Ask a Psychiatrist and Get Answers to Mental Health Questions ASAP
Good morning and welcome to JA.
Normally, I would say that a 6, 7, 8 year old boy who is "obsessed" by particular things is pretty typical.
However, the content of your son's obsessions are more reflective of an underlying problem.
Please understand that it is unethical to diagnose 3rd party over the internet... but I suspect that (given the intensity and content you report) that there may be some OCD (Obsessive Compulsive Disorder) kinds of processes going on.
Some youngsters with neurodevelopmental disorders (such as a pervasive developmental disorder or mild autism) may also demonstrate these behaviors...
but among pediatric populations, the "overall" of symptoms (OCD, ADHD, ASD, etc) is often so pronounced that it's difficult to say what is happening for certain.
In any event... OCD (even among pediatric populations) is one of THE MOST TREATABLE conditions!
In some cases, medication (typically an SSRI) is warranted.
But, again even among pediatric patients, a cognitive behavioral technique called Exposure with Response Prevention (ERP) has been demonstrated to be one of the most effective treatments available. Some research evidence shows improvement after as few as four sessions (although those first 4 sessions can be pretty "bumpy"!)
CBT is a very specialized form of therapy that is provided by a Psychologist, Counselor, or Social Worker with specific training in CBT. Unlike traditional "talk therapy," in which a patient may stumble upon a cure once s/he gains enough insight into their problems, CBT uses specific strategies and methods to change thoughts/feelings (cognitions) and actions (behaviors) that lead to the disorder (in this case, OCD). Very few therapists will work with a JUST THE CHILD (although there will be independent work done with them..)... because the child lives in a FAMILY. So, the best source for you to explore is a family--based cognitive behavioral therapists.
ERP has been demonstrated to significantly alleviate cognitions and behaviors related to OCD in a very brief period of time. (Some research suggests that ERP may even be *more* effective than medication for the treatment of OCD!)
I would strongly urge you to speak to your physician about your plan to see a Cognitive-Behavioral Therapist who can provide ERP (the best) or at least CBT to you to address your OCD. Make sure your physician is willing/able to team with the mental health professional providing the treatment. As you experience changes that may well happen after you commence ERP, the doctor will need to be made aware of this, in the event that medications may need to be changed.
When searching for your mental health therapist (again Psychologist, Counselor, or Social Worker) is would be very specific about your needs. Ask them if they employ Cognitive Behavioral Therapy. Have they ever worked with someone with OCD? Have they ever used the Exposure with Response Prevention technique to address OCD symptoms? You might have to do a little "shopping around," but it's OK for you to be demanding about your health care! YOU DESERVE IT.
Finally, you should know that, of all the mental diseases, anxiety and depression are among the most successfully treated. And among anxiety disorders, OCD and phobias are the most responsive to CBT/ERP! You have a great deal to be hopeful about! I hope you are successful in finding a qualified CBT therapist to address your concerns.
I know this is a lot of information at once... but there ARE specialists available to treat this condition.
Oh... I see you're on. I'll wait to see if there are other specifics.
Oh dear, I preferred your first sentence, but I was worried that this was like OCD. I'm not keen on medication at all, especially so young. Tell me more about ERP and what else I could do myself.
Oh, just got the rest of your message thank you
I know... I liked my first sentence a lot better too.
But I'm afraid that the content and intensity of your son's presentation *may* suggest OCD.
Of course, I can't diagnose over the internet, without having seen your son... so your first step will be to see a child/pediatric psychologist to be certain.
Are there other questions that I can try to address?
What would happen if I waited for a bit to see if he grows out of it?
Well, I suppose that's a possibility.
...but not necessarily a likelihood.
Would the treatment be more effective if started sooner?
And, please understand, if you provide developmentally appropriate ERP, THERE MAY BE NO NEED FOR MEDICATION whatsoever!
Well, the question is... the longer your son persists in the obsessions or compulsions, the more he learns that they are a "necessary" part of his life. ERP helps kids (well, anyone... not just kids) learn that the obsessions/compulsions are NOT necessary.
I really don't like the idea of being pushed into medication. If we go to see someone and don't want to go down that route, may we refuse?
Yes that is helpful
Absolutely! You don't have to do ANYTHING you don't want to do with your son.
Explain that you've done some research and have learned about ERP... and would like to try that with a qualified psychologist first.
It won't get taken out of our hands then, once the experts are involved?
(I would encourage you to search some online for this process/procedure.)
As parents, you have to grant consent for ALL assessments and treatment.
Now, you may have to be assertive! You might have to say, "No! I don't want this..." <or> "I want A,B,C."
But nobody can do anything with your child without your consent.
That's a relief!
How might it have started?
Some kids I've treated with ERP have found it actually sort of fun. And they experience relief quite quickly.
What is 'quite quickly' - weeks? months?
The question of how it started is one that I really can't answer... (not knowing you or your son)... but I don't think it's related to the moves from country to country.
Are there typical causes?
Research has indicated that, while the first 4-5 sessions of ERP can often be "rocky..." by session 4-5, individuals have essentially learned "Oh, gosh - what was I *thinking*!" and apply a host of new skills to eradicate the problem.
They will often continue for several (4-5) sessions beyond this to be certain that the treatment has "held."
There may also be monthly follow-up to be certain that all is well. (Sometimes individuals with OCD may develop other fears or anxieties that may need to be monitored.)
What age group is ERP mostly used on? (Is 7 normal?) Give more detail on 'rocky' please...
ERP can be used on pediatric through geriatic populations. I have conducted ERP sessions with children (and their parents) for kids as young as 5 years old.
Well, when I say rocky, please understand what ERP is asking the client to do...
Let's say a client is obsessed with touching doorknobs 4 times in quick succession before walking through a door.
A typical session would involve:
teaching physiological relaxation techinques
Having the individual walk toward the door in a relaxed state
allowing the individual to touch the doorknob JUST ONCE (not the "necessary" 4 times)
and them having them walk through the doorway.
on the otherside of the doorway, the relaxation techniques are reapplied.
So... those first 3-4 sessions can be a little "rocky" because we're asking an individual to STOP doing what they think is necessary... and it often makes them very anxious.
Once they get through it enough times, they realize, "Oh! Wow! What I thought was necessary ISN'T!"
With a caring, gentle, developmentally appropriate therapist, it's very simple and straightforward.
Yes I see
So, I've very hopeful for your son!
Thanks for writing in to JA. I hope you understand that we're fast approaching the end of the time I can provide right now.
Thank you very much. I suppose you are more used to all this than I am. It has been very disturbing to have my fears confirmed but very informative. I shall talk it all over with my husband and plan our way forward.
I'm very grateful for the amount of information you have given and for your friendly approach
Thanks to you. Don't worry... all will be well. Check out resources online on Pediatric OCD... very helpful.
Best of luck to you and your family.
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Yes. Thanks again and bye!