Thursday, September 24, 2009

A Trip to the Therapist

N's OCD behaviors have been increasing significantly since school started. So last night, T & N went and met with his therapist for the first time since January. We had some new concerns because the OCD patterns have changed some. Instead of touching door jambs and holding his breath when someone "fat" is on the tv, he has started being concerned about chemical contamination, becoming autistic, becoming gay, and masturbation. Some of these are pretty tough topics - which we don't avoid, but are trying to be sensitive about how to talk with him about them. He hears his friends bring up these topics (in a less sensitive manner) and it scares him. I've been concerned about whether our reassurances "that he isn't autistic" for example, were just feeding the OCD loop. I didn't know whether to reassure/discuss (and potentially enable the cycle) or to refuse and potentially make things much more difficult.

N's therapist indicated that it was okay for us to reassure him once -- to give him the information and reduce his anxiety. But after that, if he seeks reassurance on the exact topic again, we should refer to our earlier conversation. His therapist didn't seem to think that the intense topics were indicators of larger issues, but rather were just the anxieties N was encountering at this moment.

Other than some of this new information, the appointment was just a rehash of many concepts and principles that have been addressed before. In some ways, it felt like a waste of time, but I wonder if N needs to be constantly reminded of the ways he can address the OCD.

I also suspect that the stress of a new school year is aggravating the OCD behaviors. N is doing well with his grades and assignments. I'm trying to let him be responsible for when he does his homework and the potential natural consequences of waiting to the last minute. He's had some of those consequences and it seems to make a difference. N is pushing himself pretty hard to get all As. We don't really care about his grades - just that he turns his assignments in. But he often lapses back to that typical "all or nothing" approach. He would rather not turn in an assignment than turn in one that is imperfect. In fact, last night I drew attention to the fact that he had very little time left to do his homework -- but he was so wrapped up in finding the perfect "third argument" that I could envision his essay taking another two hours (and it was already late). So I reminded him that it was better to get the paper done, turned in, and get a B - than to not have it done at all. I don't know if that helped or not.

His doctor was very surprised to see how much N had grown -- and that his voice has now deepened (I knew that it was happening, but it just isn't as noticeable when you live with him everyday).


Erica said...

Hey Wendy. Did your son's T give him exercises with how to deal with his ocd behaviors? did you discuss medication? Definitely school is a stressor for our sensitive kids ...I hope things get better. Thinking of you!

Wendy said...

Erica -

Thanks so much!

We did discuss medication. It's really the first time that it has come up. I think the idea is that we'll explore it more if things continue to worsen with the anxiety/ocd. He did go over some anxiety relievers/exercises. Not anything new, though.

Have you found any techniques/exercises that work well for your daughter?

Erica said...

My daughter's co-morbid condition was anxiety. She had very intense worries, mainly about things that she couldn't do anything about, like global warming, earthquakes. In her therapy, learning to do reality checks was something she worked on -- "is this worth worrying about or not. Do I have control over the outcome or not", that kind of thing. Also medication helped even out her emotional responses. OCD is really hard and I have heard that intense behavioral therapy can work, but I have no experience with it.

Wendy said...

Last night when he was really struggling, I had him write down a list of his worries. My suggestion was that he could leave the list on his desk and worry about it tomorrow. He suggested that he rip it up and throw it away instead. I was okay with that. It seemed to help.

Erica said...

That is a great idea! My d had a "Worry Box" that she could write down her worries and put them into the box. Later on her therapist had her start a "Good Thoughts" box, where she would put things that were positive in her life.

Wendy said...

Also good ideas. I'm going to have him try the worry box idea.

Thanks for all of your support and good suggestions.