How to help my child that has OCD with Sexual Obsessions?
I have a son that is 15 years old. He has Tourette's and ADHD and they have been managed well by my wife and I and his teachers at school. He also has Auditory Processing Disorder.
Some of the problems we deal with on a daily basis are constant movement, fidgeting, and vocalizations. He doesn't understand body language, many social norms, sarcasm, among other things. He is in a Collegiate High School and has A's with a few B's.
On top of these problems that have become normal in our household, he recently started having problems with OCD. It emerged and escalated very, very quickly. In a matter of 1.5 months he went from what was his normal day to day to his constant fixations, ruminations, and the need to talk to us about them all the time.
He will fixate on something that disturbs him and he can't let it go. He started doing things like rubbing his hands together until he got blisters. He is not intentionally harming himself, he is just doing things compulsively to deal with the obsessive thoughts.
Then the OCD took a serious turn and his obsessions become sexual in nature. And he will see someone, and the thought comes to him, "why did I look at that person" or "I just noticed X body part". He then questions why he looked and if he is attracted to it. It includes members of the family including grandchildren. He is extremely disturbed by this and one of his compulsions is to constantly want to talk to us about what is bothering him.
He is in our bedroom first thing in the morning, he talks first thing when he gets home from school, and every night before bed. We have explained to him that it is the OCD, that he isn't attracted and that articles we have read and printed for him explain that because they disturb him he isn't thinking about it because he is attracted.
Sexual Obsessions and OCD explains what he is dealing with to the letter. Some portions of that are below:
Sexual obsessions can take many different forms. One of the most common is related to homosexuality. A girl who is heterosexual might
become obsessed with the idea that she is gay. She might have every
reason to believe she’s straight — she has always had crushes on male
movie stars, she might even have a boyfriend — but she starts to
wonder: What if I’m gay? What if I’m attracted to that girl — does
that mean I’m gay? Kids with this obsession might try to “test”
themselves by looking at pictures of pop stars and trying to evaluate
whether they find them to be attractive or not.
Or a child might worry that he has done or will do something sexual
without consent. This can be something as small as worrying that he
has offended a peer by inadvertently brushing against her in a crowded
hallway. Or he might be plagued with worrying that he might commit
rape. He might have zero desire to actually commit rape, but the
possibility that he might is terrifying to him. He might walk with his
hands in his pockets and keep a larger distance than is normal from
people, to lower the risk that he might do something inappropriate.
People with sexual obsessions might also worry that they have taboo
sexual desires such as pedophilia or incest. Just as in the other
examples, they don’t actually experience these desires, but they are
disturbed by the possibility that they might. These kids might avoid
being alone with family members, or avoid being alone with children,
at all costs.
And
“Like other obsessions, the difference is when kids have them they
cause a lot of anxiety and distress and avoidance of the situations
that cause the thoughts,” explains Dr. Bubrick. “Pedophiles actively
seek out situations to be alone with children and like those
experiences, whereas someone with OCD who has those obsessions will
feel extreme guilt and shame. They’ll avoid those situations and feel
horrible about themselves just for having the thought.”
He starts therapy next week, and I have a psychiatrist appointment for him in two weeks. The question is how do my wife and I deal with him on a daily basis? While we understand the condition it is getting increasingly difficult for us to hear him say the disturbing things that pop into his head as he continues to fixate. Mind you, these are thoughts that include kids from school, church, and people in his immediate family. It is constant and relentless, we feel so badly for him, we are very worried. We spend at least 2 hours a day talking to him. It is affecting relationships all around. It is draining us and we are almost to a breaking point, which he won't deal well with.
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it is getting increasingly difficult for us to hear him say the disturbing things that pop into his head as he continues to fixate.
You can't change his intrusive thoughts, but you can reassure him that they are not a true representation of him as a person, or what he really wants. Intrusive thoughts are just that, unwanted thoughts that intrude into our normal thoughts.
Almost everyone has had an intrusive thought or two. Anyone who has worried that they will start to yell or laugh for no reason in church or in an important meeting and will embarrass themselves has had one, as have people who approach the edge of a precipice and suddenly are afraid they will impulsively jump off. People may suddenly imagine themselves pushing someone into the path of a train or car. New mothers might imagine harming their infants.
You will get more help from the therapist and the psychiatrist (I hope) than here, but I would say you might help him by reminding him (and yourselves) that these thoughts are just thoughts, not an indication of bad character, and normal for all people, but worse in people with OCD. They do not really mean anything. It's just a symptom of a certain mental illness (absolutely no judgement attached; there should be no stigma to further burden the mentally ill.)
Wile you are distressed by is thoughts, please know that they are far more distressing to him. They are draining you, but they are torturing him. Please let him continue to express his thoughts to you until he can start expressing them to his therapist. Then work out a treatment plan with the therapist where you hear only the ones he really needs to express for some reason. That he is neuroatypical may make this harder for you than other parents.
It might help to have a de-escalation "mantra" to repeat as he vocalizes his concerns. It might go something like this (modify as needed):
I know that these thoughts are scary. It's like a "brain tic"; you care about something and it's getting twisted up somehow. It doesn't mean you're a bad person and it doesn't mean you'll do something you're afraid of doing. It's just a thought. It will pass.
If you give the same response and don't get into discussions about it, he might let it go sooner, or at least stop verbally engaging for overly long ruminations.
Him: I'm afraid I'll kill the cat.
You: Sweetheart (or chosen loving nickname), you won't kill the cat. You're having an intrusive thought, which is part of an illness you have. I know that these thoughts are scary. It's like a "brain tic". It doesn't mean you're a bad person and it doesn't mean you'll act on it. It's just a thought. Take a deep breath and it will pass.
Him: But what if I do kill the cat?
You: Sweetie, you're a good person. You won't kill the cat. You're having an intrusive thought. It's like a brain tic. You won't act on it. It's just a thought. Take a deep breath and it will pass.
Him: But why am I thinking that then?
You: Because you're having a problem like your Tourette's, but it's a brain tic. It doesn't mean you're a bad person and it doesn't mean you'll act on it. It's just a thought. Take a deep breath and it will pass. What were you doing when it came?
Him: I was reading Harry Potter, but...(expresses a concern)
You: It's just a thought, it will pass. How about going back to your book? It's a good book.
Him: What if...(expresses a concern)
You: It's just a thought. You're a good person.
Him: But I'm not! (expresses a concern)
You: It's just a thought; Deep breath.
The professionals are really the people to ask about this. I have one child with OCD, but it was/is mild and easily managed by establishing routines. Telling them that their fears were supposed to be irrational and scary helped them to let them go more quickly, and we established routines (or rather rituals which had to be adhered to) which comforted them.
I'm sorry I can't provide more insight into how I as a parent handled my child's OCD.
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