How Parental OCD Affects Families

Morgue Files

People with Postpartum OCD first experience symptoms right before or after childbirth. Some begin to have symptoms during pregnancy.

Other parents may develop OCD symptoms when their children are a bit older and more independent. For these parents, the obsessive thoughts may begin when it is time for the child to go to daycare or attend school. Often this is the first time the child has been away from home and the close supervision of the parent(s).

 Parents may begin to obsess about contamination or their inability to ensure the child is safe or getting his/her needs met, among other things.

For those who had OCD before their children were born, new thoughts or fears may arise. Even people who have been successfully managing their OCD symptoms can relapse if parental responsibilities trigger new intrusive thoughts. During times of high stress or life transitions, breakthrough symptoms can recur with different obsessions and compulsions.

Parental OCD Affects the Whole Family

Black, Gaffney, Schlosser and Gabel found in a two-year follow-up study that children with a parent who has OCD are more likely than others to develop social, behavioral or emotional conditions. Parents with OCD often experience problems in their own social, emotional and behavioral functioning. Jennifer Jencks, LICSW and Barbara Van Noppen, Ph.D. suggest in their article about accommodation that these problems also affect family functioning and may impact child development.

They explain accommodation in the case of OCD to be ways in which the family intuitively supports the parent (reassurance, avoidance, etc.) that may unintentionally reinforce his/her OCD.  Accommodation is one of the primary factors that predicts the severity of OCD symptoms, according to Van Noppen and Steketee.

Treatment for Parental OCD   

Treatment for parents with OCD is much like treatment for others with OCD. Ideally, anyone with OCD would get individual therapy based on a cognitive-behavioral therapy (CBT) model. Most people respond well to a combination of Exposure and Response Prevention (ERP), a specific type of CBT, and traditional CBT to address the thoughts that drive compulsions.

ERP involves repeated exposure to the fear without engaging in the behavior that is used to decrease anxiety. A parent with Postpartum OCD might be asked to observe his/her child sleeping without placing a mirror by the child’s nose to ensure s/he is breathing (or any other ritual the parent may use to manage intrusive thoughts that the child might die in his/her sleep). The goal of ERP is to realize that the anxiety will fade without engaging in the rituals or behaviors one generally uses to calm the fear and/or anxiety.

Another component of therapy for parents with OCD is family therapy. It is important for family members to understand the disorder and ways they may inadvertently contribute to it.

Children and spouses or partners learn how they accommodate the parent with OCD, and new strategies to disengage in that behavior. By talking about these issues together, children and spouses/partners learn how to resist old behaviors and responses and replace them with new ones. The parent with OCD also learns from each family member how s/he feels when asked to engage in behaviors or rituals that are harmful to the parent.

Medication is often used for the treatment of any type of OCD. It is important to work with a psychiatrist who can guide and direct your treatment, especially any medications you take. Antidepressants are often effective in the treatment of OCD. Finding the right medication at the correct dose can take a while, so follow through and good communication with the psychiatrist and therapist is critical. It is helpful to keep a log or journal of your symptoms to share with the doctor and therapist. This allows them to see patterns over time and tweak medication as needed.

Self Help for Parental OCD

Self-help and support groups are also very helpful for parents with OCD. Groups allow the members to learn from those who share similar challenges, and to give back to others as they learn to cope with their condition.

Relaxation activities and mindfulness meditation are key to managing OCD and daily stress. Most researchers recommend these techniques for people with OCD.

It is also important to take care of your health, as physical health impacts mental health. Get plenty of sleep, eat nutritious foods and try to get some exercise most days. It is helpful to avoid caffeine as it may contribute to anxiety.

Black, D.W., Gaffney, G. R., Schlosser, S. & Gabel, J. (2003). Children of parents with obsessive-compulsive disorder- 2-year follow-up study. Acta Psychiatry Scand, April 107 (4) 305-13.

Jencks, J., & Noppen, B. V. Have we ​forgotten the children who have a parent with OCD?: Accommodation and early intervention. International OCD (Obsessive Compulsive Disorder) Foundation.

Van Noppen, B. & Steketee, G. (2009). Testing a conceptual model of patient and family predictors of Obsessive Compulsive Disorder (OCD) symptoms, Behavior Research and Therapy, 47, 18-25.

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