What about Siblings?

by sattva freedigitalphotos.net

by sattva freedigitalphotos.net

Well, we’ve made it through the holidays, with so much focus on family and spending time together. We’ve read all the articles about how to get along with those difficult relatives that, thankfully, you only need to interact with once or twice a year. We do what we need to do, and then we’re good for another year!

But what if that “difficult relative” lives with you? What if he or she is someone you love dearly, someone you long to have a close relationship with? And what if you are too young to truly grasp the reasons why this closeness isn’t happening? Actually, there’s a lot you don’t understand. Why does he or she act oddly at times? Why (in some cases) does this person avoid you, or worse, not even allow you both to be in the same room?

I’m talking, of course, about being a sibling of someone with obsessive-compulsive disorder. I have previously written about my family’s situation and how we dealt with our daughters when our son Dan’s OCD was severe. I talk about what I think we did right, and what I think we did wrong. Of course each family’s story is unique, but for younger children who are living with a sibling with OCD, there are some questions I feel should always be considered:

Are they being teased about their brother or sister at school? Do they resent not getting as much attention as their sibling with OCD? Do they feel uncomfortable in their own home? Do they think their sibling’s OCD is somehow their fault? Do they feel frustrated because they want to help their sibling and don’t know how? Are they embarrassed, confused, jealous? Do they feel scared, or neglected? Do they think they might develop OCD also?

This is only the tip of the iceberg. So much to consider!

The Washington Post recently published a wonderful article titled “Eight things siblings of children with special needs struggle with.” While it doesn’t specifically focus on OCD, each struggle mentioned rings true for families dealing with obsessive-compulsive disorder. I highly recommend checking it out.

While it is quite possible that siblings of those with OCD will grow up to be more empathetic, responsible, and understanding than many of their peers, we must realize they are also often burdened. As are we parents. It can be heartbreaking to witness the toll OCD takes on everyone in the household. And while it is a monumental task to do right by each child in the family when obsessive-compulsive disorder is involved, it is necessary. Parents should seek support and professional advice whenever possible.

And we need to remember that children themselves can be extremely helpful as well. Asking all of our children what they feel and what they need from us is so important. Open communication among everyone in the family can go a long way. With a lot of hard work, love, and proper treatment for OCD, there’s a good chance that close sibling relationship can become a reality.

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2017 Here We Come!

by krishna arts freedigitalphotos.net

by krishna arts freedigitalphotos.net

For many people, with or without OCD, the onset of a new year stirs up a wide range of emotions……hope, trepidation, excitement, fear. Basically, a little bit of everything as we look ahead.

I find myself looking back as well. As I reflect upon this past year, both personally, professionally, and globally, I realize that as with every other year, there were ups and there were downs. I feel lucky to have so many blessings in my own life; at the top of the list are my wonderful family and friends. But I’ve also had my challenges in 2016. Haven’t we all? Isn’t this in fact, LIFE? The highs, the lows, and everything in between. Continue reading

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Relationship OCD (R-OCD)

by sira anamwong freedigitalphotos.net

by sira anamwong freedigitalphotos.net

This post originally appeared April 2011. I’d like to wish all of my readers who celebrate Christmas and Hanukkah a very happy holiday…….

I am continually learning about OCD, and the more I learn, the more I hate this disorder. I had never even heard of  Relationship OCD (or R-OCD), but it’s not new, and all of a sudden I seem to be reading about it everywhere.

Basically, those with R-OCD believe that they should no longer be with their spouses (or significant others) either because they do not love them anymore, aren’t compatible, or whatever. I’m not talking about  those fleeting thoughts that we all have once in a while (sorry Gary). I’m talking about unrelenting, strong obsessive thoughts that tell the sufferer to get out of the relationship. These feelings are so overpowering that some people even become physically ill because of them.

One of the reasons why these thoughts are so distressing is because, as with other OCD thoughts, the sufferer knows his or her thoughts are not rational. But these thoughts torment nonetheless. They incite doubt. So it is upsetting and  confusing to not only the person with OCD, but to his or her partner as well.

From everything I read, R-OCD can come on quite suddenly. It is most common in those with other OCD traits, though there do seem to be cases of those with just R-OCD. And it often goes misdiagnosed or even undiagnosed. The treatment is the same for OCD in general: Cognitive Behavioral Therapy (specifically ERP) and/or medication. And finding the right therapist is paramount.

Left untreated, sufferers commonly will either be in an on-again off-again relationship with the same person, or be in a series of failed relationships. How sad is that? That even one of the most basic human desires, to love and be loved, can be shattered by OCD.

Like I said, the more I learn about OCD, the more I hate it.

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OCD and The Holiday Season

Image result for happy holidays sign



This post first appeared November 2015…..

With the holiday season upon us, many of us are firmly entrenched in the excitement, anticipation, and busyness of this time of year. Maybe we will visit friends or relatives. Perhaps a small army of loved ones will descend upon us in our own homes, or maybe we will be part of smaller, more intimate gatherings.

Whatever our holiday plans involve, there are bound to be changes in our routines. While this can be unsettling for many people, those suffering from obsessive-compulsive disorder might have a particularly tough time, especially when dealing with vacationing and traveling. It’s not hard to see why these situations might trigger all kinds of concerns for those with OCD. No matter what type of OCD they suffer from, there’s always lots to worry about when stepping out of their comfort zone. Some concerns might include:

Will I be able to use the public or hotel restroom?

What if I hit someone while driving on the highway?

What if I get sick while I’m away?

The questions are endless and will be different for each person with the disorder. As you can see, however, all these concerns revolve around one thing: the uncertainty of what will be. Those with obsessive-compulsive disorder have the need to know, for sure, that all will be okay.

Friends and family also are affected when traveling and vacationing with someone with OCD. Having to alter plans, not being able to be spontaneous, and dealing with high levels of anxiety are just some of the many examples of how OCD can impinge upon a vacation. Before actually leaving home, anticipatory anxiety with all of its “what ifs” and doubt can be particularly distressing. Interestingly, anticipatory anxiety is often worse than the actual event being agonized over. So what should those with OCD do when faced with all these holiday events fraught with doubt and uncertainty?

The answer is clear. They should push through their anxiety and embrace the doubt and uncertainty that is holding them hostage. Yes, there is uncertainty that comes with traveling or vacationing or entertaining. Indeed, there is uncertainty in every aspect of our lives, and we all need to learn to accept, not fear, it.

I know it’s not easy. But it is possible.

If you have obsessive-compulsive disorder, I propose that you give yourself a gift this holiday season and make the commitment to stand up to your OCD. Embrace exposure and response prevention (ERP) therapy and reclaim your life. You deserve to enjoy the holidays, and every day, with your family and friends instead of being controlled by obsessions and compulsions. It will not only be a gift to yourself, but just might be the best gift you could ever give to those who love you.

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OCD and Mental Imagery

brainIn this article published in Frontiers in Psychiatry, mental imagery is defined as:

…the experience of conscious contents that possesses sensory properties and therefore resembles actual perceptual experience. The perceptual properties can be visual but can also cover other sensory modalities such as tactile, acoustic, or somatic experience. In contrast to cognitions, mental images are not purely verbal or abstract.

In other words, we see, hear, or feel something without the presence of the corresponding external stimuli.

Not surprisingly, people with obsessive-compulsive disorder deal with mental imagery a lot. Some examples include vivid intrusive thoughts, inner voices warning you of some impending danger, or actually feeling dirty when you’re not. Because OCD manifests itself differently in each person, there is no limit to the types of mental imagery that might be experienced.

Because I write about OCD, a disorder that I don’t have, I’m always trying to understand it. What does it really feel like? I’ve learned that the thoughts of those who have OCD are typically no different from the thoughts we all have at times. What differs is the intensity of the thoughts as well as the weight given to them. But what about mental imagery? How can I possibly relate to that?

Well, after reading the article referenced above, I now realize that most of us, whether we have a brain disorder or not, experience mental imagery. Again, it is likely the intensity and vividness of the imagery that varies. In fact, the article states that intrusive mental images lie on a continuum with hallucinations on the far end. Also, it is important to note that mental imagery can either be unwanted or voluntary. So while someone with hit-and-run OCD might clearly envision hitting someone when they haven’t, the same person could possibly conjure up a clear mental image of something that brings them joy, such as the birth of their child. I’m not talking about just “remembering,” but rather vivid mental imagery that evokes our senses. While the first example is an involuntary mental image which likely leads to feeling anxious, the second example might bring about feelings of warmth and love. I think many of us, whether we have OCD or not, can relate to this in the context of our own experiences. I know I can. The article says:

…if we remember how we met our loved one, we sometimes see a visual image of how we first met them and this visual image can be accompanied by intense positive emotions. Similarly, we may vividly remember how it hurt when we were beat up in the school yard and again this tactile image may come with intense negative emotions.

If you’re interested in learning more about mental imagery and how it relates to brain disorders, I recommend reading the article, which goes into more detail and also discusses a couple of studies. Once again, I’m thankful for researchers who work so hard to uncover the mysteries of OCD and other brain disorders.












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The Janine Books


This week I’m going to shake things up a bit and talk about something not directly related to obsessive-compulsive disorder. Most of us are familiar with some version of the old adage, “It’s not what happens to you, but how you react to it that matters.” This is especially true for those who experience ongoing challenges in their lives.

I recently reconnected with an old friend, Maryann Cocca-Leffler. Maryann has had a long career writing and illustrating children’s books. Her two most recent picture books, Janine and Janine and the Field Day Finish were inspired by her daughter, Janine Leffler, who as a child navigated life with disabilities. Janine has always lived her life with courage and optimism despite facing many challenges. While Janine is now a college graduate who visits classrooms to speak about inclusion and tolerance, in the books she is a spunky, resilient, self-assured eight year old who is often made fun of by the “cool kids.” Because Janine is inherently kind, upbeat, and amazingly comfortable in her own skin, she earns the admiration, respect, and support of her classmates and always triumphs in the end. These books, which are based on real events in Janine’s life, inspire children to be themselves, to be proud of who they are, and to stand up for those who are bullied. Maryann and Janine sum it up by encouraging everyone to BE SPECTACULAR!



While Maryann had the idea years ago to create children’s books where the main character has a disability, she waited until her daughter Janine was an adult to pursue the project. She felt these were Janine’s stories to tell, not hers. Janine (not surprisingly, given who she is) was on board one hundred percent and has embraced her advocacy role, encouraging others to focus on their abilities, not their disabilities. But it doesn’t stop there. Maryann and Janine educate children, parents, and teachers and because Janine is so willing to talk candidly about her own limitations, she no doubt encourages others to share their struggles as well. Maryann and Janine have also created a website to encourage inclusion: http://janinesparty.blogspot.com/

But the best part? To me, it’s the by-product of HOPE. For children who are hurting, and for parents who are struggling, these books, and Janine, provide a glimpse into the future with the assurance that everything will be okay. HOPE is a great gift for those with challenges. It doesn’t matter what the disability is; we need to believe that we will get through the tough times and the future will be brighter.

I am proud of both Maryann and Janine for being brave enough to share their stories. I can’t help comparing them to those whose lives have been touched by OCD who also willingly share their struggles and triumphs in the hopes of helping others (you know I couldn’t get through a post without relating something to OCD). I highly recommend Janine and Janine and the Field Day Finish for preschoolers, young elementary school students, and their parents. Actually, I recommend these books for everyone. We can all learn a lot from Janine.


Maryann and Janine

Maryann and Janine

Maryann Cocca-Leffler is the Author-Illustrator of over sixty books for kids. As well as the  Janine Books,  some recent books include, A Homemade Together Christmas and Bus Route to Boston. Also a playwright, Maryann’s award winning play Princess K.I.M. The Musical is based on her Princess KIM books. This National New Play Festival Winner can now be licensed worldwide through StageRights.com. Maryann creates books in her home studio in New Hampshire.   http://www.maryanncoccaleffler.com

Janine Leffler is the inspiration for the character JANINE. She lives her life focusing on the positive, despite the fact that she has many challenges in life. She has become a role model to children and adults, as she encourages them to focus on abilities, not disabilities. Like her character in Janine and the Field Day Finish, Janine never won a trophy or came in first place in any sporting events, but she was always number one in her gracious sportsmanship and unyielding focus on personal best. Janine has a BA in Communications and visits classrooms speaking about inclusion and tolerance. She lives and works in New Hampshire.

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Should OCD Therapists Participate in Exposures?

by stuart miles freedigitalphotos.net

by stuart miles freedigitalphotos.net

I’ve written a lot about exposure and response prevention (ERP) therapy and how to evaluate your therapist. I’ve said that many good therapists will tell you,“I won’t ask you to do anything I wouldn’t do myself.”

But do these therapists actually go ahead and do these things? Do they, or should they, participate in exposures with you?

In my son Dan’s case, as far as I know, his therapist at his residential treatment program worked on creating a hierarchy with him, but never directly participated in any exposures. The same is true for Dan’s later therapist whom he connected with after residential treatment. Perhaps this was due to the fact that Dan was 100% committed to ERP therapy and didn’t need that type of encouragement. I’m not really sure. There are those, however, who struggle more with ERP and could use all the help they can get.

I have heard from parents who were frustrated because their children were at residential treatment programs, yet refused to participate fully in ERP therapy. One mom described how her daughter just stared out of the window all day because she couldn’t tackle her exposures. “Why couldn’t a therapist have done them with her, at least in the beginning?” this mom wanted to know. She felt that would have been especially helpful for her child. Instead, time and money were wasted, and her daughter returned home with the same severe obsessive-compulsive disorder she went in with.

There are healthcare providers who do exposures along with their clients. Some make house calls, others go out into the world with their patients, and still others participate in exposures in their office. One woman wrote to let me know how helpful it was that her therapist touched a toilet seat in a public restroom while encouraging her to do the same.

But I don’t get the impression that this is the norm. And as difficult as it is to find a good OCD therapist, my guess is it’s even harder to find one who has the flexibility to do all kinds of exposures with you. Indeed, many times it’s just not possible logistically. For example, if some of your triggers occur in your workplace, it might not be feasible for your therapist to accompany you to work.

I do wonder if some therapists don’t participate in exposures because they might believe it offers their clients reassurance (“Look, I did it, and I’m okay”). According to a study (which I highly recommend reading) conducted by Dr. Seth Gillihan, providing reassurance is one of the most common mistakes OCD therapists make. ERP therapy can get complicated, especially for new therapists, and there can be a fine line between encouragement and reassurance. A good therapist acts as a coach and provides gentle yet firm encouragement – not reassurance.

Good ERP therapy is individualized, and my guess is participating in exposures might be appropriate for some clients and not for others. Certainly if you feel this might be helpful in your fight against OCD, you should discuss it with your treatment provider. I’d also love to hear from those who have had their therapists take part in exposures with them and how you felt, and feel about it.



Posted in Mental Health, OCD | Tagged , , , , , | 8 Comments