Q: My 8-year-old daughter is having anxiety issues that seem to border on obsessive-compulsive disorder. She wants me to repeat certain things back to her and has a set routine of things I must say when I'm tucking her into bed. She's genuinely upset by all this and tells me she thinks there's something wrong with her. I'd say it is something she can't control, but she does not do this sort of thing when she's alone with my husband. I've talked to her, tried ignoring her, refused to cooperate and even yelled - all to no avail. Could she have OCD at this age? Does she need medication? What can we do to help her?
A: I can't do a long-distance diagnosis; furthermore, I am of the heretical opinion that a) a psychiatric diagnosis concerning a child this age is rarely helpful and can actually hinder a solution, and b) the risks of psychiatric medication with a child or teen often outweigh the benefits. Now, my opinions are not shared by a majority of my colleagues in the mental health professions, so if you feel the need for an in-person evaluation of your daughter's issues, by all means, pursue one.
Based on the scant amount of information you provided and more than 40 years of experience in child and family psychology, my initial impression is that your daughter does not have a mental "disorder" that can be objectively determined. That she is exhibiting the behaviors in question only with you suggests that your relationship may have developed co-dependent aspects - a lack of emotional boundary between parent and child. If, for example, you tend to be an anxious, worrisome mom - not atypical these days, unfortunately - that would elevate the likelihood that your daughter will develop an anxiety issue of some sort.
Keep in mind that children look to their parents to interpret the world for them. In that regard, a parent's frequent concern and worry about a child or a child's academic performance can act as a self-fulfilling prophecy.
But even absent co-dependency or parental worries, children do odd, strange things at times. More often than not, and especially if parents handle these glitches calmly and confidently, they come and go. Sometimes, they may look "psychiatric" but are nothing more than an example of the inevitable bumps in life's road.
In any case, you need to experience parental competency with the behaviors at hand before they become habit and begin to spread to other people and situations. Parents I've counseled concerning similar problems have had great success simply telling obsessing children that a doctor they spoke with says such kids aren't getting enough sleep. Consequently, the doctor recommends that your daughter go to bed at
7 p.m., lights out, seven days a week until her obsessing has stopped for two weeks straight. During her rehabilitation, you should take her out of activities that would prevent her from getting to bed at the appointed time, and she should not participate in sleepovers or evening birthday parties.
In the meantime, you must stop cooperating with your daughter's requests/demands, no matter how distraught she becomes when you do. Blame it all on the doctor.
If my experience serves me well, I predict that this will be memory in a couple of months. If it isn't, then you definitely should seek a professional evaluation.
Family psychologist John Rosemond answers parents' questions on his websites, johnrosemond.com and parentguru.com.