It May Be OCD

Q: I have a family of seven children, bli ayin hara, the oldest being my 14-year-old daughter. She is what every mother would want — smart, helpful, tzniusdig, with very good middos. Until about a year ago, she showed a lot of simchas hachaim and, generally, was a pleasure to have around. At that time, however, she began to have doubts about herself and expressed her feelings that she was lacking in many ways. She no longer seemed comfortable in her own skin. She began to question if she remembered to say a brachah before she ate something, and was very upset that she couldn’t always remember whether or not she did. She was concerned about the extent to which she had to cover up at night if she needed to leave her room — but felt uncomfortable at the thought of asking a she’eilah. She would wash her hands excessively, for fear she wasn’t doing it correctly. She became very self-conscious, and her simchas hachaim has been replaced by a lot of anxiety.

This anxiety began at about the same time that she had a falling-out with a close friend, after which she was no longer part of a “group” in her class. Could there be a connection between her social isolation and her new attitude and behavior? What can we do to help her?

A: Though certain events could have triggered your daughter’s anxiety, it is likely that this tendency has a genetic component. Any disturbing or disappointing event or circumstance in her life could eventually have brought on this response. Your daughter’s symptoms point to OCD (obsessive-compulsive disorder). This is not a formal diagnosis; I have not met your daughter and can therefore not make such a definitive statement.

When a person responds to life stresses in such a manner, it reflects discomfort over not being able to control the environment. OCD behavior is based on an irrational assumption, e.g.: “Although I cannot control this situation that is causing me anxiety, at least I can control my personal territory by a) washing my hands many times, and, b) worrying about whether my behavior was satisfactory.”

Though one can understand this on an intellectual level, it is much more difficult to change obsessive thinking and behavior once these concepts are explained. In other areas of psychotherapy, a cognitive understanding of the source of one’s problems is often extremely helpful in solving them. However, with OCD, other strategies have proven to be more useful.

To deal with your daughter’s religious questions, try to find a Rav who is comfortable talking to people with anxiety-provoking religious issues. If none live in your neighborhood, you may find one who is available for telephone consultation. Actual halachah can be explained and unnecessary feelings of guilt thereby prevented.

Obsessive thoughts are not necessarily pushed away successfully. Just try telling yourself not to think of a pink elephant; needing to push away the thought will bring it on — along with the accompanying thought that you need to push it away!

It is best to let the thought pass before your mind like a wave that comes in and then moves back out to the sea.

Is your daughter maintaining social relationships with others — if not classmates, then neighborhood or camp friends? If fears have taken over her life in other ways, you can attempt to work with her by motivating her to connect and reconnect with peers.

If this is unsuccessful, professional help would be the next step in dealing with your daughter’s needs.