My Anxiety Plan (MAP) for Obsessive Compulsive Disorder
The following strategies are designed for you the parent to use with your child as s/he begins to tackle OCD. These strategies are best used for children with mild-moderate signs of this type of anxiety. For children with more severe symptoms or who have been diagnosed with OCD, we recommend treatment with a mental health professional, although MAP strategies can be used at home to support your child’s therapy work.
Step 1. Helping your child become an expert on anxiety
This is a very important first step, as it helps children understand what is happening to them when they experience anxiety. Teaching your child that the worries and physical feelings h/she is experiencing have a name -anxiety- and that millions of other people also have anxiety, can be a great relief. Help your child become an expert on anxiety by providing her with facts and important information.
To learn how to explain this to your child, see Anxiety 101: What You and Your Child Need to Know About Anxiety and Talking to Your Child about Anxiety and the ABCs of Anxiety: Understanding How Anxiety Works and Fight-Flight-Freeze.
Step 2: Teaching your child about OCD
- Reading or explaining some of the information outlined on the OCD main page can help your child to feel more in control of what is happening to him or her. Knowledge is power.
- Explain to your child that some children have obsessions that involve very upsetting, scary, or gross thoughts. For example, some children may have thoughts like “What if I pushed somebody in front of a car?” or “I imagined my mom getting hit by a car today; that must mean that it will happen!” A good way to help your child deal with these types of thoughts is to talk to them about obsessions. We know that everybody has unwanted or unpleasant thoughts sometimes. It is normal. However, just thinking about something won’t make it happen. For example, if you think about breaking your leg, it won’t necessarily happen. And furthermore, thinking a bad thought does not mean you are a bad person. Nor does not mean you want to do anything bad. Obsessions are just “garbage of the mind.” Unfortunately, youth almost always feel compelled to have to do something to cancel out or prevent these unwanted thoughts from happening or returning. Just like thinking certain things doesn’t make them true, and doing certain things also has no effect on whether the thoughts will happen or not. All is does is leave the youth in an endless, vicious trap of having unwanted thoughts-doing stuff-having unwanted thoughts-doing stuff…
- You can also explain to your child that his or her worry about having unwanted thoughts and feeling “forced” to do certain things to stop these thoughts from happening is like a thermostat that is set too high and the temperature makes them feel uncomfortable. Tell your child that you will work together, as a team, to give him or her tools to help cope with anxiety and gradually face his or her fears to get the thermostat back to a comfortable setting.
- Let your child know that OCD is not that uncommon and in most medium to large sized schools there are often at least 10-20 other kids with OCD. Your child is not alone.
Explaining how OCD is like a computer virus
Parent: “Let’s talk about your OCD today. One way to think about it is as a computer virus. What do viruses do to computers?”
Child: “Well, viruses can mess up the computer. Some programs might not work well, but it could also break the whole computer”
Parent: “That’s right. Well, think of your OCD as a computer virus in your brain. It can mess up certain programs, and sometimes it just shuts the brain right down. For example, sometimes you just keep washing your hands over and over again. That’s your OCD virus messing up the program that normally sends the data command <you can stop washing now>.” Other times, you just don’t want to leave the house because you are so anxious; that’s the OCD virus again. Your OCD virus turns the volume of scary thoughts up really high in your brain. So, together we need to get rid of that OCD computer virus. What do you think?”
Explaining how OCD is like a hiccup
Parent: “Let’s talk about your OCD today. One way to think about it is as a hiccup in your brain. What happens when we hiccup?”
Child: “We make a hiccup sound, and it keeps happening again and again.”
Parent: “That’s right. It just keeps coming back, and we have no control. Well, OCD is like a hiccup. You have thousands of thoughts in your head every day, but when you have an OCD hiccup, the same thought comes up again and again, and just won’t go away. For example, sometimes when you go to bed at night, your brain has an OCD hiccup. Do you know what it is?
Child: “Yes. I check all the doors and windows to make sure they are locked.”
Parent: “Exactly. The OCD hiccup in your brain tells you that you need to check again and again to make sure that everything is locked. So, together we need to stop your brain from hiccupping. What do you think?”
Step 3: Creating your child’s MAP
The best way to help your child deal with OCD is to give him or her tools that can be used to cope with the unwanted thoughts and commands to engage in rituals. These tools are intended to increase your child's ability to tolerate anxiety, rather than to eliminate anxiety. Anxiety exists everywhere, and therefore it is an illusion to believe we can eliminate the source and experience of anxiety. It is far more effective to provide your child with the tools to tolerate and cope, rather than to control and escape. For OCD, you can use any or all of the following anxiety tools to create your child’s My Anxiety Plan (MAP). These tools are listed in a recommended order, although proceeding in this order will depend on the needs and interests of your child. For OCD, Facing my Fears, will be the most important tool for your child to obtain relief from his or her symptoms.
- Talking to Your Child about Anxiety
- Strange Thoughts
- When Anxiety Becomes a Problem: What’s Normal and What’s Not
- Naming the Bully
- Changing or Delaying OCD Rituals
- Learning to Relax: Calm Breathing
- Learning to Relax: Muscle Relaxation
- Balanced Thinking
- Cognitive Coping Cards
- Addressing Excessive Reassurance Seeking
- Parent Assisted Rituals
- Exposure and Response Prevention for OCD
- Rewarding Bravery
- Overcoming Perfectionism
- Tolerating Uncertainty
- Test Anxiety Booklet
Final point: Although increased knowledge and the many tools available on this website can be very effective in helping you to manage your child’s anxiety, sometimes it is not enough. Sometimes children have very severe anxiety, and despite all your best efforts, your child might still be struggling daily with anxiety symptoms. If this is the case, seek some professional help through a consult with your family doctor, psychiatrist, or a child psychologist/mental health worker.
Please view this comprehensive list of OCD resources prepared by Dr. Juliana Negreiros.