Practices

When the words for feelings are not there, ask for a number instead. How much did the handwashing take over this week, one to ten, is a question someone can answer on a bad day.

A number asks far less of a person than a description, which matters when putting feelings into language is hard for them, and you still end up with…

Agree a short phrase to use at home. Saying I am having OCD worries tells a parent what is going on without handing them the worry to solve.

Once a parent hears the details they will nearly always try to help by answering, and answering is the thing that feeds it. A label gives them…

The thing your obsession keeps circling is usually something you care about a great deal. Contamination worry sits on top of wanting people safe, and harm worry sits on top of never wanting to hurt anyone.

This is worth saying out loud, because most people carry these themes as proof that something is rotten in them. Read the other way round, the theme…

What the thought is about matters far less than what happens next. Germs, illness, something too silly to say aloud: the machinery running underneath is the same in each case.

Chasing the content puts you in a game that cannot be won, because the moment one worry is settled the next turns up wearing different clothes. The…

Notice how when one worry is finally settled, another takes its place. That pattern is the thing you are actually dealing with, more than whichever worry is currently in the chair.

Most people work this out for themselves long before anyone names it. Naming it still helps, because it gives you something to watch that is bigger…

Some worries are perfectly reasonable, and settling them still will not settle you. Someone living where the storms come can build the kit, check the kit, and find the worry has quietly moved on to something else.

This one is worth testing on yourself, because it removes the argument that you would be fine if only the fear were irrational. The probability was…

Plenty of people quietly believe that thinking about something bad makes it more likely to happen. It has a name, it is a known part of this condition, and having the belief does not make you dangerous.

Hearing that it is a documented feature tends to do more than any argument about probability, because arguing about odds is a game the doubt plays…

It can help to give the parts of your brain jobs. The front of your head is the manager, the memory system is the librarian, and the alarm is a security guard who is good at his work and far too keen on it.

The point is not accuracy, it is having language you can reach for quickly. Saying the guard is overreacting again gets you further than trying to…

If stopping the ritual is out of reach for now, do it differently every time. Different order, different hand, different room, as long as it is never the same twice.

Compulsions take a lot of their grip from exactness, and disturbing the shape loosens that grip while you are still allowed to do the thing. It also…

Offer choices rather than instructions. With a problem that runs on control, being told what to do gives that control somewhere to dig in.

Two or three real options, the trade-offs said plainly, and then the pick is genuinely theirs. That holds for the big decisions too, like moving to a…

When obsessions start early and dig in deep, ask gently what anxiety looks like elsewhere in the family. Often there is an undiagnosed parent, and often that parent is helping in ways that keep the whole thing running.

None of this is about blame. A parent who checks the locks for their child, answers the same question fifteen times, or arranges the evening around a…

If the urge to arrange has to go somewhere, point it at something that can actually be finished. A kitchen drawer ends. A desk you keep re-sorting never does.

The ending is the part that matters. Finishing leaves you with something real to have done, which competes with the small relief that compulsive…

If this has been going on for years, medication is often part of what helps, and it usually needs a longer run at it than people expect. Starting low and building up slowly is the normal way of doing it.

The slow build is there to keep side effects bearable through the first few weeks, which is where most people quietly give up. It helps to agree with…