Most children with OCD are and want to be “good kids.” Many, however, struggle with anger and irritability. Some have developed a habit of throwing tantrums. Anger and irritability are frequently side effects of living with OCD. Think about it: how do you feel when you are in a room with a radio pounding, people demanding something from you, and a television blaring? Thinking, listening, and functioning are extremely difficult because of all the extraneous noise. In such circumstances you probably feel angry and stressed and want to scream, “Be quiet!” because you can’t hear yourself think. This is similar to how children with OCD frequently feel. It’s hard for them to think, focus, and concentrate because there is so much noise going on in their head. So much of their resources are devoted to filtering out the noise that they just don’t have the patience that a non-affected child might demonstrate.

There’s a second contributor to the anger your child may display. Many children with OCD have lived with extreme anxiety for a long time and may have discovered that when they are distressed their parents will shift their limits. When this is the case, the result can be that the child’s distress rules the household. Sometimes, the distress takes on a life of its own. The household revolves around keeping the child calm and expectations are abandoned in order to pacify the child. Under these circumstances, tantrums and demands can become a way of life.


Discipline Strategies

Every parent needs strategies for discipline. Without them, the parent has no system to rely on and will inevitably revert to reactive parenting. A full discussion of discipline is beyond the scope of this book. However, we will review some guidelines here. Problems that parents experience usually have to do with two related kinds of behaviors. One kind comprises the behaviors that you would like your child to do, or “start” behaviors: doing therapy homework and school homework, putting things away, practicing an instrument, and so on. The other comprises the behaviors you would like your child not to do, or “stop” behaviors: yelling, screaming, hitting, demanding stuff, instigating arguments, and so on. Start and stop behaviors are often closely related in that for every behavior you want your child to stop, there is an accompanying desired start behavior that could be substituted.


Reinforcements to encourage start behaviors.

Generally, to establish start behaviors parents should use reinforcements, or rewards, such as earned privileges, money allowances, special activities, and liberal attention and praise. A common mistake that many parents make is to overlook and take for granted all the positive things their children do. Noticing this good behavior and appreciating it is the first step toward encouraging more of the behaviors that you want to see. When a child becomes hooked on positive attention, he or she will want to please you more and will be inclined to tackle other start behaviors. When first attempting to establish a start behavior, you may need to rely on extrinsic reinforcements (goodies); as the behavior becomes established you will rely more on verbal reinforcements and shift the extrinsic reinforcements to other, more difficult start behaviors.


Time-outs to discourage stop behaviors.

The more effective tools for stop behaviors are natural consequences, logical consequences, and time-out procedures. Many parents who come to therapy report that their children do not respond to time-outs. A few words about this may be helpful. First, time-outs are most useful when disciplining children twelve and under. As a child matures (starting around age ten or eleven), parents need to begin using natural and logical consequences more often. Second, time-outs should not be considered punishments but rather should be viewed as an opportunity for the child to get control of his or her behavior. A good rule of thumb for the length of time for a time-out is generally one minute for every year of your child’s age. Begin timing after the child is in the time-out location and not engaging with the parent.

Generally, when time-outs are not effective it is because they are implemented poorly. They are most effective when parents are consistent, firm, and not reactive. They are almost always ineffective when the child has engaged the parent in argument or negotiation or when the time-out is given after the parent has already become angry. Time-out must be implemented before the child has successfully pressed the parent’s buttons. To learn more about how to effectively implement time-out procedures, we highly recommend the book 1-2-3 Magic: Effective Discipline for Children 2-12, by Thomas W. Phelan, Ph.D. (1996). It provides numerous useful scenarios showing how children may counter the time-out procedure. It also helps parents to understand these situations and respond more effectively so that the strategy will work.


Natural consequences to discourage stop behaviors.

When you use natural consequences as a discipline strategy, you are letting the world teach your child for you. As your child grows, it is often preferable to sidestep a power struggle and simply let your child experience the natural consequence that follows from a poor decision. This approach affords the child the opportunity to learn that every action has a consequence, allows him or her to learn personal responsibility, and eliminates the risk of your losing a power struggle. Repeatedly losing power struggles with your child erodes your base of authority, so this outcome is to be avoided as much as possible.

Additionally, the more children experience natural consequences, the more likely it is that they will actually begin considering the possible results of their actions before they act. Rather than argue with a twelve-year-old about wearing proper clothing, let her be cold. Sidestep the nightly power struggle with a thirteen-year-old over doing his homework, and let him experience some failure. Don’t nag a sixteen-year-old out of bed in the morning; instead let her miss the bus and get to school under her own steam.


Logical consequences to discourage stop behaviors.

Relying on natural consequences is not always possible or advisable because the circumstances may be impractical, dangerous, or insufficiently aversive. An example of insufficiently aversive consequence might be when a child does not do his homework and receives a low grade but does not seem to care. An example of a dangerous natural consequence would be the car accident that could result from permitting your child to drive while under the influence of alcohol. An example of an impractical natural consequence would be letting your child miss the bus when there is no accessible pedestrian route to school.

In such circumstances, parents need to rely on logical consequences, which are consequences that are logically related to the problem at hand. For example, a report card littered with D’s and F’s because a child hasn’t been doing homework might suggest too many extracurricular activities. A logical consequence could be to drop out of basketball until the end of the season so that more time can devoted to homework. A child who drinks and drives could be required to entertain friends at your home so that you can supervise their social activities. A child who misses the bus and needs you to drive him or her because it is too far to walk could be charged a fee for your service.

As we mentioned earlier, sometimes parents of children with OCD become so consumed by their child’s symptoms that they stop leading their family. Rather than the parent being in charge, distress is calling all of the shots. In such cases, discipline seems to be a hopeless endeavor. These parents often believe discipline does not work with their child. But children with OCD are still children, with the same needs and tendencies as other children. They respond to the same parental strategies. As we said earlier, sometimes they require more parenting. If you have not been using a discipline strategy, then establishing one will be challenging but imperative. Understand that your child will not respond at first. The behavior will inevitably get worse before it improves. Your child will likely push you to see if you will be as good as your word. However, if you calmly persist and don’t back down, children with OCD will respond just like other children. Count on it.


Excerpt from Parenting through the Process in Helping Your Child with OCD: A Workbook for Parents of Children with Obsessive-Compulsive Disorder by Lee Fitzgibbons, Ph.D., and Cherry Pedrick, RN.