Understanding Obsessive Thoughts

Worries. Doubts. Fears. Most people have them every day, including young children, preteens, and adolescents. But when worries, doubts, and fears take over his mind and body, these thoughts are defined as obsessions.

The most likely underlying cause of your child's OCD is a chemical imbalance in his brain. Although no cure is yet known for OCD, medical knowledge and treatment of the disorder have taken great strides in the last decade. In order to help your child manage his illness, it's important to differentiate between cause and triggers, so that you can help him manage the latter.


What is the difference between an obsession and a compulsion?

An obsession is an irrational, intrusive, and involuntary thought or image that your child is unable to make “go away.” A compulsion is the repetitive or ritualistic behavior that results from that thought or image. A child performs a compulsive behavior in an (always) unsuccessful attempt to vanquish his obsessive thought.

The OCD Challenge

When a child has OCD, unwelcome, intrusive thoughts do not stop despite his earnest desire to quiet or change them. This is at the heart of what makes the disorder so challenging for both children and parents. Even if his thoughts are irrational and lead to self-defeating behaviors, knowing better doesn't help him stop thinking this way. Imagine how powerless he feels!

Even people who don't have OCD can be plagued by obsessive thoughts and bouts of anxiety. Anxiety is a part of the human experience. However, the obsessions and compulsions of an adult or child with OCD are more frequent and severe than for those who don't suffer from this disorder. Their underlying anxiety is more pervasive and more easily triggered.

Picture having just finished the dinner dishes. The kitchen sink is spotless and dry. But then your husband fills a glass of water and leaves droplets of water on the stainless steel sink basin. You cannot imagine going to bed without drying it again. But it remains a constant concern for you. Even after you've dried it again, you can't sleep because the thought keeps returning, urging you to check it again and again.


Although the underlying cause for OCD is a most likely a combination of genetics and brain chemistry, a trigger is something in your child's immediate environment that provokes his compulsive reaction. It can be real or imagined; as small as a person glancing in his direction, or, simply, a belief he's being watched.

Just as logic doesn't quell the anxiety felt by an adult with OCD who worries excessively about an undone chore or an oven that may or may not be left on after she's left the house, your well-meaning efforts as a parent to point out that your child's obsessive thoughts are “silly” or “not real” are also likely to be futile. They can even be harmful; such remarks often create more frustration and tension for both of you.


As a parent, you must never lose sight of the fact that the driver behind your child's obsessions is the uncontrollable internal anxiety he feels. His OCD does not result from anything you've done or not done as a parent. It has nothing to do with a difficult toilet training or any other early childhood upsets. It is a neurobiological condition very likely with a genetic cause.

Remember, it's your child's anxiety creating his obsessive thoughts, and these thoughts are involuntary on his part. It isn't rebelliousness, or a desire for attention, even if the same behavior in another child might easily be classified as an act of defiance or a ploy for attention.

The Desire for Order

In addition to a wish for an unobtainable degree of cleanliness, an OCD obsession can also take the form of an extreme need for order in the face of perceived chaos. At an early age, your child may create rituals based on superstitions designed to protect loved ones from imagined threats. No matter what his age, his obsessive thoughts can also involve aggressions. Each of these categories of obsession requires closer examination.

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