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My Daughter Refuses Our Help

Posted on Monday, July 28, 2008

Question: My daughter has really severe OCD and every time we try to get her to do exposure she just refuses and hides in her room and tells us to “go to hell.” What should we do?  Should we just give up until she decides that she really wants to get better?

Answer: This is a really common and difficult situation for many families with a child who has OCD.  It is terribly frustrating to feel like you are doing every thing possible to help your child and then have him or her fight against you.  First, it is important to understand that no child, or adult, chooses to stay disabled by their OCD.  I have treated lots and lots of kids who will fight every step of the treatment but then thank me at the end because they feel so glad to be better.  The issue here isn’t motivation to get better; it’s being overwhelmed by fear.  When anyone gets scared they tend to do one of 3 things, fight, flee or freeze.  Your kid is someone who gets so scared that she fights.  Some kids get quiet and shut down and some just avoid. 

The best way to combat this is to do several things.  1) Reframe the situation as her being scared and tell her that, “Looks like you are so scared that you don’t think you could possibly do the exposure.” 2) Try to find a smaller exposure step that she might be willing to take so that she can discover that she can get started in challenging her OCD.  Then once she is warmed up, she might be able to do the full step, 3) Remember that she is a kid and, therefore, unable to do things just because they are good for her.  How many kids and teens would clean their rooms or floss their teeth every day unless a parent was there to remind and reward them for doing it?  4) Set up a reward system that guarantees things or activities she wants to earn for doing her exposure practice.  Make sure that it is enticing to her.  Do not punish her because she cannot do it. 5) Talk with her therapist about making the exposure more gradual, or about doing more practice with the therapist first before trying to do it at home. 6) If you do not have a therapist, then try consulting with one who knows how to help you make the exposure gradual enough that your daughter can do it.