I had the privilege of visiting with a third-grader named Faith over lunch this past winter. She is the cutest nine-year-old in the world, all eyes and sweet, sweet smile. Not kidding, you look at this little girl and think, Oh my gosh, a hug from this child could change the world.
Faith is the strongest, bravest nine-year-old I know. She has obsessive-compulsive disorder, and she is dealing AT NINE with obsessions that buckled me in my twenties. My heart just breaks when I think about the daily battles she fights, and it makes me hate OCD even more than I already do for the way it could dare to target such innocence and loveliness.How do you talk about OCD with a third-grader?
That was the question that I grappled with in the week leading up to this lunch. My OCD first appeared when I was seven, but I didn’t have the vocabulary to really discuss it until after my post-college diagnosis. I am such a huge advocate for cognitive-behavioral therapy (CBT), and while it is possible for children to go through CBT, it gives me pause: when it nearly snapped me in half at age 26, is it even reasonable to expect someone one-third of that age to try something like it?
What we ended up talking about was the narrative therapy that I practiced on myself and my OCD. Narrative therapy reminds us that the person is not the problem; the problem is the problem. I chose to separate myself from my OCD by imagining it as a black dot that followed me around … and I got the upper-hand by belittling it. Most often, I would “dress” it in a pink tutu and make it twirl around. My OCD hated this.
Perhaps this sounds strange to you, but it was a good strategy for me … and hopefully for children too. Faith was intrigued by the idea of the black dot, and I told her, “It’s okay to bully the black dot because it’s so mean and it’s a liar. So you get to bully it back.”
I tried to incorporate elements of ERP (exposure and response prevention) therapy into our conversation as well. I told her, “When the black dot tells you that you have to have your locker clean before you go to your next class, you can ignore it because it’s a liar. And when you feel like you need to wash your hands again, just to be safe, you can ignore the black dot because it’s a liar and a bully. Instead …”
“… I tell it to put on its tutu!” she said, giggling.
Just last month, I had the opportunity to get coffee with 11-year-old Madeline and her parents. Madeline is a bright-eyed, funny, precocious young girl who developed a sudden onset of OCD a few months ago, and she has been courageously diving headfirst into ERP. “I hate it,” she told me. “I have to say bad words, and they make me feel so guilty.”
We talked about how no one seems to understand either OCD or the crazy, seemingly backward therapy that is the best weapon against it. We compared it to chemotherapy: no one likes it, it sometimes appears to be making the situation worse, but it really is the medicine that heals us. I tried to make it clear to Madeline that when her parents enforced her evening exposure therapy, it was because they loved her and were just making sure she took her medicine.
It was clear to see how worried Madeline was about her exposure therapy; she was especially concerned that it was sinful or that she might end up liking her exposures one day. I tried to level with her that she would probably never enjoy going through ERP—but that one day she would be glad that she had gone through it. She is a special girl and so blessed to have parents who are 100% on board with ERP.
I remember being that young, remember overthinking every single thing, remember the obsessions and the intrusive thoughts and wondering why no one else my age thought about these same kinds of things. I am so glad that Faith and Madeline have a name for OCD at such young ages, but I am deeply saddened that they have to struggle. My heart hurts for all obsessive-compulsives but today especially for the young ones, who are so confused, who feel so guilty, who are so scared.
I wish I could tear through the lies and fear for them, show them truth. I am trying. Grade-schoolers should be thinking about best friends, recess, and pencil collections—not carrying the weight of the world on such tiny, tiny shoulders.
For more information about talking to kids about OCD and ERP, please visit www.OCDinKids.org.