH, Kathy R. in Indiana ----- Original Message ----- > We have not found a good therapist--they seem elusive. > Did your dd ever feel like 'she wanted her OCD thoughts'? Lexi really > feels like these are 'her thoughts' and that 'she's pretending to have > OCD' and that she 'wants these thougths' If she wants this monster, she > certainly isn't gleeful about it! When I told her she didn't appear to > be having fun, she said, " Mom, I feel like I " m pretending. " This OCD is > one big fat liar!! In the midst of this, we've had some laughs...thank > God. > Bless our little children, > cristey Quote Link to comment Share on other sites More sharing options...
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