ERP causing anxiety ?

[Beth S]

Hi!

So, my 10 year old son has been seeing an ERP therapist for almost a year and  the improvement is happening when we aren’t doing the ERP work or by coincidence.

 

In other words, I was intense , and I made it a priority to do ERP initially  , but my son hated it , wasn’t motivated, and we were both so miserable. Since taking a breather and not focusing or talking about OCD, my son seems a lot better. Coincidence? I think the  ERP caused him so much anxiety that maybe we should work on relaxation techniques first before trying ERP again?

When my son is less anxious, his OCD is less noticeable.  Focusing on his OCD and doing ERPs made him more anxious which made his OCD worse. Am I wrong? Does ERP only work if you’re motivated? Does grinning and bearing it do anything?

Things have been happier and calmer since we have done nothing except that I don’t accommodate and throw in a thing here and there he doesn’t like…

I feel guilty not doing more but it seems like the more I tried to fix it, the worse it got! My son functions with OCD. It doesn’t impact his day to day that we can notice but I am scared that we shouldn’t let this go but when we step it up, he gets worse ?!

 

Thoughts?

[Natasha]

Hi Beth,
I think working on the education piece and building motivation before starting ERP is so key. Kids need to know why responding to OCD grows it and is harmful long term vs just doing exposures. They also need to be motivated and cheered on. Bravery points and incentives help with this. It is also important for the steps to be small enough that they don’t overwhelm the child, but put them to the edge of discomfort. The idea is to build their skills for a life time.

ERP can cause anxiety – the very nature of exposures is to sit with discomfort which is often anxiety. But it is a balancing act of finding the edge of that discomfort without going over the cliff.

As kids get older we won’t notice OCD as much. Our kids often move towards mental compulsions (and if they aren’t educated on this, they don’t even know they are feeding OCD) and other compulsions that are not as obvious.

I personally would still want to teach a child skills if they show any OCD tendencies. OCD is like termites, even a little termite problem makes me nervous.

You could just work on the education piece and eventually move into the “defense” piece (e.g. what he does when OCD comes knocking). I would go at his pace and start where he is comfortable.

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