Anxiety is the root of Obsessive-Compulsive Disorder



11.09.1998 00:00

Family therapy helps children with obsessive-compulsive disorder

Gabriele Rutzen Press and communication
University of Cologne

Overcoming the compulsion

Some people become serfs with recurring tormenting thoughts. Thoughts forcing them to do the same pointless actions over and over while not trusting their own common sense. With the help of behavioral therapeutic measures introduced at an early stage, however, it is often possible to win the confrontation with the inner urge. If those affected are still in their childhood or adolescence, the involvement of their families is of particular importance. This is the conclusion reached by Dr. Manfred Döpfner and Blanka Breuer from the Clinic and Polyclinic for Psychiatry and Psychotherapy of Children and Adolescents at the University of Cologne.

In their investigation, the Cologne psychotherapists point out that one third of the obsessive-compulsive disorders have their roots in childhood or adolescence. In particular, washing, control, order and repetition compulsions begin in this phase of life. Those affected check countless times whether light switches are off or doors are closed. For fear of contamination, they constantly wash their hands. For some of them, asymmetries, such as an unevenly tied shoelace, cause panic. Others get the idea that a catastrophe they feared can be prevented, for example, by using a blue pen instead of a red pen to write.

Obsessive thoughts feed on diffuse fears. As with adults, the fear of contamination, contamination or poisoning also plays a major role in children and adolescents. While the fear of harming themselves or others has become a constant companion for some, others feel dominated by obsessive thoughts of a religious or sexual content. By giving in to the inner urge, those affected reduce their tension in the short term without, however, mastering the fear in the long term - a vicious circle from which there seems to be no way out. In order to transfer the pressure from themselves to others, children and adolescents often try to involve their parents in the obsessional process, for example by showering them with questions, disciplining them or letting them do controls for them.

This is exactly where family therapy should start, according to the Cologne psychotherapists. The parents are asked to consciously no longer support the child in his compulsive behavior, but rather to offer him alternatives. So instead of answering every compulsive question, parents should come up with incentives for other, more attractive activities. You should make your affection clear to the child and possibly give him a previously negotiated reward if he resists his compulsive impulses. Parents should also be careful not to show any over-anxious behavior themselves, because children tend to adopt this as a model.

Furthermore, in the opinion of the Cologne psychotherapists, a method has proven itself in the treatment of obsessive-compulsive disorder in children and adolescents, with which good results have already been achieved with regard to adult obsessive-compulsive disorders. Under the guidance of a therapist, the person affected is consciously exposed to the respective anxiety-inducing and compulsive stimuli and encouraged to resist them.
Dr. Döpfner and Breuer tell of a boy who, for fear of contamination, hadn't patted his dog for six months. He was asked to romp around with the animal and then to eat a sandwich with unwashed hands. Through this type of overcoming, which at the beginning requires just as much courage as motivation, those affected learn that the catastrophe they fear will not happen even if they do not comply with their compulsion - e.g. to wash their hands. The vicious circle is broken. The more often the compulsion is not given in, the weaker it becomes until it finally disappears completely. In order to break through obsessive thoughts, the therapist practices the mental confrontation with the feared catastrophe with the affected person.

In addition to obsessive-compulsive disorder, thirty to forty percent of affected children and adolescents suffer from depression. Since it is usually the result and not the cause of the fault, it usually disappears after it has been rectified. The clinical picture also often includes a tendency towards social withdrawal - according to the Cologne psychotherapists. It also mostly turns out to be reversible. The situation is similar with school problems that can be traced back to the impaired ability to pay attention of those affected.

Responsible: Dr. Wolfgang Mathias
If you have any questions, please do not hesitate to contact Dr. Manfred Döpfner on the phone number 0221 / 478-4370 or 470-6105, fax number 0221 / 478-6104 and the email address [email protected]
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