Anxiety disorders are the leading diagnostic category for children.  Obsessive Compulsive Disorder (OCD) affects one million children in the USA (National Alliance for the Mentally Ill).  Neuroimaging has helped us further understand OCD.  PET scans indicate higher glucose levels with those struggling with OCD.  These higher glucose levels indicate increased activity in frontal lobes of the brain which are involved in executive functioning.

There is a subgroup of individuals with OCD that appear to have symptom onset triggered by streptococcal infections commonly referred to as strep throat.  These Pediatric Autoimmune Neuropsychiatric Disorders associated with streptococcal infection (PANDAS) must also receive treatment for the infection in addition to other interventions.  Sometimes the obsessive compulsive behavior will remit after the infection is treated while other times further psychological intervention is needed.

Many people spend their days obsessing on things.  Our brain is great at bringing up information that we may not want to attend to.  Often times when we have gone through a conflict then our brain will bring up this conflict over and over.  Our brain wants us to heal from the conflict or solve the problem that created the conflict.  Our central nervous system can change and improve when we allow it to and when we use this system in a healthy way.  There are some people that struggle with overactive frontal lobes and may have persistent ideas, thoughts, or impulses that are not relevant to learning.  These ideas are senseless and when we pay attention to them these ideas do not create positive change in the brain but only reinforce the pattern of attending to senseless ideas.  For example, a child may have learned that it is important to wash his hands to get rid of germs and instead of learning this and using this method in a healthy way he may begin washing his hands repeatedly to avoid germs.  A simple way of saying this is that his brain may take the information to the extreme. 

Common rituals for people struggling with OCD include feeling a need to repeatedly check things, count things, or touch things (especially in a particular sequence).  Many people with OCD struggle with obsessions that commonly include frequent thoughts of violence or harming loved ones which are considered as distressing.  In my experience, people with OCD are often trying to protect themselves or others but when engaging in compulsions they end up hurting their relationships.

Adults struggling with Obsessive Compulsive Disorder view their obsessions as intrusive, senseless, or time-consuming and experience increased anxiety in the presence of these obsessions.  However, children often do not have this insight since their behavior may be more troubling to others than to themselves.  These obsessions and impulses interfere with school performance and social relationships.  Attempts to ignore these thoughts or impulses have failed, and repetitive and excessive behaviors are done to prevent discomfort.  This creates a dysfunctional cycle that is difficult to change.

Strategies for Obsessive Thinking

There are many strategies that are helpful in dealing with obsessive thinking.  Try these strategies if you are struggling with obsessive thinking.  It is important to remember that the Central Nervous System (which of course includes your brain) does not benefit from trying to control your thoughts.  When people try to control their thoughts, they may feel more anxious because it is not possible to subtract a thought from your Central Nervous System.  It may be important to redirect your thinking and energy when needed.  Do some activities that use large muscles (e.g. arms and legs).  Take a walk!  These activities help your mind refocus due to engaging your five senses.  If you can notice your five senses as you walk, then this offers information for your brain to refocus on.  For example, during a walk you may notice the smell of flowers, the sound of your footsteps, the feel of the breeze on your skin, the sight of fluffy white clouds, and perhaps the taste of the drink of water that you brought along for your walk.  These techniques help ground you into your experience of the walk and most of all help get you out of your head.

It may help you to remember that thoughts are different from actions.  Thoughts do not have to be followed by actions.  It is important to value the privacy of thoughts.  We all have many thoughts throughout the day.  These thoughts are based on our learning experience, so people with OCD may have many unwanted thoughts due to their overactive frontal lobes.   You are not to be judged by your thoughts.  You are not your thoughts.  It is important to attend to the actions that you would like to engage in, choosing behaviors that are healthy for you.

It is important to care for yourself.  Thoughts tend to be worse when you are tired or have not eaten a balanced meal.  You need to rest and eat healthy.  If you have tried these strategies and cannot find relief from your obsessions and compulsions, then it may be important for you to receive treatment from a psychologist who specializes in treating Obsessive Compulsive Disorders.

 Treating the OCD Cycle

There are many ways that treatment can help a child or adult no longer engage in the OCD cycle.  As you can see by the cycle depicted, when anxiety is experienced, persons with OCD engage in obsessions that lead to the compulsions.  For example, a boy may worry that germs may kill people and obsess about the dangerousness of germs.  This obsession leads to him making sure people are safe by washing his hands.  After this compulsive behavior, he may experience a brief period of relief but this is soon followed by Anxiety due to reinforcing his obsessive ideas.  He may think that since he washed his hands that no one got sick in his family so he then has to continue this cycle.  He was not able to experience that if he did not wash his hands repeatedly that his family would not have gotten sick anyways.  Usually over time this cycle gets so reinforced that the compulsions increase in frequency over time. 

For treatment to be effective it is important to reduce the time involved with obsessions and compulsions by creating behavior commitments.  The behavior commitments are based on the person’s values and life goals.  Other times it can be important to resolve key life or family conflicts and the emotional stress that fuels obsessive-compulsive behavior patterns.  Treatment can be effective and works to develop the ability to function daily with less interference from compulsions.