Little-known subtypes of childhood OCD
Little-known subtypes of childhood OCD
Obsessive-compulsive disorder (OCD) is a common yet poorly understood mental health condition. There are “stereotypical” symptoms of the disorder that the general public are more likely to recognise, such as frequent hand washing due to a fear of germs, or excessive stove checking to prevent the house from burning down. However, there are many other symptoms of OCD, such that one sufferer will rarely present with the same symptoms as another.
The presentations we see for childhood OCD are diverse, with children reporting many different “strange” or “bizarre” obsessions that trouble them. Kids with OCD usually know their worries are irrational, but still find it impossible to stop their OCD and can be very distressed by their symptoms. The following three OCD subtypes are very common, but can unfortunately be misunderstood by the person, their family, and even health professionals.
Magical thinking.
It’s relatively common for all of us to engage in “magical thinking” such as knocking on wood to prevent bad luck. However, for OCD sufferers these sorts of rituals are performed multiple times a day due to a fear that, if they don’t, bad things might happen. A child with OCD might engage in superstitious rituals to prevent their bad thoughts from coming true, such as a special goodnight routine they feel will stop their parent from dying.
Magical thinking is often associated with repeating compulsions, such as tapping things a certain number of times, rewriting their schoolwork, flicking light switches on and off, or walking back through doorways – all to prevent an unpleasant event from occurring. This OCD symptom can be highly distressing for children, as they worry that just thinking something bad might cause it to happen, and that they need to find a way to stop it.
Transformation obsessions.
During late childhood and early adolescence, kids start to become more aware of who they are as an individual, and how their thoughts, feelings and interests might be different from their peers’. Sometimes, OCD can use this awareness against the young person and make them worry they could somehow lose their individuality and become like someone else.
Transformation obsessions involve a fear of turning into another person, taking on unwanted characteristics and/or losing a part of their own personality. For example, a child with transformation OCD might worry they will lose their sporting ability, and will avoid looking at or talking to people they perceive have poorer athletic skills. They might also wash their hands after touching certain people or objects, avoid saying certain words associated with their transformation fears, or perform other compulsive behaviours to prevent themselves from transforming or changing in some way.
Emotional contamination.
People with OCD often worry about physical contamination from germs, bacteria or particular illnesses. Emotional contamination is a little bit different. Young people with emotional contamination obsessions develop a fear of a particular person or place and feel they must avoid them at all costs. They might feel the person is dirty or contaminated, and experience fear or disgust when around them or after touching something they have touched.
Unfortunately, the object of the emotional contamination can often be a family member, including a parent or sibling. This can result in devastating impacts on family functioning, as the child refuses to go near or touch anything that has come into proximity with that family member.
Fortunately, these subtypes of OCD respond very well to current evidence-based treatments, including exposure-with response prevention (ERP). Our clinical psychologists have many years of experience treating these symptoms. If you think your child might be suffering from a type of OCD that isn’t commonly understood, contact us today to arrange an assessment and treatment planning session.
Author: Cassie Lavell, Clinical Psychologist at the Children’s Centre for Anxiety and OCD
