Ask a Pro: Concerned about 12 year old son's possible OCD causing inappropriate thoughts

[Linda-ROPro]

About 3 months ago, while my husband/his father was out of town at a class he needed to take, my 12 (almost 13) year old son came into the living room and said he wanted to talk to me about something. He wanted me to remove an app from his tablet because apparently there had been some inappropriate pictures on it. In speaking with him it appears they were of women in very little clothes and he felt bad as he had been seeking them out to look at them. We discussed sexuality and the changes going on in his body and that desire can be a normal feeling, etc. He seemed to get better but for days after that he would come to me to confess little things and just seem to have an overwhelming amount of guilt over anything he'd done 'wrong'. Eventually in time those confessions faded and then stopped.

Fast forward about a month ago, again when his father was out of town for class, he came to me with some sexual dreams and thoughts he had been having. I again told him that was normal at his age. He said thoughts and images kept popping into his head and no matter what he can't get them out. I spoke to him about perhaps trying something new or going outside and playing basketball, etc when that happens. He seemed to calm down enough to go about the day but I could tell he was still having problems. The next afternoon he came to me and said he was really worried something was wrong with him because earlier when I had been cleaning up a spill he was able to see down my shirt and ever since he kept having sexual thoughts that include me. I remained calm, though inside I was anything but calm!, and tried to explain to him that it may have nothing to do with me, just that I was a female he happened to see often. Still the guilt ate away at him, the thoughts kept plaguing him and getting worse until I came home to find him in a full anxiety attack, crying and saying he felt like he had hit his breaking point. At this point I did some research and learned about OCD with a sexual obsession component. It spoke about how often a child will even worry they are attracted to a parent. My husband and I went over this with him. Learning that there may be a reason, like OCD, that this was occuring helped but it was a really, really rough week. He had many breakdowns. We discovered in the process his 'confession sessions' with us were likely actually compulsions to relieve the anxiety his obsessions were causing and could be making things worse. We discussed this with him and he began trying to handle things himself and talk down his anxiety on his own. We told him we would help him seek professional help if needed. After that week things got better though and seemed to even go back to normal.

This past week I could tell he has been acting different. He was very quiet and withdrawn from me. I thought it may be his end of year exams stressing him out. Then last night he said he had been having some problems again and that he feels so much guilt due to his previous thoughts of me. I didn't ask if he had more recent thoughts of me and he didn't say. I think in a way I didnt want to know. I did ask if overall he felt this was better than last time and he said yes, a little. He was playing a video game with his father and I was working on my computer. We spoke about it a few minutes and then I could hear him taking deep breaths to ease his anxiety for a long while afterwards until finally I got up and went to bed as I felt like I was part of the problem. He later told his dad he had even had fears before that he (meaning his dad) may have hurt me when we argued and then felt very guilty he had doubted his dad. So his OCD seems to be centered around guilt with a sexual component thrown in. Thinking back he had other OCD tendencies when he was younger, we just never recognized them as OCD.

My problem is now I dont know how to be around him. I feel like I'm causing problems. In addition he does virtual schooling (and did so even pre-Covid) so he is with me and only me all day long. I have long suffered from anxiety and depression myself and this has kicked them into high gear. I even went out and bought some new clothes so they could fit me big and make my figure less noticeable, however because I am large chested that is very hard to do. I am at a loss. My husband is off work today so I literally stayed in my room until noon and then he took our son out to do something with just the two of them. I hate losing the very close relationship I've always had with my son and I want him to know I love him deeply but I am worried that everything I do will trigger him so I avoid him. I also hate seeing him suffer like this. I'd would rather suffer everyday of my life than to see him suffer any. I also feel like this is my fault, that I did something to trigger this because the day before he first said that about me I kissed his cheek when I hugged him and joked that he wasn't too old for it. He is a great kid, always has been very sensitive, and has also discussed crushes he has had on girls he knows so I do know he is attracted to girls his own age.

Anyone ever been through anything similar or have any advice?

TRIPLEP13

Dear @TRIPLEP13 ,

You’re obviously a very caring and engaged parent, and have spent some time thinking about what could be happening for your son, so that you can best support him.

Firstly, I want to let you know that while feelings of guilt are really common in these types of situations, things like kissing your son’s cheek, hugging him and spending time with him have not caused this. The causes of OCD are complex, but there is no evidence that normal, supportive parenting behaviours (which is what you have described) increase the risk of OCD.

I don’t have enough information to tell if your son does have OCD because sometimes other forms of anxiety can seem similar to OCD at first (and it is generally not possible to diagnose without having spoken to the person), but as you have mentioned, some forms of OCD do involve having sexual thoughts about inappropriate people (such as family members).

You mentioned that you would be willing to help him get professional help if needed. I would suggest that now is a good time to do that. It is really wonderful that you have been able to talk to him about OCD to help him understand his thoughts and feelings, and this is a great first step.

A psychologist who has experience with working with people with OCD will be able to further explore what is happening for your son and work with him and you to learn skills to address these symptoms. If your son does have OCD it is important that he receives professional treatment, as untreated OCD can sometimes worsen over time. When OCD treatment is provided early, then improvements can happen quite quickly.

If you’re in Australia, you can search for a psychologist experienced in OCD here: https://www.psychology.org.au/Find-a-Psychologist by selecting ‘OCD’ from the list of conditions.

I can understand why you would be feeling self-conscious at the moment, and wanting to do what you can to minimise any distress for your son. It’s really common for parents and other family members to try to support children and teens with OCD by changing their behaviour to avoid ‘triggering’ these symptoms. However, this can actually be unhelpful, because it generally doesn’t prevent these thoughts from occurring, and can reinforce the idea that distressing thoughts should be responded to with a change in behaviour (which can increase symptoms over time). A professional working with your son will be able to come up with a plan for how you can support the work he is doing in therapy, which will provide some support and guidance for you in knowing how to respond to your son.

In the meantime, I would encourage you to continue to let your son know that you don’t blame him for the symptoms he is experiencing and to continue to encourage him to do things which have been helpful in the past for his anxiety. You can spend as much time with your son as you feel comfortable with - spending time with him isn’t the cause of his symptoms. Since you have such a close relationship with your son, I imagine that he is missing spending time with you and being able to talk to you, as much as you are missing him.

If you do find that the situation is continuing to cause you a lot of distress, it might also be helpful to explore professional support for yourself, so that you can have your own space to talk through your feelings about this difficult situation.

Best wishes,

Linda

Linda is a psychologist experienced in working with people across the lifespan, including teenagers and their families, in a variety of settings, and is ReachOut's Clinical Lead.

[Linda-ROPro]

Fast forward about a month ago, again when his father was out of town for class, he came to me with some sexual dreams and thoughts he had been having. I again told him that was normal at his age. He said thoughts and images kept popping into his head and no matter what he can't get them out. I spoke to him about perhaps trying something new or going outside and playing basketball, etc when that happens. He seemed to calm down enough to go about the day but I could tell he was still having problems. The next afternoon he came to me and said he was really worried something was wrong with him because earlier when I had been cleaning up a spill he was able to see down my shirt and ever since he kept having sexual thoughts that include me. I remained calm, though inside I was anything but calm!, and tried to explain to him that it may have nothing to do with me, just that I was a female he happened to see often. Still the guilt ate away at him, the thoughts kept plaguing him and getting worse until I came home to find him in a full anxiety attack, crying and saying he felt like he had hit his breaking point. At this point I did some research and learned about OCD with a sexual obsession component. It spoke about how often a child will even worry they are attracted to a parent. My husband and I went over this with him. Learning that there may be a reason, like OCD, that this was occuring helped but it was a really, really rough week. He had many breakdowns. We discovered in the process his 'confession sessions' with us were likely actually compulsions to relieve the anxiety his obsessions were causing and could be making things worse. We discussed this with him and he began trying to handle things himself and talk down his anxiety on his own. We told him we would help him seek professional help if needed. After that week things got better though and seemed to even go back to normal.

This past week I could tell he has been acting different. He was very quiet and withdrawn from me. I thought it may be his end of year exams stressing him out. Then last night he said he had been having some problems again and that he feels so much guilt due to his previous thoughts of me. I didn't ask if he had more recent thoughts of me and he didn't say. I think in a way I didnt want to know. I did ask if overall he felt this was better than last time and he said yes, a little. He was playing a video game with his father and I was working on my computer. We spoke about it a few minutes and then I could hear him taking deep breaths to ease his anxiety for a long while afterwards until finally I got up and went to bed as I felt like I was part of the problem. He later told his dad he had even had fears before that he (meaning his dad) may have hurt me when we argued and then felt very guilty he had doubted his dad. So his OCD seems to be centered around guilt with a sexual component thrown in. Thinking back he had other OCD tendencies when he was younger, we just never recognized them as OCD.

My problem is now I dont know how to be around him. I feel like I'm causing problems. In addition he does virtual schooling (and did so even pre-Covid) so he is with me and only me all day long. I have long suffered from anxiety and depression myself and this has kicked them into high gear. I even went out and bought some new clothes so they could fit me big and make my figure less noticeable, however because I am large chested that is very hard to do. I am at a loss. My husband is off work today so I literally stayed in my room until noon and then he took our son out to do something with just the two of them. I hate losing the very close relationship I've always had with my son and I want him to know I love him deeply but I am worried that everything I do will trigger him so I avoid him. I also hate seeing him suffer like this. I'd would rather suffer everyday of my life than to see him suffer any. I also feel like this is my fault, that I did something to trigger this because the day before he first said that about me I kissed his cheek when I hugged him and joked that he wasn't too old for it. He is a great kid, always has been very sensitive, and has also discussed crushes he has had on girls he knows so I do know he is attracted to girls his own age.

Anyone ever been through anything similar or have any advice?

TRIPLEP13

Dear @TRIPLEP13 ,

You’re obviously a very caring and engaged parent, and have spent some time thinking about what could be happening for your son, so that you can best support him.

Firstly, I want to let you know that while feelings of guilt are really common in these types of situations, things like kissing your son’s cheek, hugging him and spending time with him have not caused this. The causes of OCD are complex, but there is no evidence that normal, supportive parenting behaviours (which is what you have described) increase the risk of OCD.

I don’t have enough information to tell if your son does have OCD because sometimes other forms of anxiety can seem similar to OCD at first (and it is generally not possible to diagnose without having spoken to the person), but as you have mentioned, some forms of OCD do involve having sexual thoughts about inappropriate people (such as family members).

You mentioned that you would be willing to help him get professional help if needed. I would suggest that now is a good time to do that. It is really wonderful that you have been able to talk to him about OCD to help him understand his thoughts and feelings, and this is a great first step.

A psychologist who has experience with working with people with OCD will be able to further explore what is happening for your son and work with him and you to learn skills to address these symptoms. If your son does have OCD it is important that he receives professional treatment, as untreated OCD can sometimes worsen over time. When OCD treatment is provided early, then improvements can happen quite quickly.

If you’re in Australia, you can search for a psychologist experienced in OCD here: https://www.psychology.org.au/Find-a-Psychologist by selecting ‘OCD’ from the list of conditions.

I can understand why you would be feeling self-conscious at the moment, and wanting to do what you can to minimise any distress for your son. It’s really common for parents and other family members to try to support children and teens with OCD by changing their behaviour to avoid ‘triggering’ these symptoms. However, this can actually be unhelpful, because it generally doesn’t prevent these thoughts from occurring, and can reinforce the idea that distressing thoughts should be responded to with a change in behaviour (which can increase symptoms over time). A professional working with your son will be able to come up with a plan for how you can support the work he is doing in therapy, which will provide some support and guidance for you in knowing how to respond to your son.

In the meantime, I would encourage you to continue to let your son know that you don’t blame him for the symptoms he is experiencing and to continue to encourage him to do things which have been helpful in the past for his anxiety. You can spend as much time with your son as you feel comfortable with - spending time with him isn’t the cause of his symptoms. Since you have such a close relationship with your son, I imagine that he is missing spending time with you and being able to talk to you, as much as you are missing him.

If you do find that the situation is continuing to cause you a lot of distress, it might also be helpful to explore professional support for yourself, so that you can have your own space to talk through your feelings about this difficult situation.

Best wishes,

Linda

Linda is a psychologist experienced in working with people across the lifespan, including teenagers and their families, in a variety of settings, and is ReachOut's Clinical Lead.

[Toby98]

It sounds to me like moral scrupulosity which is a type of OCD. The important thing to remember with OCD is that it doesn’t mean a person wants to act out their thoughts. Im guessing he came to you because he was overwhelmed with intrusive thoughts, not because he was dangerous. A person with OCD is usually so scared by their unwanted thoughts they can’t stop thinking about them. This relieves anxiety by constantly monitoring the feared behavior as a way of feeling in control. Exposure Response Prevention can be helpful for this type of OCD. I’ve seen doctors give assignments like hanging pin up girls or picking pictures of young children and rating them by cuteness. I’m sure it was incredibly difficult but there was absolutely no judgment either from staff or patients. My advice is not to avoid him or walk on eggshells. People with OCD often “catastrophize” or jump to the worst case scenario. Having a bit of a “so what” attitude can help treat this. For example if I say “I’m too afraid to drive. I could get in an accident”. A therapist might say “well yes, that could happen” and allow me to sit with that anxiety. Over time the person will learn to cope with the uncertainty. It’s okay to confront him with his fears. It’s important for him to see that even if he has intrusive thoughts, it doesn’t mean they’ll turn into actions. Every time they don’t, he’ll feel less of a need to fixate on these thoughts as he develops the mental processes to have confidence in his own reasoning and morality. Of course, always consult a therapist and take any changes at a slow and measured pace.