My patient’s parent recently complained about her adolescent daughter’s angry outbursts. These episodes occurred particularly during discussions about taking showers and completing assignments for school. Early adolescence is a time when children often desire more independence. As it turns out, defiance was not the problem. Fear was the culprit.
Let’s call my patient, Pearl. Some inquiries about Pearl’s habits revealed that she liked to do some of her activities a certain number of times. She explained that certain numbers made her feel better, but she particularly liked the number six. Pearl would repeat many behaviors six times. She often felt that if she didn’t do something six times, something terrible would happen to someone she cared about. When washing, she had to clean each body part six times. When doing homework, she would delete and retype words six times. If Pearl lost track, she would have to go back to the beginning and start over. It became so exhausting and time-consuming; she would avoid specific tasks like showering or doing school work. When pressed by her parents, she would become angry, and an argument would surely follow.
Pearl was suffering from Obsessive-Compulsive Disorder (OCD), a psychological disorder routed in fear and anxiety. Pearl was experiencing fears (or obsessions) about harm coming to family members that she could only manage by avoiding certain activities or engaging in compulsions designed to reassure and lower her anxiety level.
Like many people with OCD and other anxiety disorders, Pearl felt embarrassed about her worries and had put considerable energy into hiding her anxiety. She thought her parents might not understand her irrational fears, which felt very real to her. Instead, it manifested through her anger. Think to yourself: have you ever been afraid of something? Perhaps it was flying, a spider, or a long elevator ride. Imagine if someone forced you to do that very thing. You probably would feel so scared that the fear would quickly lead to the secondary emotion of anger.
Fortunately, there was a clear path for Pearl. With some effort, Pearl was able to share her concerns with her parents. Once they understood her anger’s underlying cause, we established a treatment plan that helped her gradually overcome her fears.
Is there anyone in your life that sounds like Pearl? Perhaps they are avoiding something that makes them feel uncomfortable. The best thing you can do is to allow them to talk about it. Many people with anxiety are relieved when they don’t have to hide. Below are some tips for helping family members with anxiety:
- Always ask: Is my request making you feel uncomfortable?
- Remain Nonjudgmental: This step is critical. People often worry that others will think their fears aren’t valid because they might not be rational. Reassure them that you won’t question their fear even if it doesn’t make sense to you.
- Offer Support: Offer to support them in their efforts, whether it’s managing fears, taking actions that feel scary, or seeking out a mental health professional.
- Be Patient: There are many ups and downs when trying to overcome fears. It takes time and effort and a healthy dose of courage. Remind your loved ones that you will be there for them as long as it takes.
By taking the steps above, you can play an essential role in helping someone you care about to let go of fears that may be detrimentally impacting their ability to function. Additional information about the treatment of OCD can be found at www.iocdf.org.
Francine Rosenberg, PsyD., practices cognitive-behavior therapy, specializing in the treatment of adults and children with obsessive-compulsive disorder and stress, depression, and anxiety disorders.
