How to Respond When Your Child is in OCD Crisis

How to Respond When Your Child is in OCD Crisis

It’s 9 PM and your daughter calls, saying, “Sorry to bug you, Mom, but my OCD is really bad right now, and I don’t know how much more of this I can take.” 

What do you do? 

In this blog, I’ll share with you a proven protocol to respond to somebody drowning in OCD drama—without drowning yourself.

 I’m Dr. Vicki Rackner, and I wear three hats as I speak to you today. The first is that of a mom of my son diagnosed with OCD when he was in college. We’re now 7 years into our OCD story. Second I’m a surgeon who spent many years treating breast cancer patients.  And third, I’m a certified life coach who has spent the past two decades helping my clients get their desired results. I use all of these experiences to help my clients rise to the challenge of parenting a child with OCD

Let’s dive into today’s blog..

The Challenge of Helping Someone Who’s Drowning

I wish you could have met my colleague and mentor Dr. Joseph Yon. Dr. Yon was a gynecologic oncologist; he operated on women with cancer of the uterus of ovaries. He was a great surgeon who served with an open heart. 

There was standing room only at his funeral. Dr. Yon’s son talked about the final moments of his father’s life. The two of them were on vacation, and the son heard sounds of distress coming from the lake. He looked in that direction and saw Dr. Yon swimming towards a drowning dog. 

While Dr. Yon was a strong swimmer, the dog was stronger. By the time help got to the scene, it was too late. Dr. Yon drown trying to save the dog’s life.

When your child is in an OCD crisis, it can feel like they’re drowning in drama. For me, this is the most frightening part of parenting a child with OCD.

You’re Not Your Child’s OCD Lifeguard

Think of your child’s therapist as the OCD lifeguard. Unfortunately, your child could have an OCD crisis when the lifeguard is not on duty.

I often wished there were a 911-like line you could call in the midst of an OCD crisis. 

You can respond to a person in OCD crisis while staying safe yourself. It’s like throwing out a life preserver.

Your Best Choice: The ABLE Protocol

I invite you to try the ABLE Protocol. The name itself—ABLE—communicates that you have what it takes to make a positive difference in a turbulent time.  Plus, ABLE is an acronym to help you remember the four simple steps of the protocol.

The ABLE Protocol is NOT OCD lifeguard training. It’s not about how to become a therapist yourself. Instead, It’s a safe way of connection with your loved one in a time of crisis. Remember human connection is powerful medicine.

Think of the Protocol as a choreographed ballroom dance between the story-teller —the person in crisis, and the story-receiver—that would be YOU. 

The story-teller is in crisis because they’re spinning in a story that by its very nature, keeps them stuck. The story might be something like, “I’m going to jail” Or “My life is over.” Or “I HATE OCD!” It’s like a scratched record playing the same musical praise over and over.

In the ABLE protocol, you focus on the things that are under your control. That would be your own thoughts and feelings. We will NOT try to fix or change things for your child.

However the steps are designed in a way to optimize the chances that the story-teller will get unstuck. 

First, we’ll go through the protocol.

Then we’ll address what the protocol can and cannot do for you. 

The A in ABLE Stands for ALLOW and ACCEPT. 

In this first step of the ABLE protocol, you decide that you will accept and allow things to be just as they are in the moment. You allow your child’s thoughts and feelings and circumstances to be exactly as they experience them without any need to change them.

You act from the belief it’s okay for your child not to be okay.

This is very hard. You might be screaming out, “No, it’s not okay that my child is not okay. My child is in pain, and I want the pain to stop.”

We agree. The outcome of any crisis intervention is for things to get better.

The question is, “What’s the best way to get there?” 

Let’s say your child has the thought, “I’m going to jail.” They are in crisis because they do not recognize that the origin of this thought is the OCD brain wiring glitch. They’re treating this thought as if it were generated by the healthy brain.

You might have an urge to say, “Don’t be silly. Of course you’re not going to jail. That’s just your OCD telling lies.” 

And in your fantasy, your child says, “Thanks, Mom. I believe you. You’re so helpful. Crisis averted.”

If you’ve ever tried to change anyone’s mind about anything, you know how difficult this is. If you’re trying to change the beliefs of a person in the midst of an OCD crisis, you know that now you’re negotiating with a terrorist. Your child’s OCD monster will dig in and double down.

Why doesn’t this work?

How do you feel when someone tries to invalidate your experience? 

When I was a child, my beloved hamster died. I was heartbroken. After a few days of grief, my parents said, “Come on. This is not a big deal, like when Grandpa died. It’s just a hamster. We’ll get you another one.” 

Their words built a wall between us instead of a bridge. They made things worse. They offered a judgment, “It’s not so bad.” For me it was the hardest moment in my life up to that point. They tried to solve for the problem of how to get me out of unpleasant feelings by offering to get another hamster. In reality they were most likely trying to manage their own discomfort with my grief.

Imagine how different it would have been if they said, “It looks like you are very sad. You and your hamster were such good friends. That’s part of the reason it hurts so much”

In a similar way, you can say to your child,  “It must be very frightening to think about going to jail.”

This does not mean that you agree with their thoughts. You’re saying, “I hear you. I see you.”

In this way you build a bridge with your child. Human connection is powerful medicine. It’s the most important tool in your parenting toolbox.

This is easier said than done, especially when someone you love is in pain.

You’re not only managing your child’s thoughts and feelings; you will also have your own thoughts and feelings. You can accept and allow them, too.

Your own human brain might offer unhelpful thoughts like, “You’re not a good parent.” Or,  “I can’t do this! I’m in way over my head. Maybe I can just hire my child’s therapist to be on call.”

You might feel scared or anxious.

You can witness your thoughts and say, “Oh, I’m thinking I caused my child’s OCD . What an interesting thought!” You understand that your brain lies to you all the time. You don’t have to believe every thought that crosses your consciousness.   

What are some alternatives to accepting and allowing?

The first is resisting. “I can’t believe we’re here again.” Or, “I wish my child didn’t have OCD.”

As with so many other things in life, the things you resist persist. 

You may find yourself judging the circumstances by thinking something like, “Oh, this is terrible.” Judgment build walls instead of bridge.

Third, your might want to pull away from a crisis like you pull your hand from a hot burner. Your  urgency to get out of crisis mode communicates that there’s something wrong or dangerous about being in this human condition.

When you ACCEPT and ALLOW, you see the circumstances as neither good nor bad. They simply are. You trust that you and your child can get through the uncomfortable episode.

The first step in the ABLE protocol is like looking at the map at the shopping mall and finding the “You are here” arrow.

The B in ABLE STANDS for BREATHE.  

When your child calls in crisis, there’s a very good chance that they feel that life and death is on the line.  They are in their reptile brain.

Animals living in groups tune into to other’s sense of danger. When my dog gets too close to the lake shore, the Canadian geese sound their warning call. When one goose takes flight, the rest do, too, even if they can’t see my dog.

Fear and anxiety are communicable. You can catch your child’s panic.

Your body will respond to a crisis before your mind does. Your reptile brain prepares your body to flee. You heart beats faster. Your breathing increases. All of this takes place without a singe conscious throughs on your part.

Your mind observes your racing heart and says, “Okay, we’re in trouble, Where’s the threat?”

It’s very easy to mirror the feeling state of another. the problem is that you have access to the most resources when you ascend from your reptile brain. 

How do you do that? 

The mind and the body are connected in feedback loops. The body informs the mind and the mind informs the body.

For example, You already know that when you feel happy you smile. Even blind babies do it. 

What you may not know is that if you smile, you will feel happier. The is called the facial feedback effect.

You can interrupt the mind-body loop you’re in by changing your thoughts or by changing your physiology. Both work.

The simplest and easiest way to get out of the fight/flight/flee response is to breathe. When you do deep belly breathing, you are much more likely to keep the calm rather than catch the chaos. 

Here are three reasons to harness the wisdom and power of your body.

First, your body can give you important clues about what’s happening. I can tell within seconds when my child is in OCD crisis. I get a tightness in my gut. So, too, your child may have a sensation in their body when they believe an OCD thought. Then when your child is in crisis, you can ask, “How is your body feeling right now? What is your body telling you?”

Second, it’s much easier to manage your brain when your body is nourished with food and sleep and exercise and even human connection. Evolutionary biologists tell us that our brain was designed to help have more control about how we move in space. This allowed us to be more effective hunters and conferred a survival advantage.

Third, you can change the way your experience the world by changing your interpretation of the sensations that course through your body.

When I first began as a professional speaker, I got nervous. My palms got sweaty  and my heart raced. 

One of my mentors told me, “When don’t you just rename the sensations you have in your body as excitement.” It made a huge difference.

We’ll discuss the brain-body loop more in later. For today, remember this: when you are responding to someone in crisis, breath. 

The L in ABLE Stands for LISTENING 

I remember being at a store and witnessing a customer drop a bottle of merlot. it shattered. He froze. His wife said, “Don’t just stand there; DO SOMETHING.”

There are times in which you do need to spring into action. 

If your child were choking, you would do a Heimlick maneuver. If your parent’s heart stopped you would do CPR. If your friend had a plan to end her life, you would bring her to the hospital.

When life and limb are on the line, you don’t just stand there; you do something.

When your child is in OCD crisis, they believe that life and death is on the line. 

After you have made sure that your child does not have an active plan to harm themselves or others, you go down a different path.

You deal with an OCD crisis differently than you deal with choking.

I have a new mantra for OCD crises: “Don’t just do something; stand there!”

Free yourself from the idea that you are there to fix something. 

Your job as a story-receiver is that of an active listener.

You want to communicate, “I hear you. I see you. I see your pain. You’re not in this alone. I’m here with you.”

Why is active listening so important?

Think about what happens when you eat contaminated food or breathe contaminated air. Your body gets the bad out. It may be with coughing or vomiting or diarrhea. It may not feel good to vomit, but you know you will feel better when the toxin is out of your system.

So, too, a person is usually in crisis becuase of the story they’re telling about their circumstances. The best way to get past the crisis is to get the bad out. 

I personally have a self-coaching practice. I’ll write all of my thoughts and worries down on paper. Once it’s all out, I can look at the words and ask, “Is this true?”  It allows me to be a witness to my life rather than being trapped in my life.

As the story-receiver for someone in crisis, your listen as the story-teller gets the bad out. 

The bad might be the thought or the urge. It might be the unpleasant feeling like anxiety or fear or disgust.

The story-teller gets to decide how they get the bad out. They might yell and scream. They might punch pillows. They might want to be held as they cry. 

As you listen, remember the A step in ABLE . Your goal is to allow and accept anything that that the story-teller vomits out. This does not mean that anything goes. You can place boundaries around acceptable behavior. No breaking things. No hitting.

Quite often once the bad is out, your child will, in fact shift and tell a different story. “Oh that was just OCD.” Your child is no longer drowning.

A mom told me about a crisis call with her daughter. She said, “I knew right away Sara was being held hostage by her OCD monster. It’s like she was living through her own OCD nightmare, and I wanted to wake her up.  Ay the beginning of the call I said, ‘Sara, this is just your OCD.’  She told me all the reasons I was wrong. I backed off and went through the ABLE protocol. By the end of the call, Sara woke herself up and said, ‘That was really bad. I believed the OCD lies.’ She went from ‘this is absolutely not OCD’ to ‘this is OCD’ in less than a half hour.”

The E in ABLE Stands for Embarking on One Tiny Step.

Once the story teller has the bad out, the story-listener can ask, “What’s one small step you can take right now?” 

You might have perfect clarity about what they should do next. You might be tempted to give your child a to-do list..

I encourage you to resist that urge. Let your child create the next steps.

There you have the four steps of the ABLE protocol: Allow and accept, breathe, listen and embark on a next step.

Here’s What You Did Not See in the ABLE Protocol. 

At no point do you jump in the water and buy into their story. If your child said something about what their boss or prof said, you don’t respond with, “I can’t believe they said that. That’s terrible.”

You don’t offer solutions. You don’t say, “Let’s go get a voodoo doll poke needles in it!”

You don’t share your own stories about when something like that happened to you.  

The ABLE protocol is not about changing someone else. It’s about creating a safe place that allows others to do their hard work of managing their brains. You deliver the message that you are there to love and accept your child no matter what.

I think that you will agree that you can do this!

Here are Some Important Points about the ABLE Protocol. 

1. If someone is at risk of harming themselves or others, you are now facing a medical emergence. Treat it as such. If someone with a history of panic attacks describes symptoms of a heart attack, err on the side of conservatism and rule out the heart attack.

2. You might not be the right person to be the story-receiver for any specific circumstances. As a parent, you might want to help your child identify other story-receivers willing to try the ABLE protocol.

3. As my son’s little league coach said, “Games are won and lost in practice.” the things that you say and do before and after the crisis matter. You and your child can debrief after the crisis is over and ask, “what was helpful? What was not helpful? What can we do differently next time?” You can identify triggers that place people at higher risk for crises. We’ll go into this is a separate podcast episodes,

Don’t underestimate the power of simply being there in this very simple way. Human connection is powerful medicine.

Will the ABLE Protocol Work for YOU?

You might be wondering, “Does the ABLE Protocol work?” and “Will this work for me?” 

The feedback I’ve gotten from parents is a resounding yes. 

One mom said, “I used to dread the crisis calls. Now I have more confidence in my own ability to respond in a way that makes things better.”

Another mom said, “With the ABLE protocol, the crises don’t last as long.” 

Another mom said, “We don’t just use the ABLE protocol for OCD crises. I’ve shared this with friends and we use it when I’m having my moments.”

That was an AHA moment for me. 

We as parents have our own moments of crisis.  I tried an experiment in a small community of my private coaching clients. 

We call it #ABLE Initiative. Her’s how it works.

Let’s say that you as a parent are freaking out. You can go into the community and place a post that says #ABLE. This is a shorthand for “I’m freaking out and I need some help.”

One person in the community responds with “I’m here.”

The story-receiver asks, “How bad is this on a scale from one to 10?”

The story-teller responds “11.”

The story receiver says, “I’m going to set a timer for 10 minutes.” That means that the story-teller has 10 minutes to get the bad out.

The only thing that the story-receiver says is “9 minutes left. 7 minutes left.”

At the end of the time, the story-receiver asks, “Would you like more time?  How much more?”

At the end of the timer, the story-receiver says, “Thank you for sharing. What’s one small step you can take right now?”

If the story-teller says, “I don’t know”, the story-receiver can offer an option. “How about going out for a walk?” “How about getting a cup of tea?” “How about setting aside 15 minutes to consider how you will apologize to your child?”

At the end, other members of the community can share their support. But not during the protocol because it’s too overwhelming.

The results have been phenomenal. One member said, “It’s hard to believe that something this simple and easy could be this powerful.” Another member said, “Just this alone would make the investment in coaching with you worth it.” 

You don’t need a formal community to try the ABLE protocol. Use it when your child is in crisis. Share the ABLE protocol with a friend and let us know how it works for you.

That said, my son and I host a private online membership community called the OCD Haven. It’s a safe place of refuge for people living with OCD—and the people who love them— to share what’s on their minds and in their hearts. We offer coaching resources to help people get to the other side of OCD. 

We’re about to launch the #ABLE Initiative in a broader membership. Since we have an international community, that means there will be a story-receiver 24/7. Our members will never have to be alone in a time of crisis.

Membership is currently closed. If you want to be the first to be notified when we open our doors, you can get on our waiting list. You can click here to get on the waiting list. 

As always, thanks for stopping by. I hope you found value in this content.

Please feel welcome to share this episode with your child. Ask what he or she things.

Feel welcome to also share it with people who are there to support your child. Your child’s champions might including family, friends and teachers. 

Let us know how the ABLE Protocol works for you!

As always, thanks for stopping by. I hope you found value in this content.