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I have a son that is 15 years old. He has Tourette's and ADHD and they have been managed well by my wife and I and his teachers at school. He also has Auditory Processing Disorder.

Some of the problems we deal with on a daily basis are constant movement, fidgeting, and vocalizations. He doesn't understand body language, many social norms, sarcasm, among other things. He is in a Collegiate High School and has A's with a few B's.

On top of these problems that have become normal in our household, he recently started having problems with OCD. It emerged and escalated very, very quickly. In a matter of 1.5 months he went from what was his normal day to day to his constant fixations, ruminations, and the need to talk to us about them all the time.

He will fixate on something that disturbs him and he can't let it go. He started doing things like rubbing his hands together until he got blisters. He is not intentionally harming himself, he is just doing things compulsively to deal with the obsessive thoughts.

Then the OCD took a serious turn and his obsessions become sexual in nature. And he will see someone, and the thought comes to him, "why did I look at that person" or "I just noticed X body part". He then questions why he looked and if he is attracted to it. It includes members of the family including grandchildren. He is extremely disturbed by this and one of his compulsions is to constantly want to talk to us about what is bothering him.

He is in our bedroom first thing in the morning, he talks first thing when he gets home from school, and every night before bed. We have explained to him that it is the OCD, that he isn't attracted and that articles we have read and printed for him explain that because they disturb him he isn't thinking about it because he is attracted.

Sexual Obsessions and OCD explains what he is dealing with to the letter. Some portions of that are below:

Sexual obsessions can take many different forms. One of the most common is related to homosexuality. A girl who is heterosexual might become obsessed with the idea that she is gay. She might have every reason to believe she’s straight — she has always had crushes on male movie stars, she might even have a boyfriend — but she starts to wonder: What if I’m gay? What if I’m attracted to that girl — does that mean I’m gay? Kids with this obsession might try to “test” themselves by looking at pictures of pop stars and trying to evaluate whether they find them to be attractive or not.

Or a child might worry that he has done or will do something sexual without consent. This can be something as small as worrying that he has offended a peer by inadvertently brushing against her in a crowded hallway. Or he might be plagued with worrying that he might commit rape. He might have zero desire to actually commit rape, but the possibility that he might is terrifying to him. He might walk with his hands in his pockets and keep a larger distance than is normal from people, to lower the risk that he might do something inappropriate.

People with sexual obsessions might also worry that they have taboo sexual desires such as pedophilia or incest. Just as in the other examples, they don’t actually experience these desires, but they are disturbed by the possibility that they might. These kids might avoid being alone with family members, or avoid being alone with children, at all costs.

And

“Like other obsessions, the difference is when kids have them they cause a lot of anxiety and distress and avoidance of the situations that cause the thoughts,” explains Dr. Bubrick. “Pedophiles actively seek out situations to be alone with children and like those experiences, whereas someone with OCD who has those obsessions will feel extreme guilt and shame. They’ll avoid those situations and feel horrible about themselves just for having the thought.”

He starts therapy next week, and I have a psychiatrist appointment for him in two weeks. The question is how do my wife and I deal with him on a daily basis? While we understand the condition it is getting increasingly difficult for us to hear him say the disturbing things that pop into his head as he continues to fixate. Mind you, these are thoughts that include kids from school, church, and people in his immediate family. It is constant and relentless, we feel so badly for him, we are very worried. We spend at least 2 hours a day talking to him. It is affecting relationships all around. It is draining us and we are almost to a breaking point, which he won't deal well with.

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    I had to say this, you guys are great parents creating a conducive environment for your son. I hope you guys get a solution and be well. – timon pumba Oct 24 at 11:39
  • @timonpumba, thank you for your kind words. We have 7 children (he is the 6th) and we often feel like the opposite of good parents. This weekend is our 25th wedding anniversary, we have had plans to go out of town for many months. His mother is having a lot of anxiety now about leaving him. I can't find a balance it seems. – DRT Oct 24 at 12:19
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    Normally, good parents often feel like they are parenting badly, even though they are not. It's an empathetic response to the troubles of your children and a natural tendency of parents to blame themselves for their children's problems (just as the opposite - to take credit for their successes - is erroneous.) It's when you have complete confidence in what you're doing that you're likely not giving it enough thought. – anongoodnurse Oct 25 at 14:44
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it is getting increasingly difficult for us to hear him say the disturbing things that pop into his head as he continues to fixate.

You can't change his intrusive thoughts, but you can reassure him that they are not a true representation of him as a person, or what he really wants. Intrusive thoughts are just that, unwanted thoughts that intrude into our normal thoughts.

Almost everyone has had an intrusive thought or two. Anyone who has worried that they will start to yell or laugh for no reason in church or in an important meeting and will embarrass themselves has had one, as have people who approach the edge of a precipice and suddenly are afraid they will impulsively jump off. People may suddenly imagine themselves pushing someone into the path of a train or car. New mothers might imagine harming their infants.

You will get more help from the therapist and the psychiatrist (I hope) than here, but I would say you might help him by reminding him (and yourselves) that these thoughts are just thoughts, not an indication of bad character, and normal for all people, but worse in people with OCD. They do not really mean anything. It's just a symptom of a certain mental illness (absolutely no judgement attached; there should be no stigma to further burden the mentally ill.)

Wile you are distressed by is thoughts, please know that they are far more distressing to him. They are draining you, but they are torturing him. Please let him continue to express his thoughts to you until he can start expressing them to his therapist. Then work out a treatment plan with the therapist where you hear only the ones he really needs to express for some reason. That he is neuroatypical may make this harder for you than other parents.

It might help to have a de-escalation "mantra" to repeat as he vocalizes his concerns. It might go something like this (modify as needed):

I know that these thoughts are scary. It's like a "brain tic"; you care about something and it's getting twisted up somehow. It doesn't mean you're a bad person and it doesn't mean you'll do something you're afraid of doing. It's just a thought. It will pass.

If you give the same response and don't get into discussions about it, he might let it go sooner, or at least stop verbally engaging for overly long ruminations.

Him: I'm afraid I'll kill the cat.

You: Sweetheart (or chosen loving nickname), you won't kill the cat. You're having an intrusive thought, which is part of an illness you have. I know that these thoughts are scary. It's like a "brain tic". It doesn't mean you're a bad person and it doesn't mean you'll act on it. It's just a thought. Take a deep breath and it will pass.

Him: But what if I do kill the cat?

You: Sweetie, you're a good person. You won't kill the cat. You're having an intrusive thought. It's like a brain tic. You won't act on it. It's just a thought. Take a deep breath and it will pass.

Him: But why am I thinking that then?

You: Because you're having a problem like your Tourette's, but it's a brain tic. It doesn't mean you're a bad person and it doesn't mean you'll act on it. It's just a thought. Take a deep breath and it will pass. What were you doing when it came?

Him: I was reading Harry Potter, but...(expresses a concern)

You: It's just a thought, it will pass. How about going back to your book? It's a good book.

Him: What if...(expresses a concern)

You: It's just a thought. You're a good person.

Him: But I'm not! (expresses a concern)

You: It's just a thought; Deep breath.

The professionals are really the people to ask about this. I have one child with OCD, but it was/is mild and easily managed by establishing routines. Telling them that their fears were supposed to be irrational and scary helped them to let them go more quickly, and we established routines (or rather rituals which had to be adhered to) which comforted them.

I'm sorry I can't provide more insight into how I as a parent handled my child's OCD.

  • Thank you for your answer. I will wait for further answers. This is actually what we are currently doing. It may still end up being the answer, our problem is that I think we are delivering it poorly. Maybe it is because of his other conditions, but he latches on to certain things we say and misconstrues their meanings. Almost without fail, this makes the problem worse. – DRT Oct 24 at 12:15
  • For example, there was a bad behavior he was doing that he had stopped for 24 days, we said to him 2 days ago that it seemed that his OCD got worse since he stopped that habit - the next morning he came to us shaking and in tears saying he had done it to see if it would help. We know that this is a part of the process for him, he is testing and then from us wanting reassuring, but it made him much much worse for the last 2 days – DRT Oct 24 at 12:16
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    I would recommend that you treat it as a process, not assessing the outcome. People have no control over OCD (that's why it can be so disturbing to them), so apprising it (better/worse) is not fair (it's complicated.) I'm glad he came clean; handling it on his own is not something he can do just yet, but he will get there, maybe less quickly because of his ADHD. Just be there for him until you can start getting better advice from a professional. I added a link; it's ok, but the first page is really helpful. – anongoodnurse Oct 24 at 13:27
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    This is a good video, but I'm posting it as a comment, not in the answer, because it recommends a purchase at the end, sites which I don't usually advocate. But it does show the reasoning behind labeling and letting go. – anongoodnurse Oct 24 at 14:26
  • Thank you for the link, I will look at it after work, and for the update with the dialog example. – DRT Oct 24 at 16:49

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