Monday, December 7, 2015
9 yr old with OCD and anger overload
Dear Dr. Gottlieb,
We bought your anger overload manual for parents, and it described perfectly what we are seeing in our 9 year old girl who has OCD.
In your experience, are your strategies effective on kids who have anger overload from OCD? Would any of the techniques you offer need to be modified as we continue to support our daughter?
Are there any other resources you would recommend for this combination of symptoms?
Hi, A book I have found helpful in working with children with OCD is "Talking Back to OCD" by Dr. John March, a psychiatrist from Duke University. He has an approach for OCD that is similar to what I recommend for anger overload: Teach the child how to be the boss of her thoughts.
Some of my strategies are not actually taught to the child but are employed by the parents, especially at the outset, but then the child becomes a partner and is taught ways to be in control. For example, one strategy is using mantras. This is explained in some of my previous blog posts and in my two parents' manuals, and can be used for anger overload and for OCD. Mantras are ways to help children take a different perspective and thereby help them feel more in control of their anger.
The strategies in my manual can be employed with children who have OCD. Think about what some of her routines or obsessive thoughts are, and also think about what some of he anger triggers are. How much overlap is there? Does the anger come when she is being rigid and can't adapt well to the demands of the situation. Will humor and emotional distraction work to help her move on? Or will new mantras help her look at the situation differently and prevent her getting into a rigid behavior pattern?
If the problem is obsessive thoughts, and not ritualistic behaviors, try to teach her that she can be the boss of her thoughts, and maybe draw a picture or sing a tune of her "beating" the thoughts. Dr. March's book and my manuals speak to changing a child's thoughts. Practice the new mantra and admire her whenever she tries to use it. Make sure she does not expect it to work perfectly, because OCD children sometimes expect themselves to be perfect. Trying the new strategy would be the goal, whether or not it helps right away.
Do some of her OCD habits come after she is angry? Does she have negative self-talk and guilt after she explodes in anger. In that case, you can forestall the OCD by using the strategies in my manuals to lessen anger overload.
Basically, think about how the two issues overlap, and then focus on the initial triggers to to try change her response. First, you would keep an anger diary, so to speak, in order to see how the two issues interact and what some of the triggers are. Then you would look through the manuals to apply the strategies to those triggers.
Best, Dr. Dave Gottlieb