How to Talk to Your Child About OCD

01 Discussing mental illness with a child requires a different approach than adults. However, many parents might be surprised how easily their children can grasp certain concepts when explained in a relatable way.

02 In this article, Nathalie Maragoni, a therapist based in California, offers some recommendations for teaching children about intrusive thoughts and anxiety.

03 You can keep up with Nathalie on Instagram at @mindonfire_ocd

Children battling OCD are often afraid and confused. However, with the right guidance, they have the capacity to both understand their OCD and overcome it. As parents, it’s your responsibility to support them on their recovery journey and help them understand what’s going on. Below are some recommendations for discussing and combating OCD with your child.

Explaining normal anxiety vs. OCD anxiety

As uncomfortable as it is to feel anxious or afraid, fear is our brain’s way of letting us know we’re in danger. It signals us to be alert and respond accordingly. A healthy level of fear is necessary to keep us safe.

However, the anxiety that comes with OCD is your child’s healthy warning signal gone haywire. In essence, the signal your child is receiving is a false alarm. Explain to them that OCD can cause scary thoughts, pictures or urges that get stuck in their mind. Let them know that these scary thoughts are like a fire alarm going off when there is no fire, and that although it’s hard to believe, they aren’t in any danger.

Teach your child how to let fear be present

Most people would agree that fear is uncomfortable and that we want to get rid of it when it shows up. If this is the narrative we tell ourselves, you can bet it’ll be the narrative our kids learn. The saying “what you resist, persists” rings true here. The more you push fear away, the stronger it comes back. The key is to teach your child that scary thoughts are just thoughts - they aren’t actually dangerous and don’t need to be pushed away.

Discuss shame and guilt

Kids who have OCD oftentimes feel shame and guilt as a result of their obsessions and compulsions. It is important that your child understands that even people who don’t have OCD get “weird” thoughts. Tell them: “Your thoughts are no different than the thoughts everyone else has, your's just get ‘stuck’ sometimes.” Remind your child that these thoughts are a false alarm, and that they don’t make them weird, dangerous or different.

Explain “sticky thoughts”

It can be helpful to use visuals - like silly putty or play dough - when discussing OCD with children. Stick the putty to something and demonstrate that having OCD is like having “sticky thoughts.” These thoughts aren’t good or bad, they just cling to us when we don’t want them to. Say, “These thoughts get stuck and really scare you. Our job is to help them get unstuck by practicing being afraid and not doing (insert your child’s compulsion here).” Let your child pull the putty free and practice “unsticking” it from the object.

Teach your child about obsessions and compulsions

Keep it simple… obsessions are the “sticky thoughts” and compulsions are what makes the “sticky thoughts” feel better momentarily. Compulsions are like the “bad guys in disguise” - they don’t actually help, but they pretend to!

Teach your child about Exposure and Response Prevention (ERP) and why it works

Let’s play school! Have your child pretend to be the “teacher” and your child’s brain be the “student.” Say: “Right now, your brain is sending off alarms that feel real. Let’s teach your brain that these alarms are just false alarms. You can do this by practicing facing your fears without doing compulsions.”

Use your child’s actual compulsions as an example. Have them “teach” their brain, that doing compulsions is like convincing themselves that these alarms are real. Have them tell their “brain” that these alarms don’t deserve our attention. They can even give their “brain” the homework of resisting a compulsion. This exercise doesn’t only encourage your child to engage in ERP, but has them repeat what they’ve learned back to themselves in order to increase their understanding.

Starve the OCD

Teach your child that compulsions are what feeds the OCD and makes it worse. To demonstrate this, ask your child to draw a picture of the OCD (perhaps a monster) standing next to his or herself. Teach your child that the compulsions are feeding the monster and making it stronger. Say, “When we face our fears and resist doing compulsions, we are taking away the monster’s food and starving it.” Enforce the idea that we want to weaken the OCD by taking away its food (compulsions) and strengthen the child by facing fears.

Teach your child that it’s OK to be scared

Teach your child that bravery is not the absence of fear. Rather, bravery is doing scary things even though they’re scared. If your child is crying while doing an exposure, that’s bravery!

Model doing scary things

Normalize fear for your child by doing things that scare YOU! For example, if you’re afraid of elevators, purposefully ride elevators and teach your child that you are practicing facing your fears. Your child will pick up on these behaviors and be more likely to want to face their own fears if they see you facing yours.

Resist giving in to compulsions

Seeing your child suffer is hard. You want nothing more than to comfort them and give them all the reassurance in the world. Unfortunately, giving reassurance is another compulsion that feeds OCD. As a parent, it’s important to resist getting sucked into your child’s compulsions. No matter how much your child understands the ERP process, when they are scared and want you to give in to a compulsion, nothing else will matter. Your child understanding why you’re not giving into their compulsions is vital. You may get accused of being “mean” in the process. Remind your child that you want to help them starve their OCD.

A note to parents…

One of the best things you can do for your child is encourage them to face their fears. As a parent, you may want to accommodate your child’s compulsions because it is difficult for you to watch them feel fearful and uncertain. Although compulsions provide temporary relief, they ultimately strengthen OCD. To help strengthen your child and weaken the OCD, practice tolerating anxiety together without doing anything to solve it. Most importantly, have compassion for your child - this is scary work for them! You can empathize with them by saying, “I know you’re afraid. You can feel afraid and still do scary things.”

Nathalie Maragoni is an Associate Marriage and Family Therapist in California. You can learn more about her work on Psychology Today here, or by following her on Instagram.