Multicultural Issues and Parenting Styles
The presence of OCD has been documented since at least the eighteenth century, and it remains present throughout the world. The expressions of OCD, its contamination fears, unwanted thoughts and rituals, are remarkably similar across cultures. What are more varied are individual cultural reactions to the presence of the disorder in a family member. In a multicultural society such as the United States, cultural differences can be a factor in the recognition and treatment of childhood OCD. Among these factors are strong feelings about family privacy, the openness of a particular family to therapy, and the ability of a parent with a particular, perhaps culturally shaped, parenting style to adapt to OCD treatment. As Tamar E. Chansky, Ph.D., outlined in her book, Freeing Your Child from Obsessive-Compulsive Disorder, there are three types of parents:
Authoritarian-style parents, reflecting a more “top-down” cultural model, expect to set forth rules that are not challenged, only obeyed. Children make few, if any, of their own choices. Punitive measures are taken if rules are disobeyed.
Permissive parents tend to go to the opposite extreme and provide very little structure or boundary setting for their children. Children are then given the power to make their own choices.
Authoritative parents fall somewhere in the middle of these two poles; they set rules and enforce them but remain flexible and open to input from their children.
According to Dr. Chansky, for a family coping with OCD in a child, the third, authoritative model of parenting tends to create the most workable environment to assist your child in reaching her treatment goals. Rather than a “you will do this” message from parent to child, in this model, a child is given autonomy and encouragement to select her own exposure targets, and asks for help when she needs it. The child's progress is monitored, not directed. At the same time, parents in the authoritative model have the ability to set limits and ground rules for how the child with OCD will be permitted to behave in the household when it affects other family members.
In families with grandparents, uncles, and aunts in close geographic proximity, open communication about a grandchild, niece, or nephew's OCD is the best course — when and where possible. In some ethnic groups where a high priority is put on privacy and when there is an inherent resistance to the acknowledgement of mental health issues or family therapy, it may not be possible to enlist either their active or emotional involvement in your child's OCD treatment.
In many circumstances, grandparents or other close relatives may have already noticed behavioral issues with a child, but have not had the language to express their concern. They also may not feel they have permission to raise such a delicate issue.
Your choice of how much to disclose to and involve extended family members is a very individual one, sometimes dependent on cultural factors. If they can be drawn into a helpful relationship in this time of great need, you and your child will benefit from other relatives' support. One way to help make this happen is to give extended family members brief educational materials about OCD and invite them to join you if you attend a parent support group in your local area.