cont from

Co-Morbid Conditions: Obsessive Compulsive Disorder (OCD)

OCD, I find, is the most closely related to the tics of Tourette Syndrome. I have often referred to my obsessions and compulsions as tics of the mind. My body tics and my mind tics as it gets "stuck" on thoughts and ideas. An obsession is a thought that your mind gets stuck on which causes great anxiety. A compulsion is what you have to do to alleviate the anxiety of an obsession. For example, one of the most common obsessions that we hear about is a germ obsession. A person has a fear of germs and contamination, most often irrational. In order to alleviate this obsession, this person must wash. They may wash their hands over and over again, take very long, very frequent showers, clean their houses and belongings continually.

As a French teacher, I travel to Europe each summer with my students. On my most recent trip, I had with me a 13-year-old boy who suffers from OCD. He is obsessed with germs. One day, he had to go to the bathroom very badly, but just could not go because there was no soap in the public bathroom. The only way that I got him to use the facilities was to give him some moist towelettes that I had with me to disinfect his hands after he had used the bathroom.

Although germ obsessions are the ones we hear about the most, OCD can takes literally hundreds of other forms. A person can become obsessed with counting things over and over again. With OCD, there is always the doubt that you did something right the first time, so you must do it repeatedly, just to be sure. I once met a young girl who developed a counting obsession which took the form of counting every word in every line the she read or wrote. She was a sophomore in high school and was soon failing everything. The more anxious she became, the worse the compulsion was. Everything she attempted to read or write took hours and hours. Until the obsession subsided, it became necessary to provide her with a note taker and books on tape to allow her to be able to finish her work.

When I was 7 years old, I began a compulsion which caused me to read five words in my reader and then in my head count to 25 before I could go on to the next word. I was moved from the top reading group to several groups below because the teacher assumed that I simply did not know the next word. When I tell that story today, people inevitably ask me why I didn't simply tell the teacher what was going on in my head. There are two reasons why kids don't tell. First of all, you have nothing to compare it to. How did I know that other kids weren't doing the same thing in their head? Secondly, the biggest fear is that everyone will think that you're crazy. You feel crazy doing these ridiculous things over and over again.

An obsession could take the form of checking things over and over again. You're never quite sure that you did it right the first time. I would check the stove, the coffee pot, the iron, the thermostat, eight and nine times before I could get out of my house in the morning. Symmetry is a very common obsession. The blinds must be perfect, the bedspread without a wrinkle. Sometimes the silliest things can become an obsession. I became obsessed with the milk carton being perfectly straight on the refrigerator shelf. One morning I went back 8 times to straighten the milk carton. Feeling that I would never be able to get out of my house, I decided to take the milk to work with me. What is perceived as perfectionism is almost always a red flag for OCD-- kids who erase over and over again, kids who asked repeated questions. People with OCD don't transition well. They may appear to be stubborn, but may just be having a difficult time moving on to a new activity.

Whether you're dealing with tics, obsessions or symptoms of ADHD, I reiterate that the key word is creativity. First you must accept that this is not a child misbehaving or purposely trying to aggravate you, this is merely a neurological disorder over which the child has very little control. I once worked with a boy whose obsession was to always have a perfectly sharpened pencil. He would interrupt the class 16 or 17 times every class period to re-sharpen his pencil. The solution was quite simple. We gave him 20 sharpened pencils at the beginning of every class. Two weeks later, the boy himself came up with an even better solution. He bought a mechanical pencil. Of course, it's not always that easy, but as an educator you must always be creative and keep an open mind.

For more information, contact the National Tourette Syndrome Association at (718) 224-2999 or visit their website at www.tsa-usa.org.

next: Educating Children With Tourette Syndrome

top . pages 1 2 . send to friend . tourette's site map

Reviewed: 03/2006