The Health Blog

THE FIRST STRATEGY FOR COPING WITH OCD: IGNORE OBSESSIONSa student in our university health services group was struck by obsessions of loved ones becoming sick. She could only restore them to health with tapping or touching. She was devastatingly embarrassed when, as sometimes happened, her friends made light of her rituals.
Shelly: I get these pictures in my mind of awful things happening. Usually, it’s my Mom having a heart attack. First I see it taking place really clearly. Then I have the feeling—I know it doesn’t make sense, but I definitely have the feeling—that it might come true unless I do some little “thing.” So I tap my fingers on the table eight times—always eight—and I feel better. Or else I touch everything on the table. I hate it when someone says: “What did you do that for?” That kills me. It just kills me.student: I used to have almost exactly the same obsessions. I would be afraid that something bad would happen if I didn’t arrange things a certain way. Like before I went to bed, I had to touch every single thing in my room. But now I just try to ignore those thoughts. I pretend they’re some creep who’s trying to bother me.
Ignoring obsessions is an ideal coping method. It is, after all, the way most people deal with intrusive, unwanted thoughts. They say to themselves something like, “That sure is a silly thought, I won’t. pay it any attention”—a fitting response, because ignoring an obsession saps its strength, whereas fighting it only forces it to come back stronger.OCDers need to look on their obsessions in such a way as to allow them to stay in the forefront of consciousness. That way, habituation can take place and the unwanted thoughts will eventually go away on their own. The perfect attitude might be summed like this: It’s okay that I had that thought, and it’s okay if it stays. It’s no big deal.Of course, the whole problem with OCD is that a chemical disorder of the brain makes ignoring obsessions very difficult. Often it is helpful to find a metaphor that helps to put an unwanted thought in its place. It may be likened to a wino on a city street, static on the radio, flies at a picnic, or an unwanted suitor (this one works particularly well for college-age women). The response is the same: Once an obsession is recognized, pay as little attention to it as possible.Ignoring obsessions works best when obsessions are mild. Sometimes OCD sufferers advance to this strategy only after they have progressed in treatment. Sherry, for instance, who once suffered harm obsessions so frightful that she could hardly bear even to bring them to mind, recently told me: “What works now is just to let them happen. Not to knife myself, obviously! But just to let the thoughts come and to let the thoughts go. Ignore them. Treat them as a person I don’t want to deal with.”*30/338/2*

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ADHD (ATTENTION DEFICIT HYPERACTIVITY DISORDER) IN CHILDREN AND ADOLESCENTSAttention deficit hyperactivity disorder is not something that develops at a specific age, like acne. Research suggests that ADHD children are probably born with the syndrome, and many strong indicators may be present from the very first day of life.It’s usually during the many developmental stages of infancy and childhood that ADHD begins to show itself in its myriad forms. The underlying symptoms of the disorder are strikingly similar throughout life, but manifest themselves differently according to a child’s age and developmental level. For example, in infancy an ADHD child may be “colicky” and have crying fits. At age seven, his impulsivity and hyperactivity may exhibit themselves in temper tantrums and an inability to remain still. The symptom is the same, but it manifests itself quite differently according to age.In determining whether a child has ADHD, doctors and specialists perform what’s known as a “differential diagnosis.” In brief, this means that all the patient’s symptoms are analyzed and all possible causes are eliminated one by one until only the true cause remains.A differential diagnosis is especially important when working with children because the potential causes of their disruptive behavior can be numerous, depending on their age and developmental stage. Some of the most common include con duct disorder, separation anxiety or overanxious disorder, bipolar affective disorder (mania or depression), schizophrenia, mental retardation, learning disabilities, lead poisoning, and medical problems such as hyperthyroidism or migraine headaches.*13\173\2*

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