A few days ago, I received an urgent personal message from a friend. For some reason, his child, a dear happy-go-lucky daughter, has started to grow increasingly distant to her family and and irritable. Her parents are extremely worried and are not sure what to do . One thing they notice is that that she has started to wash her hands a lot more frequently … till the point that they are beginning to bleed.
You may have read of children who take things to extreme. Some children refuse to write certain numbers because the believe the numbers are evil. Some ensure that they step on certain lines as they walk on paths and some keep things till they are unable to store them anymore. What does it have to do with constant hand-washing? They are all signs of Obsessive Compulsive Disorder.
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What is Obsessive Compulsive Disorder?
You may have heard of adults who are compulsive hoarders or really sticky about cleanliness – so much so that it affects their social lives. They do things repeatedly because they are really feeling uncomfortable and repetition allows them to relieve the anxiety. In fact, it is one of the top 3 mental disorders in Singapore and affect 3% of the population here.
One little known fact is that this issue occurs at the age of 97 to 12 and it is fairly common in children.
The IMH Child Guidance Clinic runs an OCD programme for children and teens up to 19 years old with moderate to severe forms of the disorder. It sees between 100 and 200 children and teens with OCD each year. – Today Online
Children with OCD will be constantly thinking that something harmful, dangerous, wrong or dirty can happen to them. These thoughts are very hard to shake off and they will constantly be thinking about them or obsessed. The only way for them to gain relief from these thoughts will be to do things repeatedly in a ‘correct way ‘s as to relieve their anxiety.
To the child, it can a very scary experience as they do not understand why they are so. They do not comprehend the need for constant repetition of a ritual to ‘feel right’ and would need the support of the family to guide them through.
OCD interferes with Life
When there is a natural obsession to complete something repeatedly, it tends to interfere with life and make one more irritable than usual. Since they feel like they are the only ones going through this, they may have low self-esteem.
Among kids and teens with OCD, the most common obsessions include:
- fear of dirt or germs
- fear of contamination
- a need for symmetry, order, and precision
- religious obsessions
- preoccupation with body wastes
- lucky and unlucky numbers
- sexual or aggressive thoughts
- fear of illness or harm coming to oneself or relatives
- preoccupation with household items
- intrusive sounds or words
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These compulsions are the most common among kids and teens:
- grooming rituals, including hand washing, showering, and teeth brushing
- repeating rituals, including going in and out of doorways, needing to move through spaces in a special way, or rereading, erasing, and rewriting
- checking rituals to make sure that an appliance is off or a door is locked, and repeatedly checking homework
- rituals to undo contact with a “contaminated” person or object
- touching rituals
- rituals to prevent harming self or others
- ordering or arranging objects
- counting rituals
- hoarding and collecting things of no apparent value
- cleaning rituals related to the house or other items
Causes of OCD
No one knows the exact cause for OCD. It can be related to the environment or even stress. Researchers believe that the constriction of the flow of serotonin, a transmitter that relates messages to brains, can cause the brain to misinterpret information as ‘danger’ and keeps dwelling on them.
They also believe that OCD runs in families who have one or more members who also variations of anxiety influenced by the brain’s serotonin levels.
Imaging scans also show that there are structures change within the brain itself.
I suspect my Child is suffering from OCD. What should I do now?
If you believe your child is suffering from OCD, you should consider taking to see a specialist as soon as possible. Here are the types of treatments available:
- Mild to moderate OCD is the use of cognitive behavioural therapy (CBT), which may span up to 14 sessions over a three-month period
- Medication for more severe cases where they would provide serotonin
The way a teacher handles the bullying can impact a child for life. According to statistics, most secondary school students believe that their teachers are not very interested to help them if they encounter bullying. This is quite interesting how it is switched to this as they have the perception, as primary school children, that their teachers will help them.
Some possible examples is that they have watched the way how the teachers deal with complaints, shows unequal concern for different students as well as inconsistency in advocating individual rights.
You may have read this article or even heard of someone who has engaged in self-harm or also known as “non-suicidal self-injury” (NSSI). When I was teaching, self-harm was one of the top cases that our school counsellors and teachers often reported. In fact, it is actually a rising trend; it was reported in the local news in 2008, 2012 and just recently. This act is, indeed, very terrifying and it is worse if it happens to your child. However, while many of us are quick to dismiss it easily as a ‘cry for help‘ or ‘attention seeking‘, science explains why this act of self-harm actually causes feelings of pleasure in our children.
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Acts of Self-Harm
Here, we defined self-harm as literally making small cuts on his or her body, usually the arms and legs. It is an act where the child injures themselves on purpose by making scratches or cuts on their body with a sharp object enough to break the skin and make it bleed . It seems as if your child is suicidal and honestly, its appearances will terrify any parent.
Some may cut themselves on their wrists, arms, legs, or bellies. Some people self-injure by burning their skin with the end of a cigarette or lighted match. When cuts or burns heal, they often leave scars or marks. People who injure themselves usually hide the cuts and marks and sometimes no one else knows.
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Who and Why They Self-Harm
It is easy to stereotype wile and rebellious teenagers as the ones who will engage in such acts but the truth is, there is a growing number of studious and quiet girls and boys who are engaging in this act. Self-harm is an act of control where victims feel gives them power over something. Reasons for making them feeling that they have lack of self-control ranges from struggling to live up to expectations and lack of warmth from family. Some may copy these acts from their friends and stick with it as they enjoy the pleasure of cutting. People usually start self-injuring in early adolescence, between the ages of 11 and 15 (though there are some cases where children as young as 5 start hitting themselves repeatedly as well) and most of them report that it calms them and brings a sense of relief. This is most likely to occur in those who have much trouble regulating their emotions.
Science Explains Why They Feel Good in Self-Harm
Researchers conducted a brain imaging study using pictures and temperature to invoke a warmth or heat-pain sensation (set at individual’s threshold) in their participants. Those who have issues coping with emotion have heightened activation of limbic circuitry in response. The limbic system, also known as the ‘emotional brain‘ as it contains the brain’s reward circuit, is a set of brain structures that supports a variety of functions including emotion, behavior, and long-term memory. When its response is heightened during the act, it means that the brain sense the ‘cutting’ as a reward for physical pain. The amygdala ,which is part of the limbic system, is also inhabited and thus, fear is also inhibited.
Thus, some people cut themselves to provide pain relief from emotional distress due to the inhibitions of some brain regions involved in emotions.
When bullying cases surface, why do most parents claim that they were not aware of the bullying in the first place? According to the statistics below, most students prefer to tell their friends rather than their parents for various reasons.
When bullying occurs in school, the victim does not feel safe and happy. This fear can cause the victim to skip school or play truant to avoid the bully.
When I conducted the latest parent-bonding session recently, a primary 5 student scribbled her thoughts furiously on a sheet of paper while sobbing. Before this session, the child has been loud and outspoken while showing slight disrespect to her peers and facilitators. The mom was a very soft-spoken lady who obviously loved her child very much.
Yet, it was soon discovered that the child was keeping many things within herself. She wrote that she thought of attempting suicide and to be with the ‘angels in heaven’. When probed later, it was discovered that she was bullied badly in school. Although she did not skip school, she was extremely frustrated with the way things were going. The biggest issue was that most parents and teachers tend to take action only when the child starts to skip school frequently. However, as statistics show – most victims actually continued as if it was part of their daily lives.