Family Feuding about OCD? Try Something That WORKS.

Have you ever been in an emotional tug-of-war with your child or other family members about how OCD is managed? In the next series of 3 podcasts, I’ll uncover the origins of the most common conflict within families—which are usually power struggles— and show you how power struggles do more harm than good. Then I’ll lay out an alternative I call the Relationships Reboot.

 

Welcome to the Free Me From OCD Podcast. If you or someone you love has OCD, you know that OCD can hold you hostage. OCD can get in the driver’s seat of your life. Here you will find information, tips and tools to put YOU back in the driver’s seat of your life. I’m Dr. Vicki Rackner your host. I call on my experience as a mother of a son diagnosed with OCD when he was in college, physician and certified life coach to help you evolve into the best and highest version of yourself.

 

So let’s dive into today’s episode. 

You, your child and your family members are in a battle against OCD. And OCD is a formidable foe.

However sometimes family members battle among themselves. This is like football players tackling their own teammates.

Today I would like to deconstruct the most common cause of conflict between family members managing OCD: power struggles. 

When you think about power struggles, you may have memories of the morning battles with your toddler to get her shoes on so you won’t be late for work. 

While power struggles with your college-aged kids look  different, the origins are the same.

You get in a power struggle when you try to solve a problem by persuading another person to do something differently. 

To restate: you get in a power struggle when you want to change your circumstances and your plan for the transformation depends on the action of others.

You unplug from power struggles by exploring what YOU can do differently so you get what you want. 

Here’s what you need to know: You want your child to be freed from OCD. 

You will have a very strong urge to persuade or cajole or demand that your child do the work you think they should be doing.

This is how OCD power struggles begin. 

The best and most effective way to support your child is to unplug from power struggles and invest in what I call the Relationship Reboot.

There’s a lot of content here, so I’ll break this out into three podcast episodes. 

Let’s flesh these ideas out with a real story slightly tweaked to preserve this family’s privacy.

Joan—the mother of an 18-year-old daughter Kelly, who was diagnosed with OCD about 3 months earlier—called in me a state of frustration. 

She said, “I’m at my wit’s end. I don’t know what to do. Please tell me specifically what I say and what I do to get my daughter Kelly into therapy!”

I asked Joan to tell me more about her relationship with Kelly. 

Joan raised Kelly as a single parent. Joan said that she and her daughter had a strong “you and me against the world” respectful relationship.  

Joan rarely nagged Kelly. Even when Kelly was in middle school, for example, Joan didn’t take on the role of homework police. She believed that the natural consequences of incomplete homework would help her daughter make better choices.

They had very little drama or conflict.

Things changed during Kelly’s senior year of high school. Joan said, ”Kelly just lost her sparkle. She became distant and somewhat secretive. I thought this was Kelly separating from me.”

Kelly went to the other coast for college. Kelly and Joan spoke regularly. Joan noticed that Kelly was having a hard time getting her sea legs at school.

At first, Joan wrote it off as a transition to college life. 

However, when Kelly came home for the holidays, it was clear that something serious was going on. 

Joan persuaded Kelly to see her pediatrician, who made the diagnosis of OCD. 

Now all of Kelly’s struggles dating back to high school made sense. 

They made a plan. When Kelly returned to college, she would an OCD therapist. Her college had a medical school, and Joan felt confident that Kelly would find the help she needed. 

That’s not what happened. 

Kelly made appointment with two therapists through the student health services, and dismissed both of them because, “They didn’t get me.”

In the meanwhile, Kelly would regularly call Joan in crisis. At first it seemed like they had crisis calls about once a week. Then the calls started getting closer together. Twice a week. Three times a week. 

Joan said to me, “I’m not a therapist; I don’t know what to do. I’m just  making it up as we go along. But I’m scared and worried because my daughter’s get worse. Help. What do I do?”

Joan and Kelly are knee deep in a power struggle. 

Does this sound or feel at all familiar? Here are some clues you’re in a power struggle

• You keep having the same conversation over and over and nothing gets resolved.
• Emotions run high.
• You feel less connected to the other person rather than more connected.

 

Let’s deconstruct poser struggles.

Our human brains behave in predictable ways. If there is a problem in our lives, we tend to look outside of ourself for both the cause and the solution.

Power struggles have their origin on a very human thought,”My life would be better if only the people around me were different.”

Let’s say you’re going through a rough patch in your marriage. You walk into the bathroom and find a wet towel that your partner threw on the floor. Again. You think, “I’ve asked him 1,000,001 times to pick up the towels.” 

She believes that if her partner would pick up the towels, their marriage would improve. In other words, if her husband changed her marriage would change.

However, after years of nagging, the towels are still on the floor. 

Why? It’s not for lack of love.

The human brain behaves in another predictable way. 

Where you try to persuade a person to change, they resist. The harder you push, the more resistance you meet. This sets the stage for an emotional tug-of-war that rarely, if ever, gets resolved. As a lawyer said, even if you win, you lose.  

This woman has years of evidence that she is not winning this towel power struggle.

So, how could she escape the towel drama? Here’s a sneak peak of the Relationship Reboot.

If we dig a little deeper, we see that the problem is not the towel. It’s this woman’s thoughts around the towel. “Oh if he cared about me or respected me , he would pick up the towel.” That thought causes anger and frustration. 

That thought is optional. This thought could be replaced with another, “Oh, that’s Dave being Dave. Maybe I’ll just use the guest bathroom.”

Or maybe she decides that towels on the floor are a deal-breaker and she decides to leave.

In the Relationship Reboot, you focus on how YOU can change to get what you want.

That is the key to unplugging from a power struggle AND getting what you want. 

Let’s set aside OCD for a minute and talk about your job as a parent.

Parents and children are—almost by definition—engaged in power struggles.

Most parents invest 18 years to impart the values and skills and tools so that our children live successful adult lives. We working towards making our jobs as bosses obsolete.

Parenting balances two opposing forces: you want to keep your kids safe and your kids want to have agency over their own lives. 

We give children more control over their choices as their brains develop.

So, when you parent an infant you keep a hand on your child as you change diapers to keep your baby from rolling off the changing table.

As their brains and nervous systems evolve, they learn to crawl and then walk and then do calculus.  All of these things happen because their brains meet developmental landmarks. 

By age 6, your child’s brain weighs almost as much as an adult brain. But you don’t leave a 6-year-old alone when you go shopping. Why? A 6-year-old brain does not have adult function yet. 

Your child’s brain undergoes a process of pruning and rewiring. The rewiring begins in the basement of the brain and works up to the thinking brain.

You can usually identify when the pruning reaches the pre-frontal cortex during the teen years. You might ask, “Who hijacked my child?’’

When the pre-frontal cortex is under construction, you might find that your child who once made great choices now is making irrational or downright bad choices.

The pre-frontal cortex continues to mature until your kids reach their mid-twenties. A friend Lisa once said to me, “Keep ‘em alive till 25.” The higher car insurance rates for teens are a ”tax” on younger drivers. The hight rates don’t drop until about age 27 when the pre-frontal cortex is developed. 

When the the pre-frontal cortex is under construction, it has an interesting quirk: the brain has limited insights about its own limitation.

Mark Twain said, “When I was a teenager, my father was so ignorant I could hardly stand to have the old man around. As an adult, I was astonished at how much he had learned in a few short years.”

Now imagine what happens when the OCD Monster finds its way into your child’s brain when your child is, say between ages 17 and 24?

The heart of OCD treatment is for people to learn how to use their minds to manage their brains. OCD management calls on higher executive functioning of the pre-frontal cortex to manage the brain more effectively. 

The higher executive function is not all there!

This is a real catch 22.

You see that your child with OCD faces a dangerous situation in which the solution is limited by the circumstance inherent in the problem. You get scared.

What’s a parent to do?

If you have a child learning to manage OCD, my guess is that you would love to have a magic wand and magically free your child from the tyranny of OCD.

I’m also going to guess that when your child was diagnosed with OCD, you dug in and did your homework. You discovered that OCD is a treatable, manageable condition. 

Through your own education, you might have a clear understanding about the work your child needs to do to get to the other side of OCD. You might have created an OCD manual in your head that lays out the treatment plan.

What happens when your child with OCD does not follow your OCD manual —or doesn’t follow the manual on your time schedule?

As parents, we have an understandable human tendency to dive in and fix things—especially  when our children are in pain or they face health challenges. 

When your child has OCD the stakes feel very high. You might have nagged or cajoled your child to follow your OCD manual.

Joan desperately wants Kelly to follow her OCD manual. She wants Kelly to find an OCD therapist and get professional help.

From your perspective this might seem like a very reasonable request. Of course Joan needs the right words to persuade Kelly to find a therapist!

It’s perfectly understandable that Joan would try what’s known in ballroom dancing as back-leading. 

In ballroom dancing, the man leads and the woman follows. If the man does the steps wrong, a woman can try to gently push or pull her partner so that they do the steps correctly. My ballroom dancing instructors recommend against back-leading.

Before age 18, your child followed your lead. At age 18, your child wants to lead her own life. 

Back-leading in parenting might take the form of nagging. “Did you call the therapist?” “Are you doing your ERP homework?” It might take the form of interrogation. “How many times did you give its compulsions?” You might even step into the role of thought police constantly surveilling your child’s brain for new obsessions.

All back-leading is still an effort to push or pull your child into conforming to your OCD manual. 

Your emerging adult child wants to make their own choices. They have their own OCD manuals.

When their OCD manual and your OCD manual have the same instructions, it’s easier to respect your child’s autonomy.

But, when your child ignores your OCD manual, you have a human longing to step in and make your child’s choices.

As parents we tend to want to lead when we get scared.

You might be asking a different question. If living with OCD is so painful, why WOULDN”T your child follow your OCD manual?

Here are some common reasons your child resists the work they need to do to get to the other side of OCD.

Your child might want to be seen as normal and fitting in. They might wish they didn’t have OCD, and translate that longing into denial about the diagnosis. 

Your child may not even believe that OCD is real. You might hear, “Everyone has superstitions. You wear rally caps when you watch baseball games.” 

Your child has a different OCD manual. Maybe their focus is how to make the thoughts go away—as if they could surgically excise the OCD monster.

Your child may have beliefs the impact OCD has on their lives that are different than yours. 

Your child may be minimizing the impact OCD has on their lives. I remember treating a breast cancer patient who was a University professor in the sciences. I asked her, “WHAT BRINGS YOU IN TODAY?” SHE SAID “MY HUSBAND IS COMPLAINING ABOUT THE SMELL.” 

As a breast surgeon I had never hear that before! When I examined her, she had a breast cancer that had eroded through her skin leaving her with an oozing open wound. You might wonder, “How does a clearly intelligent, informed person get to that point?”

Our human brains use denial as a way of dealing with our current reality. 

Your child might minimizing the impact of to the OCD-related thoughts and behaviors. You might be catastrophising as you project what their future might look like.

Your child’s OCD Monster grooms your child. Let’s say that there is an OCD Monster that lives in your child’s brain and takes over your child’s life. (I know that there is no monster there, but it’s a helpful model.)

Over time the OCD Monster has been grooming your child to be able to take control of his life, much like a sexual predator does.  

The OCD Monster wants to get more control of your child’s life—not less. 

What do you think Kelly’s OCD Monster tells Kelly about getting a therapist? If therapy is successful, that’s a suicide mission for the OCD Monster. Of course the OCD Monster says NO to any efforts to relinquish control. 

When Joan talks to Kelly about finding a therapist, she may not be talking to Kelly; she may be talking to Kelly’s OCD monster.

Your child has lost faith in the ability of health care professionals to actually help them. The sad reality is that there are few healthcare professionals who truly understand OCD. I’m a physician, and I missed my son’s OCD diagnosis for YEARS. Treatment for depression or anxiety can actually make OCD WORSE rather than better.  Here’s the great news. We know what DOES work. It’s ErP. You will find a link to NOCD, so your child can have access to treatment that works from wherever they live. 

The most common reason your child resists your OCD manual is simple: treatment is hard. We are asking our kids to master skills that most adults have not mastered: witnessing and choosing their thoughts, leaning into unpleasant feelings and resisting urges.

However, as a parent with a mature pre-frontal cortex, you see the life consequences of unmanaged OCD. You might recognize that unmanaged OCD represent a health threat to your child. You might be scared.

Now ask yourself, “If my child is navigating these challenges, will backloading help?” The answer is usually NO.

Here are the problems with power struggles.

The headline is this: back-leading doesn’t work. People don’t like being told what to do. When was the last time you were able to persuade someone to do something they weren’t inspired to do?

Back-leading is expensive. Power struggles consume time and energy and good will that are better invested in other ways. You want your time and energy invested battling OCD—not battling your family members.

You erode your most powerful parenting tool—a loving relationship with your child. Back-leading builds walls and not bridges.

Back-leading is disrespectful. It communicates the message, “I don’t trust you to make these choices so I’m going to step in and take over.”

I hope that I have convinced you about the danger of power struggles. 

If you want the best for your child, I recommend that you unplug from Power Struggles. You simply drop the rope.

Let’s summarize:

You have a manual in your head about how other people should behave—including your child learning to manage OCD.

You get in power struggles when you try to persuade others to follow your manual.

When they resist you might try backleading

But backloading doesn’t work because people don’t like being told what to do.

Your best plan for helping your child get to the other side of OCD is the Relationship Reboot, which we’ll address in the next two podcast episodes.

‘Here’s your homework for this week. 

Simply notice when you reach for your manual about how other people behave. 

Notice how often you try to persuade others to follow your manual for them.

Notice when you think that the solution depends on the OTHER person making different choices.

You might think, “Oh, I don’t do that!”

I remember picking up a book called  The Complaint-Free World. I was troubled by the people in my life who complained, and I wanted to learn how to deal with them. I thought, “I’m optimistic. I don’t complain that much!”  But once I took a look, I was shocked at how often I complained.

When you notice your manual and your back-leading habits, don’t beat up on yourself. Simply say to yourself, “Oh, how human of me.” 

We’ll talk about how to do a Relationship Reboot with your child or your partner or the other people who are not following your OCD manual. 

Looking forward to seeing you then. In there meanwhile, please subscribe to make sure you don’t miss an episode!