How untreated Childhood Obsessive Compulsive Behavior can negatively impact a family’s interaction in their community.

 Obsessive and compulsive behavior does not just affect a child; it affects the family as a whole. Many parents struggle with supporting their child that has OCD because the family typically has internal conflicts among family members and social isolation. All family members struggle, parents who cannot participate in family social events, siblings who are argue over disruptive behaviors, and the child with OCD suffers due to the difficulties of making and maintaining friendships.

Let’s discuss basic needs for all family members before we go into detail about how to treat the OCD symptoms. First, parents always need to ensure they are meeting their own needs. Parents typically sacrifice for their child and many times will neglect their basic needs, social life, and leave their profession to assist their children. This is a noble effort but, parent neglect may increase the intensity of these symptoms because neglect leads to parent fatigue.

So what is Obsessive and Compulsive Disorder (OCD) in basic terms? Well, major results of OCD include Obsessive, Repetitive, and Ritual behaviors. The behaviors are typically maintained by fear and anxiety. Many children struggle with fears of being mortally injured or becoming fatally ill. An example many parents see are when their children refuse to eat in certain places due to the food being “Dirty,” and chronic hand washing for children terrified of germs. These symptoms are not isolated to just children but, these behaviors severely impact a child’s normal social functioning. The belief that the repetition of the behaviors will keep them safe, firmly plants the socially crippling behavior in their life.

Many times children struggling with Obsessive and Compulsive behaviors are unable to explain their behavior and feel ashamed by their feelings. Due to the shame they attempt to keep their struggle as much of a secret as they can, even from their parents. An example I have encountered of these behaviors as a Family Counselor was when I worked with a 12 year old girl who refused to eat at other people’s homes outside of the family’s home. She reported that she could not explain why she couldn’t eat at other people’s homes but she was embarrassed to visit during parties and events because she was accused of being rude because she would not eat. Her parents were also embarrassed and upset because their daughter would not eat food that was offered and received ridicule regarding their parenting skills.

In addition, school behaviors are effected as well. In some cases, some children refuse to attend school due to their symptoms.  At one point I worked with a 9 year old boy who refused to return to school because of his anxiety related to the uncertainly of school, the uncleanliness of the environment, as well as the fear of being ridiculed. When he attended school he had been bullied by the other children as well as the school personnel. When he was being re-entered into the school he was terrified he would experience ridicule again and if he started to have symptoms, he not only feared that he would have symptoms but also feared that he would be teased by his peers and caregivers.

Obsessive Compulsive behavior can be difficult to treat, and extremely hard to guide as a parent, but there is hope. Many children respond very well to Cognitive Behavioral Therapy (CBT), Family Therapy, as well as Applied Behavior Analysis (ABA). In addition, many children find relief working with a pediatric psychiatrist or neurologist for medication management.

Obsessive and Compulsive behavior does not only negatively affect the child but the entire family suffers. Parents re-arrange their life to accommodate their child’s disability and at times feel isolated and many times blame themselves; some parents attribute their child’s behavior to poor parenting skills. Siblings struggle also, many times they feel embarrassed by their sibling’s obsessions and compulsions. In addition, sibling conflict frequently occurs and this conflict places additional stress on the children involved and negative stressors on the parent managing the situation.

Overall, Obsessive and Compulsive behavior, otherwise known as Obsessive Compulsive Disorder (OCD) can severely impede a family’s functioning and over all happiness. At the Success Source Troy has a significant amount of experience helping children with Obsessive and Compulsive Disorder (OCD), and uses a unique blend of individual Counseling and Coaching, Family Counselor and Parent Coaching, as well as working (In Vivo) with children and families in real world environments were the obsessions and compulsions are happening. Troy accompanies his clients and families to the root of their difficulty and assists them with developing the skills to thrive.

 

 

Dysthymic Disorder with school age and adolescent boys.

“Sad, Mad, Irritable and Moody”; a summary of long-term low level depression, Dysthymic Disorder with school age and adolescent boys. 

Many parents are not familiar with “Dysthymic Disorder” but it is the most common form of depression and it is typically the longest lasting form; sometimes lasting for years. Often Dysthymic Disorder, or “Dysthymia” and when it occurs in boys it can be mistaken for other things. Typical symptoms parents see are mild anxiety, lack of motivation, negative self-talk or automatic expectation of failure, as well as difficulty focusing and unstable mood. Many times boys struggle with Dysthymic Disorder and are misdiagnosed or assumed to have ADHD Attention Deficit Hyperactivity Disorder (ADHD), or Attention Deficit Disorder (ADD). Let’s take a closer look at what a child or adolescent with Dysthymia looks like.

Dysthymic is common and at times can run in families but also can be the result of life transitions and or the result of a person’s inability to cope with negative situations. An overall negative outlook on life and on the future is common. Boys typically suffer in silence because many of them do not like to ask for help because they feel it may be a sign of weakness or that they cannot handle things on their own.

Here are some real world examples:
Sadness; Feelings of sadness are common of boys with Dysthymia. Many parents report, “I don’t know what his problem is, he’s always annoyed, negative, or pessimistic.” Another example would be loss of or reduced self-esteem. Many have an attitude like this, “I’m not going to try doing that, It’s not like I will succeed.” As a parent watching and hearing your child speak about their life in such a negative light is heart wrenching. For many parents they have been watching their child struggle for years and are not sure what to do.
Anger and Being Mad; Many boys struggle with a persistent and consistent mean streak. I have heard so many parents report that their sons “Sometimes have their good days but sometimes he just seems to be angry all the time for no reason.” When addressing the emotions these boys are feeling they typically report, “I don’t know, there is nothing wrong I’m find.” In reality their behavior is not aligned with their words. For many they struggle in silence until they enter a crisis and yell their discontent at the top of their lungs.
Irritability and Moodiness; The irritability and moodiness becomes more obvious as demands on the child increase. Many parents encounter this phenomenon when they ask for a chore to be completed, or homework to be started, or just attempt to interact with their adolescent and get a sarcastic/rude response. The moodiness is not just isolated to just the words a child uses but, also the avoidant behaviors which accompany the moods swings. Keep in mind you may notice some overlapping between these characteristics in Dysthymic Disorder and Oppositional and Defiant Behavior.

For boys who are struggling with the symptoms of Dysthymic Disorder, they typically struggle in silence because they seldom want to share their feelings. Many boys feel that it would be sign of weakness if they were to open up, and other simply do not realize that they are feeling symptoms because they have been experiencing them for such a long time. More often than not, parents are the first to notice. Many parents speak about how “Everything seems to bother him” or about “He does not seem motivated to do much of anything but activities he enjoys but, even those activities become boring.” Other parents spoke about how, “Almost everything can be a struggle, we have tried medication and a bunch of different things and not much has helped.” In reality, the improvements for Dysthymia are more gradual than it’s more sever counterpart “Major Depressive Disorder,” also known by many as Clinical Depression.

Situations that result in consistent sadness and or personal rejection increase the persistence of Dysthymia. For example, if a talented 16 year-old athlete suddenly receives a traumatic injury that cripples their ability to perform at their pre-injury condition they have an increased risk of developing Dysthymic Disorder symptoms. If we break the situation down to its elements it looks like this; “I was an amazing athlete and have been for years. All of a sudden I have an injury that robbed me of something I was very proud of. Now I have to wait to recover and if I try to perform like I did in the past I risk re-injuring myself. And now I am embarrassed to try because I can’t perform and I will re-injure myself.” This is devastating for a young man’s self-esteem as well as putting them in a situation where he may not have the skills to cope with the trauma of the injury and loss of personal strength. This situation creates a long road to developing pessimism and self-defeating ideas about new limitations and the loss of bragging rights, and self-esteem boosting activities with peers. In addition to the chronic long-term sadness this teen is also struggling with Post-Traumatic Stress.

Another example would be a 7 year-old boy with a diagnosed Learning Disability who struggles with making and maintaining friendships. As times goes on he tries to interact with peers but is consistently rejected, many times parents notice that he tries but left out of games and activities. Over time his already sensitive, self-esteem dwindles and he feels that he is unlikable. Parents typically see two different extremes with regards to the child’s behavior from this point. In some situations the boy will tell extravagant stories about how he has many friends and all of the dramatic interactions they have together, and on the other hand he may speak very little about his interaction with friends and report that he is liked by no one. The effects of this social situation developed long term, low level depression “Dysthymia” which later can escalate to more severe conditions such as Major Depression, Oppositional and Defiant Disorder (ODD), as well as Anxiety Disorder.

These difficulties are treatable and treatment results are long lasting but they take time. Dysthymic Disorder can be difficult to treat, especially with school age and adolescent boys because they typically do not admit any type of unhappiness due to a shortcoming or weakness. It is important that the clinician is fluent in a variety of different approaches in order to create an individualized plan of care to meet the child’s needs.
At the Success Source, Troy spends a significant amount of time creating a relationship with the child and their parents to best understand the youth’s functioning.

Oppositional and Defiant Behavior

Family stress of children with Oppositional and Defiant behavior. The importance of getting help sooner than later.

Oppositional and defiant behaviors with children can take many forms. Some children meet the diagnostic criteria of Oppositional and Defiant Disorder, Conduct Disorder, and Attention Deficit Hyper-Activity Disorder; oppositional and defiant behavior is common across multiple different diagnosis. In reality Oppositional and defiant behavior happens with most children, and it makes no difference if they have a diagnosis or not. Keeping in mind, a major feature of oppositional and defiant behavior; Sadness. Many parents may not understand the function of the behavior and desperately try various different parenting techniques, and find that many simply do not work.

Some children are extremely difficulty to redirect and at times become aggressive when they are sad/angry. Difficulties with redirection typically happen at the most inconvenient times like when grocery shopping, during homework time, and or when at church. An example would be:

A mother gets home from work and she asks her 11-year-old son to open his books at the kitchen table so that he can do his homework at the kitchen table. The mother turns her back for a few moments to start dinner, and Mother turn back around he is not at the table. She walks through the house and finds him playing his XBOX, and she reminds him “I asked you to open your books at the kitchen table. Turn off the XBOX and open your books at the table.” “Mom I’ll be there in a few minutes,” he says with frustration in his voice. His mother heads back upstairs and continue preparing dinner, and she can’t help but notice that time is continuing to go by. Now she starting to breathe heavy, walk swiftly back to his room and says, “I thought I told you to turn off the XBOX and go start your homework!” He looks at his mother and screams, “I don’t care about homework, and I’m not doing it!” His mother responds with s firm tone, “Yes you will or you will be punished. I will take your XBOX.” To which the boy cries, “No, I will do anything! No, don’t take it!” He then goes upstairs and sits at the table, and opens his books. The boy’s mother continues preparing dinner, and sees him open his books and quickly complete his worksheets and then leave the table. “Are you sure you did everything,” his mother says in disbelief that he completed the work so quickly. “Yes mom, everything,” as he heads back to the XBOX. She reviews the works sheets and then she notices that he quickly scribbled answers. “These worksheets are not completed correctly, get back here,” she says in an authoritative voice. “I did it already, I’m not doing it again and you can’t make me,” he screams from his room. She walks quickly to his room “You get off that XBOX now! I’m taking it, you’re punished and you need to do these worksheets all over again!” “I don’t care, I’m not doing it and you can’t make me, “he yells at his mother. The mother shocked at his reply says, “I can take the XBOX!” The boy responds, “I don’t care, take it. I hate you.” “Well you will have to hate me without your XBOX, and you will not get it for a month,” mother says. Then she returns to the kitchen and attempts to finish dinner. At this point she almost tears up and feels like she has eaten glass because her oldest son, her first-born, told her that he hated her.

This is a common scene in many homes. In reality the child does not need to be diagnosed with oppositional and defiant behavior in order to be oppositional and defiant. For the family as a whole, opposition and defiance can stress out everyone. The mother who has been screamed at by the oppositional child, the sibling who is embarrassed and upset by the family turmoil, and the father who is upset because his son is disrespectful to his wife and him.

There is hope; Troy has worked with hundreds of families in counseling offices as well as in their homes. Troy uses a unique approach of natural observations, Family/Individual Therapy, as well as Parent Coaching to assist families with improving their quality of life.

Childhood Social Anxiety/ Social Phobias

Childhood social anxiety and social phobias can be one of the most crippling experiences for a young person. Typically these children struggle with appropriate interaction and are excluded from normal social play. The target of bullying also has fear interacting with peers due to the potential rejection. This experience is extremely difficult for children, and can also lead to extensive sadness and depression.

As a parent, watching your child struggle with social anxiety is absolutely heartbreaking. Watching your child struggle without friends, and fear interacting with their peers is extremely difficult.

With children, Social anxiety and Social Phobias affects .5% to 5% of school-aged children and as children become adolescents’ the number affected increases to 7%-10%. I believe the number of people affected to be higher because not everyone receives help, and many struggle in silence and isolation.

Child social anxiety and social phobias directly affects family interaction. Many times parents plan ahead of time to avoid a possible occurrence of anxiety, avoid visiting anxiety provoking locations, as well as limit the family’s participation of certain activities in an effort to reduce their child’s anxiety. These accommodations are normal because, parents try their best to keep their child comfortable and happy.

Social situations are terrifying for these children. Children with social anxiety and social phobia’s typically struggle with making and keeping friends. They have difficulty speaking in an age appropriate manner and usually feel more comfortable interacting with younger peers or much older peers, and even adults.

Typical Situations that trigger social anxiety/social phobias are:

  • Meeting new people
  • Being the center of attention
  • Being watched while doing something
  • Making small talk
  • Public speaking
  • Performing on stage
  • Being teased or criticized
  • Being called on in class
  • Going on a date
  • Making phone calls
  • Using public bathrooms
  • Taking exams
  • Eating or drinking in public
  • Speaking up in a meeting
  • Attending parties or other social gatherings
  • Talking with “important” people or authority figures

Typical emotional responses these children experience are one or a combination of the following: fear of judgment by others, fear of being embarrassed, and extensive worrying about upcoming events minutes, days, weeks in advance. Noticeable physical symptoms are one or a combination of the following: blushing, butterflies in their stomach (upset stomach and nausea), sweating, feeling dizzy, trembling voice, racing heart rate, and shortness of breath. Behavioral indicators are one or a combination of the following: avoiding social situations, typically staying quiet and staying in the background, not attending an event unless a friend or buddy will be present.

If your child is struggling with these difficulties, there is hope. Troy can assist by using a combination of approaches such as coaching the child through tough social situation, role-playing appropriate responses, as well as using real life scenarios allowing the child to build confidence in their abilities to interact with peers, thus reducing their anxiety. In addition, Troy will also teach parents strategies they can use to assist their children reach success! Troy has 6 years of experience working with children with Social Anxiety/Social Phobias and has help many children reach their social goals. Contact the Success Source and we can help your child this week!