The Unraveling: Parenting a Preschooler with OCD
The sky is low, heavy gray threatening more rain. On the pavement my four-year-old son Theo thrashes. It’s afternoon, and we are on a walk with our next-door neighbors, three little boys and their mom Karin. Frozen, I stare down at Theo. Karin swoops down to scoop him up, then strides down the hill toward home.
Still crying, Theo calls back, “I’m sorry, Mama! I’m sorry!”
For the last few weeks, our days are marked by Theo’s apologies. It doesn’t matter what the offense, or if there is any offense at all. If we tell him to follow us into the house? Crumbling into tears, he says sorry again and again. We ask him to move over so his brother can sit down? Hysterics, followed by apologies.
A script starts to follow the apologies. “I’m sorry Mama. I won’t do it anymore. Let’s not have a hard day.” Always those lines, and he wants us to reply: “Okay.” But not just any “Okay;” it must be spoken in a certain tone of voice. If not, tears.
Could this be normal? What is normal? Is this a stage that will pass, or something more?
Questions multiply like mice, our minds full of the sounds they make. Evenings, my husband and I talk about Theo, and search Theo’s symptoms online. Research indicates it could be Obsessive Compulsive Disorder; in the night I often wake worrying, our future dark as night around me.
Meanwhile, there is breakfast to make. Breakfast to clean. Snacks to pack for outings. Outings to plan and follow through. Seat belt straps to buckle and unbuckle. Diapers to change, bums to wipe. Groceries to get, unpack. In the midst of all I do, the questions are with me, and all I can do is reassure Theo, again and again: everything is okay.
I consult my aunt, a therapist, and she seems uncertain at first as I describe the symptoms. When I mention the scripted apologies, her voice drops an octave: “Oh. It sounds like OCD.”
OCD. This word thickens the fear already felt. Hanging up the phone, I resolve to get Theo to a doctor, and soon.
Obsessive-compulsive disorder is characterized by unwanted and repeated thoughts, feelings, ideas, sensations (obsessions), and behaviors that drive the sufferer to do something over and over (compulsions). Often the person carries out the behaviors to get rid of the obsessive thoughts. Reassurance-seeking is the essence of OCD; it is a means to ensure all is well.
OCD is a greedy disease, never satisfied with the territory it claims. The more it has, the more it wants, until the sufferer’s day is swallowed up by rituals and repetitive behaviors. The only way to reclaim territory lost to OCD is to starve OCD until it withers. The most effective therapy is Exposure/Response Prevention therapy (E/RP), a kind of Cognitive Behavioral Therapy, in which the sufferer is exposed to the anxiety-inducing stimulus, and resists the urge to perform the compulsion. 85 percent of people with OCD respond to E/RP.
Eric and I commit to withdraw OCD-related reassurance from Theo, effective immediately. At first, this refusal causes Theo great anguish, but victory follows. Within a few days, Theo relaxes. Creativity and humor and joy start to seep back in, our days no longer consumed with apologies, tears, screams of frustration. In fact, OCD seems to almost disappear.
Relief settles over me and my husband; the sores of the last months are soothed. Around the fringes of our thoughts, we know that this might not be the end; in all likelihood, it is not. But we are too tired to really give it much thought. Lulled into complacency, we accept this new peaceful season.
When Theo, my first, was a newborn, I remember how over and over, other new mothers and I would muse together. Oh, how our babies changed; nothing ever stayed the same. Sometimes it made us angry, we admitted. We reminded each other to hold expectations loosely.
Newborn Theo resisted sleep, at night, during the day. Expectations gripped my throat like a fist. “He should be asleep.” Rocking, nursing in the dark, high-pitched cries. Two pairs of eyes, sleepless. Diaper changes, fresh sleeper, blanket swaddling his tiny arms. Standing wobbly as he screamed, I felt my surroundings recede, melt as though seen through flames. Exhaustion pouring over like a fever.
I’d place him in the crib and walk away, but never for long. His cries always drew me back, chastened, ready to give in and give up my ideas of how he should behave. It was refinement by fire. There was pain in this struggle to adapt to mothering, to giving all, to adjusting my own expectations of how my child should be behave and what I deserved. Intellectually, I gathered over time just how important it was to hold expectations loosely. But living it out was another thing altogether.
As the newborn season faded, the level of sacrifice, both physical and mental, diminished a bit. Yes, there were changes that surprised, baffled and exasperated me. But Theo no longer lived at my breast, and I slept longer than 1.5 hours at a time. We all settled in, some, and when Willem was born, I was not shaken as in Theo’s newborn days. I’d climbed the learning curve.
With OCD’s arrival, a new learning curve presents itself. It reminds me of the newborn days, in its immediacy and unpredictability, and level of need. Fears of injury and death flood Theo. Tiny playground scratches set off questions: “Will I survive?” Poison is everywhere: our hands, his hands, and on the ground. Every move is one toward protection from contamination.
And then there are attacks of panic, sweat-soaked brown hair, muscles tight with fear. We hold him, breathing, willing calm. On its own time panic subsides, oblivious to our schedule.
An irregular pattern emerges, an uneven wave. Through anxious peaks we are lifted. Then there are dips, the easy times bringing relief. Again, again; waves come, lift us. Set us down again. It is action and surrender at once; we paddle to stay above the surface, but surrender to the waves’ shape and force.
This, I never expected: Theo, full of fear of death at four. Did the cracks in my love, the broken places, bring this to us, to him? If I had never failed to love perfectly, patiently, would he be free? And yet, even as I ask, I know perfect love is an impossibility.
At night, I lay beside Theo as he falls asleep. Prayers form like breath within me; the presence of love curls around us, silent, sustaining. I feel the fragility of his life, and mine. These bodies that contain so much joy and pain. And at the meeting place of joy and pain, there is love. Love that is sacrifice, presence in pain, ushering joy.
My mothering heart cracks, broken by pain and crushed expectations. But the shape it takes is mine to choose; let it always be love.
Laura Urban is the mother of two boys, ages 4 and 2. She lives in Charlottesville, Virginia and studied English Literature at the University of Mary Washington in Virginia.