Re: Thoughts as Compulsions

[Guest guest]

That is So great. It's wonderful when they make gains isn' it? I love that my

son has gotten more verbal with his feelings even though he backslides adn has a

long way to go..Congrats:)

>

> Hi - I posted about this last week - one of my daughter's (Meg, age 7, OCD,

Panic Disorder, Agoraphobia) compulsions that she'd like to eliminate, is the

need to think " I won't throw-up " after she says " I wish I would throw-up " . Had

another appt at Duke on Thursday, and learned that this is a tough one to

eliminate, but that by practicing the obsession a lot, this will fade,

essentially with acceptance. And that Meg's being willing to even say " I wish I

would throw up " is a huge step forward - which she is right about. A month ago,

there is NO way, she would have said that out loud. After saying it, her

homework is to deliberately say it again, " yes, I really do, I do wish I would

throw up, etc " . We are also to continue to wish for fun but illogical things,

and test the power of wishing in fun ways.

>

> The appt was great, as I was feeling like I was losing perspective a little.

Meg started therapy about 6 weeks ago. She did really well, but then lost

ground at camp & again when she got a mild stomach virus while we were on

vacation (oh, that's a fun vacation!!!). Anyway, we were reminded of the

importance of writing down where you " are " with OCD at different points in time.

On the very positive, Meg can do the following (has beated OCD):

> * Does not need to scream MOM in a panic if we are not in the same room.

> * Can navigate the house by herself, pick out clothes, get dressed, use

restroom. Can go down the street to a friend's house alone. Can even play with

friends while wandering about at an outdoor concert without clinging to me.

> * While still counting sugars, can nearly always eat what she wants, when

she wants.

> * Can say the words " throw-up " and can sing songs about barfing without

freaking out.

> * Can swim underwater (not sure if this was a claustrophobic feeling, or a

get sick because of the pool water thought).

> * Can tell her dad & her babysitter what she is worried about - not just

me (mom). This is a huge improvement, and has cut back the compulsion to tell

me every little twinge.

> * Can frequently identify stomach upset as hunger, need to use restroom or

worry - rather than just panicking.

> * Cut down handwashing from about 50 times a day (camp) to about 5-8 times

a day, for short periods.

> * Can often hold off doing a compulsion, and trusts that she can handle

the anxiety (about 30% of the time), primarily if she is with a trusted person

still.

> * Meg has cut her spitting and blowing down from around 20 times an hour,

to maybe 20 times a day, as a compulsion only. The habit part of this one was

virtually eliminated by " Habit Reversal " (she needed an imcompatible activity to

spitting, so we are allowing her to chew sugar free gum, and eat Spree's - this

worked really fast!!! The deal was that she had to agree not to spit or wipe

while she got the candy - this also has been good treatment for the sugar

worries at the same time. And in light of recent posts - we are being EXTREMELY

careful around the puppy. Thanks for this heads-up, hope your dog is ok).

> * Is very motivated by point system to earn rewards, and is involved in

deciding her own goals each day. She frequently hits these goals.

> * Most importantly, during some level of anxiety - such as worrying about

whether another child is ill - she is able to say (2 times out of 10) that she

" can handle it, whatever happens, so she can just do what she wants to do " . We

will be working hard on this level of acceptance of the " worst " , while still

just living your life, and determinedly doing what you want to do.

>

> So - while this is still not an easy path, I am seeing improvements. Don't

get me wrong, there are still plenty of strong compulsions, and many times a

day, that things don't go as well as we'd like. But, she also coached us on the

fact that since Meg can now almost always identify the compulsive behavior, and

call it what it is - she is therefore now extremely frustrated when she gives in

to the compulsive behavior, and many of the meltdowns at this point are less

panic over the feeling that she has, and more just frustration about whether

she'll do the compulsion, and if she does -anger at herself. We are dialing up

the reward system for efforts, in an effort to keep her motivated, and feeling

good about what she is doing. We have a reward box that includes game time,

extra TV time, swim time, some books and toys, and a special project that will

take us multiple nights to complete. She can earn point for each effort, but

can't lose any. All rewards are multiple points - she helped assign the values.

>

> She suggests that we are now ready for a new step - trying hard to " not do "

any compulsions for 30 minutes. Up until now, we have focused on 1-2 behaviors,

until they are reduced. So we'll do 30 minutes until that is " easy " , then move

up to 45 minutes of the day, etc. The idea is to reclaim more and more of the

day in a compulsion free zone. We'll start this at home, of course, at first.

Since she has gotten the spitting & wiping down to just a compulsion, instead of

a habit, this is a reasonable goal at this point.

>

> Just thought I'd give you all a recap - things are still difficult, but we are

seeing a light at the end of the tunnel. Meg is happy for more of the day, than

she is sad or scared.

>

> Thanks for all your positive thoughts. in NC

>

[Guest guest]

this is amazing progress. The therapists at Duke must

be amazing. How did you find them. How did your daughter respond to the therapy

(readily accepted therapy or fearful of therapy)

What few things can I do to get my daughter to

cope with these issues:

panics at seeing wierd stuff (dead animals on road) and has

to rush home to tell me. Not calmed by Dad.

yells or cries if she can't find something, panics

afraid to go anywhere without me, fears she may panic

and wants to be able to leave (this impacts school).

I am so happy to hear this great progress!!!!!

Pam

>

> Hi - I posted about this last week - one of my daughter's (Meg, age 7, OCD,

Panic Disorder, Agoraphobia) compulsions that she'd like to eliminate, is the

need to think " I won't throw-up " after she says " I wish I would throw-up " . Had

another appt at Duke on Thursday, and learned that this is a tough one to

eliminate, but that by practicing the obsession a lot, this will fade,

essentially with acceptance. And that Meg's being willing to even say " I wish I

would throw up " is a huge step forward - which she is right about. A month ago,

there is NO way, she would have said that out loud. After saying it, her

homework is to deliberately say it again, " yes, I really do, I do wish I would

throw up, etc " . We are also to continue to wish for fun but illogical things,

and test the power of wishing in fun ways.

>

> The appt was great, as I was feeling like I was losing perspective a little.

Meg started therapy about 6 weeks ago. She did really well, but then lost

ground at camp & again when she got a mild stomach virus while we were on

vacation (oh, that's a fun vacation!!!). Anyway, we were reminded of the

importance of writing down where you " are " with OCD at different points in time.

On the very positive, Meg can do the following (has beated OCD):

> * Does not need to scream MOM in a panic if we are not in the same room.

> * Can navigate the house by herself, pick out clothes, get dressed, use

restroom. Can go down the street to a friend's house alone. Can even play with

friends while wandering about at an outdoor concert without clinging to me.

> * While still counting sugars, can nearly always eat what she wants, when

she wants.

> * Can say the words " throw-up " and can sing songs about barfing without

freaking out.

> * Can swim underwater (not sure if this was a claustrophobic feeling, or a

get sick because of the pool water thought).

> * Can tell her dad & her babysitter what she is worried about - not just

me (mom). This is a huge improvement, and has cut back the compulsion to tell

me every little twinge.

> * Can frequently identify stomach upset as hunger, need to use restroom or

worry - rather than just panicking.

> * Cut down handwashing from about 50 times a day (camp) to about 5-8 times

a day, for short periods.

> * Can often hold off doing a compulsion, and trusts that she can handle

the anxiety (about 30% of the time), primarily if she is with a trusted person

still.

> * Meg has cut her spitting and blowing down from around 20 times an hour,

to maybe 20 times a day, as a compulsion only. The habit part of this one was

virtually eliminated by " Habit Reversal " (she needed an imcompatible activity to

spitting, so we are allowing her to chew sugar free gum, and eat Spree's - this

worked really fast!!! The deal was that she had to agree not to spit or wipe

while she got the candy - this also has been good treatment for the sugar

worries at the same time. And in light of recent posts - we are being EXTREMELY

careful around the puppy. Thanks for this heads-up, hope your dog is ok).

> * Is very motivated by point system to earn rewards, and is involved in

deciding her own goals each day. She frequently hits these goals.

> * Most importantly, during some level of anxiety - such as worrying about

whether another child is ill - she is able to say (2 times out of 10) that she

" can handle it, whatever happens, so she can just do what she wants to do " . We

will be working hard on this level of acceptance of the " worst " , while still

just living your life, and determinedly doing what you want to do.

>

> So - while this is still not an easy path, I am seeing improvements. Don't

get me wrong, there are still plenty of strong compulsions, and many times a

day, that things don't go as well as we'd like. But, she also coached us on the

fact that since Meg can now almost always identify the compulsive behavior, and

call it what it is - she is therefore now extremely frustrated when she gives in

to the compulsive behavior, and many of the meltdowns at this point are less

panic over the feeling that she has, and more just frustration about whether

she'll do the compulsion, and if she does -anger at herself. We are dialing up

the reward system for efforts, in an effort to keep her motivated, and feeling

good about what she is doing. We have a reward box that includes game time,

extra TV time, swim time, some books and toys, and a special project that will

take us multiple nights to complete. She can earn point for each effort, but

can't lose any. All rewards are multiple points - she helped assign the values.

>

> She suggests that we are now ready for a new step - trying hard to " not do "

any compulsions for 30 minutes. Up until now, we have focused on 1-2 behaviors,

until they are reduced. So we'll do 30 minutes until that is " easy " , then move

up to 45 minutes of the day, etc. The idea is to reclaim more and more of the

day in a compulsion free zone. We'll start this at home, of course, at first.

Since she has gotten the spitting & wiping down to just a compulsion, instead of

a habit, this is a reasonable goal at this point.

>

> Just thought I'd give you all a recap - things are still difficult, but we are

seeing a light at the end of the tunnel. Meg is happy for more of the day, than

she is sad or scared.

>

> Thanks for all your positive thoughts. in NC

>