Wednesday, March 4, 2009

Compulsive

My brother-in-law and I call them "habits," because "habits" sounds so much better than "obsessions."

Nonetheless, that's what they are. Obsessions. Compulsions, really. In fact, both he and I have--at one point or another in our lives--had the words obsessive and compulsive and disorder put together into one phrase, and applied to us in writing, on a medical record.

This means that my kids? Have it coming and going, from both ends of the gene pool.

All of which is to say that the morning 'routine' N has developed should be no surprise to me. There's the fact that he almost physically needs me to park in the same spot on the side street near the school. The fact that I must stop by the same "No Parking" sign to kiss the two of them goodbye. The fact that I absolutely, positively must then walk about twenty yards away while he and Em climb The Stairs, after which I must turn and wait for him to get to the top. The fact that he and I then have a precisely scripted and yelled dialog from (his) top of stairs to (my) assigned waiting area. (N: Bye, Mom! Love you! Me: Bye, sweetie! Love you too! N: See you after school, see you in the night time! Me: See you later! Have a great day!) The fact that as I walk away, he HAS TO continue to yell and wave to me ("Bye Mom! Bye! Love you! Bye!") until he can no longer see me.

And, quite honestly, I don't mind any of it. Or, at least, I don't mind any of the part I just described to you. Because, sure, it's a little obsessive, a little "habitty," as my BIL and I would say. But it's a harmless habit, a reassuring habit, a habit that--to anyone on the outside looking in--doesn't really look like a habit, unless they realized how choreographed it is.

I guess what it comes down to is, if it doesn't bother me, I don't think of it as a problem.

But there's a part I left out, a part that does bother me...for reasons I can't quite explain. It's the part right after the kiss at the No Parking sign, and before I retreat to my designated 'wave and shout goodbyes' spot. It's the part where he says to me, "You'll go and wait and turn around to watch me at the top of the stairs, right?" It's the part where, if I don't answer him and reassure him that yes, I will, I always do, don't I?, he will ask me again and again, won't leave my side until he gets what he's looking for, what he needs.

That's the part that feels like true obsession, because there's just so much anxiety surrounding it. I've been trying, of late, to 'wean' him of it a little. At first I went too far, refusing to answer him at all, pretending I didn't hear him. When this actually resulted in him bursting into tears, I took it down a notch. Instead, I've started dropping off the "yes, I will," part, and just reminding him that I always do. The first time I said that, he kept pushing, still pushing, "But you will today too, right? Will you?" By now, he's accepted that IS my version of yes. I've even said to him, "I'm not going to answer you, because I need you to trust me. I always stand there. If I EVER forget to stand there, then you can ask me. But since I never forget, you don't need to ask me."

The problem is, he DOES need to ask me. And he needs to get a specific answer. All he's done is translate that little diatribe above into his version of "yes." He's still getting what he wants, and what he needs, and that feels...wrong. To me.

My problem is, I know exactly how right that feels to him.

Rather, I know it's wrong, and I know he needs to stop, and I know how it will mess with him as this compulsion--this requirement--morphs into other compulsions, other requirements. But I also know how it can actually hurt--deep down in places so primal you can't even name them--if you try to deny a compulsion. It's the feeling I used to have when I'd be on the subway during my lunch hour, traveling from Manhattan to Brooklyn by myself rather than eating lunch with my friends, because I absolutely had to check to be sure my iron was turned off. It's the feeling I still sometimes get, today, when we're halfway down the street, late for a soccer game or a doctor's appointment (because it's always when we're late that the compulsions get triggered, never when I'm calm and have time; stress is what they feed on), and I become convinced that I've left a burner on on the stove, and I must go back and check the knobs...even if I haven't cooked a thing all day.

If you tried to stop me then, I...I can't tell you what would happen. Most immediately, I would descend into a panic attack. But it feels even scarier than that, on the inside. It feels like you're simply going to fall apart, literally, physically. It's not in your control, this feeling. The compulsions really do take you hostage.

And so I'm trying very hard to find a place where I can challenge N's compulsions, without scaring him like that. Make him uncomfortable, without causing him to fall apart. But it's hard, because there's such a big part of me that is right there with him. It's hard, because all the while I'm pushing at him for his own good, I'm aware that I really ought to be doing the same to myself. It's hard, because it's so unfair. He doesn't deserve this, not him, especially not him, not on top of everything else.

Frickin' genes.

7 comments:

kristenspina said...

The fact that I understand this scares the hell out of me. Sending a hug. One for each of you.

Tamar said...

If it makes you feel any better, this exact kind of need for ritual is nearly ubiquitous in spectrum kids. Which N isn't, exactly, but, well...

Which is to say, yup, I've dealt with it. It goes in waves, like everything else. It comes from anxiety, and a need to have SOMETHING he can control, that works the way he wants and expects. We've worked to break some of them, let others alone. Depends on the situation and what else is going on with him at the time. Ping me if you want to talk.

Green said...

I wonder if it will be easier for N in a year or two when other kids start making fun of him for yelling "I love you" to his mother in public, to wean off the need for it? Because eventually, sadly, that will happen.

Ambre said...

Have you done any research on it? Because if I recall, that kind of treatment of compulsive behavior was never very effective (the "just say no" treatment).

Because, really, before you can get the brain unstuck, you'll need to be able to convince it that there really isn't a burner left on, and that your mom really does love you even if she doesn't tell you exactly when she's supposed to, which... well that's the whole point, right? The brain is stuck and doesn't believe you.

The good news is that SSRIs are tremendously effective in treating OCD, and paired with specific types of therapy seem to be even better. I don't think it's the life sentence it might have been for you. Things are better now!

(start preparing now- "when I was your age, I had to trudge 3 miles barefoot in the snow to satisfy my compulsions!)

Ambre said...

http://www2.mc.duke.edu/pcaad/abstracts/Integrated%20Treatment%20of%20Pediatric%20OCD.pdf

http://emedicine.medscape.com/article/918303-overview

po said...

I've always treated "habits" (both mine and the kids') as a "pick your battles." The ones that don't impact daily life, hey, no problem! It doesn't really matter if I need to eat a big salad from right to left across the plate, or that Matthew needs to have fruit every single morning as the first thing he eats.

But stuff that is debilitating, yeah, that can't be left to its own. It gets worse, too, unfortunately, as more of life starts to feel outside his control and he seeks to corral it further.

I gotta say, while I am really not sure the Abilify did anything for Matthew's outbursts, it definitely seemed to help him be more flexible about stuff. Changes in routine generally don't produce the total and complete melt down that they used to, and that is huge.

Anonymous said...

"Because if I recall, that kind of treatment of compulsive behavior was never very effective (the "just say no" treatment)."

I wondered about this as I read, too. I don't have compulsions myself, and so the "just say no" option seems like a reasonable one. I've learned that it isn't, after interacting with others. But, what I wondered is that if we're in a car together, and you want to go back and check the stove, what should I do? And, would thinking about this give anyone insight into what to do with a child?

(bj)