What is an Eating Disorder?

Eating is a way to get nourishment and sustenance; it is, for the most part, a pleasant and fulfilling act. Sometimes, however, eating becomes part of a disabling or even life-threatening disorder.

What is an Eating Disorder? 
As the term implies, an eating disorder is a mental health condition that is characterized by dysfunctional eating patterns such as overeating, deliberate starvation, binging and purging. Eating disorders are associated with extreme concern or anxiety related to one’s body shape, size or weight. Some family therapists have conceptualized eating disorders as illnesses related to issues of control, like addictions or obsessive-compulsive disorder. Whatever the cause, an eating disorder is conceded as both a physiological and a psychological problem.

Who are at Risk? 
According to the National Institute of Mental Health, eating disorders occur frequently among adolescents and young adults, although there have been reported cases of childhood eating disorders and eating disorders that occur during late adulthood. The disorders are more prevalent among women than men, although in recent years, men are suffering in greater numbers.

What are the Types of Eating Disorders?
Types of eating disorders may include:

Anorexia NervosaAnorexia Nervosa is characterized by the relentless pursuit of thinness despite severe negative consequences. People with Anorexia Nervosa are convinced that they are too fat or too heavy, even if objectively they are already underweight. They may therefore engage in excessive dieting, self-induced vomiting, overexercising, the use of diuretics and laxatives, and abuse of weight management pills. Alarmingly, people with Anorexia Nervosa are ten times more likely to die from the condition than those without the disease.

Bulimia Nervosa. Bulimia Nervosa is an eating disorder characterized by repeated patterns of binging and purging. Binging refers to the consumption of large amounts of food in a short time, e.g. eating several plates of pasta in one sitting. Purging refers to the compensatory action to get rid of the food or calories consumed during the binge episode. Purging techniques include the ones people with Anorexia use to lose weight, e.g. self-induced vomiting, laxatives, diuretics and overexercising. Unlike sufferers of Anorexia, people with Bulimia may have normal body weight.

Obesity. Obesity is a condition of excess weight – essentially the result of consuming more calories than are needed for energy. It can affect a teenager’s self-image and self-confidence and it can also affect his or her health. For instance, obesity is sometimes associated with the development of insulin resistance – a sensitivity to sugars in the blood. This condition can be a precursor to a more serious condition such as diabetes.

How are Eating Disorders Treated?
There are three steps to treating eating disorders.

The first step is the physiological or medical intervention. Eating disorders may be classified under mental health issues, but they carry with them serious medical effects. People with Anorexia Nervosa, for example, can suffer from severe malnutrition that serious and irreversible damage to vital organs occur. Eating disorders may even be fatal if not arrested in time. Therefore the first order of business is to restore the patient to an ideal weight, address nutrient deficiency, and treat the medical side effects of the condition.

The second step to treating eating disorders is psychological assistance. Counseling and therapy must be employed to address the psychological reasons behind the dysfunctional eating patterns. Eating disorders are related to dysfunctions in perception of one’s weight or shape. Often, patients suffer from low self-esteem, obsession about body weight, and a sense of helplessness about their situation. It is also not unusual for other mental health issues to develop because of the eating disorder, such as depression, anxiety and substance abuse.

The last step is maintenance to prevent relapse. Like people with addictions, those with eating disorders must consistently monitor their behavior even after treatment to prevent symptoms from recurring. Joining support groups, on-going family therapy, and education about proper nutrition and weight management are ways to maintain progress in recovery from eating disorders.

How Can You Tell if Your Child is Suffering from an Eating Disorder?
You will not be ablet o diagnose an eating disorder on your own. However, what you CAN do is take your child to a doctor or psychologist for assessment if you suspect that something isn’t right. Most parents are able and willing to do this when they see that their child is overweight. However, kids suffering from bulimia may be a totally normal weight. Kids suffering from anorexia may gradually lose weight and cover it up with clothing (and excuses). However, there are some red flags that can alert a parent to the need to have the child assessed. For instance: consuming large amounts of food without gaining weight is a red flag for bulimia. Playing with food on the plate, cutting it into small bits and moving it around, becoming increasingly picky as to what is fit to eat and clearly not eating much, may be red flags for anorexia. Other symptomatic behaviors include being very cold, growing a thin layer of hair on the skin, engaging in excessive amounts of exercise, buying laxatives and vomiting without being ill. Don’t get into a conversation with your child about whether or not he or she has an eating disorder. Instead, tell your child that diagnosis will be left up to a professional.

Bulimia

Bulimia is an eating disorder – but one that is not necessarily easy to spot in one’s own child. Other eating disorders are more visible. For instance, pills almost anyone can recognize obesity – a condition in which the sufferer is significantly overweight. People can also often recognize cases of anorexia nervosa – the condition in which a person is severely under his or her ideal weight (and may therefore look painfully skinny and boney). However, it is not possible to identify someone with Bulimia Nervosa just by looking. The sufferer of this eating disorder may be a perfectly normal weight. It is not the WEIGHT that is disordered in this condition, but rather the way in which the person maintains that weight.  A bulimic (one who suffers from bulimia nervosa) eats way too many calories in one sitting (for example, a number of grilled cheese sandwiches, a full tub of ice cream, a box of crackers, a bag of chips and a plate of waffles). This episode of overeating is called “bingeing.” It is normally followed by feelings of panic (about gaining too much weight), shame and guilt and an intense effort to “undo” the eating behavior by engaging in excessive exercise or using laxatives to empty the gut, or inducing vomiting for the same purpose. Episodes of bingeing and purging (over-eating and then “undoing” the calories somehow) can sometimes occur many times a day. On average, people with Bulimia binge 12 times a week, consuming as much as 11,500 calories. Foods rich in processed sugar and fat, such as pastry, ice cream, bread and donuts are the most common objects of binges.

Bulimia Nervosa is more common than Anorexia, and affects girls more than boys.

Signs of Bulimia
Although parents can’t tell from LOOKING at their child that the youngster is suffering from bulimia, they may be able to discern a problem by observing their child’s behavior. Those suffering from bulimia usually feel a lack of control when it comes to eating. While most of us stop eating when we feel full, those with bulimia keep on eating to the point of feeling pain.  This inability to control their eating can be very embarrassing and typically bulimics try to hide their binging and purging.  Some typical symptoms that may indicate bulimia are:

  • Wanting to eat alone
  • Eating very little in public
  • Frequent trips to the bathroom after meals
  • Disappearance of food
  • Hidden stashes of junk food
  • Eating large amounts of food without putting on weight
  • Excessive exercising
  • Using laxatives, enemas or diuretics

People with bulimia may also have physical symptoms caused by purging.  These include:

  • Puffy cheeks caused by repeated vomiting
  • Discoloured teeth caused by exposure to stomach acid when throwing up
  • Frequent fluctuations in weight
  • Calluses or scars on knuckles and hands caused by putting fingers down the throat to induce vomiting

An Impulse-Control Issue
Are sufferers of Bulimia Nervosa aware that their eating pattern is dysfunctional? Yes. However, they have difficulty controlling themselves; the act of binging and purging is a compulsion. In fact, many Bulimics report that they only stop a cycle of binging or purging when they feel physical pain. Otherwise, they can’t help themselves. They have a compulsion that is too strong for them to overcome, much like an addicts relationship to his substance.

Bulimia Nervosa has been linked to emotional stress as well as body image issues. Low self-esteem, a history of abuse, a difficult life transition, traumatic experiences and other stresses have been found to be higher in those suffering from Bulimia. In addition, there is a higher rate of bulimia in those who are drawn to a body-conscious hobby or profession like modeling, ballet, gymnastics or physical fitness training. It is not clear whether the activity and peer pressure found in the activity actually induces bulimia or whether those with bulimic tendencies (obsession about body image) may choose those activities to begin with.

A Serious Health Threat
Bulimia is a serious health issue. Chronic bingeing and purging can cause serious gastro-intestinal diseases. The purging (in the form of vomiting, laxatives, and diuretics) can lead to electrolyte imbalances, usually in the form of low potassium levels. Low potassium results in symptoms such as lethargy, confusion, irregular heartbeat, and cardiac and kidney dysfunction. In severe cases it can even cause death. Other effects of bulimia may include:

  • Weight gain
  • Constipation caused by chronic laxative use
  • Abdominal pain and bloating
  • Tooth decay
  • Chronic sore throat and hoarseness
  • Broken blood vessels in the eyes
  • Weakness and dizziness
  • Loss of menstrual periods
  • Acid reflux

Risk Factors
Bulimia generally begins in adolescence and 90 – 95% of those with the disease are women.  There is no single cause for bulimia but low self-esteem and poor body image are often contributing factors.  Some of the more common risk factors for bulimia are:

  • Dieting – people who diet on a regular basis are more likely to develop an eating disorder than those who don’t.
  • Involvement in professions/activities that emphasize weight control – the pressure placed on gymnasts, dancers, models, actors, and other athletes to maintain a certain weight can lead to the development of eating disorders.
  • Low self esteem – this can be a result of abuse, depression, a critical home environment, and a desire for perfection.
  • Poor body image – young women are often influenced by our culture’s glorification of thinness and beauty.
  • Major life changes – bulimia is sometimes a reaction to stress, which can accompany a major life change.  Examples of major life changes may be; moving away from home, puberty, divorce, and the break-up of relationships.
  • Biological factors – since eating disorders run in families there is likely a genetic component.  In addition, research indicates that low serotonin levels play a role in bulimia.

Treatment for Bulimia
Treatment for Bulimia should be a combination of a medical and a psychological program. At times, an in-patient weight management program needs to be implemented alongside counseling in order to address the two critical aspects of the illness. Most often, however, bulimia is effectively treated on an out-patient basis. People do heal from this disorder. They may have relapses occasionally but when they learn effective stress-management techniques they can usually prevent relapses over the long-run. Seeking counseling and using self-help strategies are both important for long term recovery.

Psychotherapy is the main form of treatment for bulimia.  Specifically, cognitive behavioural therapy is often used to break the binge-and-purge cycle and change unhealthy thought patterns.

Medication such as anti-depressants may also be used.  These help to reduce binge eating and treat the depression that is often a part of bulimia.

Defiant Behavior (ODD)

“I’m not eating that!”

“I can leave class anytime I want to. You don’t own me.”

“No. Make me!”

Do you have a child who is consistently negativistic, argumentative and hostile? Does it seem that every little issue in your household turns into a major battle? If so, you are probably exhausted! Parenting has turned out to be a struggle rather than the pleasure you expected it to be. And you are probably also confused – why is your child acting this way? Is there something you have done wrong? Or is there something wrong with your child?

There are  many reasons why your child may be this way, ranging from normal temperamental issues and  periods of intense emotional stress all the way  to various mental health diagnoses. In this article we will examine one possible cause of consistent defiant behavior: ODD – Oppositional Defiant Disorder.

Why Do Kids Misbehave?
Misbehavior is normal for any child; part of the natural developmental process involves testing parental limits. In addition, stress can make kids irritable and less able to control their behavior or their mouths. Sick, overwhelmed, hungry or tired kids disobey, talk back, argue or even deliberately trample parents’ authority. Sometimes, simple lack of knowledge or inexperience is the culprit behind misbehavior.

However, when a child defies authority regularly and consistently – across all situations and independent of other factors like stress, fatigue and so on – it is possible that he or she is suffering from a condition called Oppositional Defiant Disorder or ODD.

What Is Oppositional Defiant Disorder?
Oppositional Defiant Disorder is a chronic, pervasive pattern of being uncooperative, defiant and hostile to authority figures like parents, teachers and most adults. ODD symptoms are far more intense than ordinary misbehavior, impairing a child’s ability to function well at home or school. Sibling relationships and friendships are also affected.

Children with ODD have frequent temper tantrums and other dramatic displays of displeasure, engage in excessive arguments with adults, constantly challenge or question rules, and deliberately attempt to annoy or upset other people. They’re also prone to blaming others and exhibiting vengeful behavior. Symptoms usually occur at both home and school. ODD most frequently  occurs along with other diagnoses such as Attention Deficit Hyperactivity Disorder (ADHD), learning disabilities, mood disorders and anxiety disorders. ODD is estimated to affect 3 to 16% of the population of children and teens. It can manifest as early as a child’s toddler years.

What Causes ODD?
Experts point to a combination of factors including biological (e.g. an impairment on the area of the brain that manages impulse control and emotional management), social (e.g. harsh and punitive parenting techniques, stressful family transitions, difficulty relating with people) and cognitive (e.g. poor problem-solving skills, irrational thinking) issues. It is recommended  that interventions for a child diagnosed with ODD are also holistic, addressing the whole child.

What Can Parents Do?
If you suspect that your child may have ODD, consult a pediatric mental health professional for assessment, and if necessary, a treatment plan. Once a diagnosis has been made, there are strategies that parents can employ to help their child with oppositional behavior. Management of ODD may involve therapy, medication and behavior management programs to be carried out at home and school. Positive parenting styles have been found helpful as well in the treatment of children with ODD. In particular, taking the power struggle out of parenting can lessen the tendency for the child to fight authority. When parents don’t offer strong emotional reactions to provocation, kids lose interest in trying to provoke them. Parents of ODD children can take specialized parent education training.

Although many children with ODD will benefit significantly from medication, parents can also experiment with Bach Flower Remedies instead of or along with psychotropic medication. Behavioral and psychological interventions will still be required. The remedies Vine (for defiance and hostility), Chestnut Bud (for disregard for authority), Heather (for drama and the need for attention) and Cherry Plum (for loss of control) can be added together in one mixing bottle and offered 4 drops at a time, 4 times a day until the defiant behavior has significantly improved. You can find more information on Bach Flower Remedies online and throughout this site. Before starting your child on the remedies, note how many times a day he or she currently engages in tantrums and arguments. Record the child’s behavior for a month while the child is taking the remedies. If there is a positive effect, continue as is, but if no difference is noted, be sure to consult with your doctor and/or psychiatrist for proper assessment and medical treatment.

Eats Too Much

The epidemic of obesity and weight-related issues among young people has reached alarming heights. Around 25 million children below the age of seven are believed to be overweight. Experts blame the modern lifestyle of fast food and computer games for the phenomenon, alongside the phenomenon of overworked parents who lack the time and energy to pay close attention to the food they are serving their kids, or those who simply cannot afford to do so. No matter what lifestyle factors are at play, the bottom line is that when kids eat more than they can properly burn off, they will weigh more than they should.

Obesity
Eating too much can lead to being a little overweight or significantly overweight. The term “obese” normally refers to a person who possesses a gross excess of fat in the body. Obese children often suffer harassment at the hands of their peers who may mock or tease them. This experience alone can leave emotional lasting scars. However, obesity also puts youngsters at risk for many serious and even potentially fatal diseases. According to the World Health Organization, childhood obesity increases the likelihood of premature death and disability during adulthood. Obese people are more likely than normal weight people to suffer heart attack, stroke, liver problems, diabetes, osteoarthritis and even cancer. Obesity is also linked to mental health issues, such as low self-esteem, depression and anxiety disorders.

What can Parents Do?
Some children are food addicts. Despite their parents’ best efforts, the children eat too much and too often – with weight issues being the result. Nagging children does not cure their addiction – it just annoys them and makes them feel shame and guilt. Criticizing your child for his or her eating habits will likely just be a waste of time and can even damage the parent-child relationship. So what can parents do?

Avoid Strict Diets
Efforts to strictly limit caloric intake can backfire, turning kids into food thieves and/or rebellious eaters. It’s better to help kids learn to enjoy the right foods in the right amounts. Parents can refrain from serving foods that are rich in fat and sugar such as french fries, fatty cuts of meat, cakes and sodas and other white flour and white sugar products, replacing them with delicious foods that are healthier and less calorie dense. In fact, parents can offer vegetables, fruits, nuts, lean meat, dairy products, legumes and grains – but only when they are prepared in such a way that the kids will actually enjoy them. Foods that are real foods are much more difficult to consume in excessive quantities: they are naturally satisfying and filling. It is far easier to eat too many potato chips than it is to eat too many roasted baby carrots!

Many parents have discovered the secret power of spices: children will actually enjoy healthy foods when they are skillfully spiced; it’s the bland foods that lack appeal. Many international cuisines use spices that may not currently be in your cupboard but that are easily available in your local supermarket. Home-made desserts can be made with nut flours and coconut flours – products that are so nutritionally enriched that they actually reduce cravings. Borrow a few cookbooks from your neighborhood library, look online to get some new ideas for enhancing the flavor of your foods or take a cooking class – do whatever you need to do to introduce your children to nutritious AND delicious foods. If you are short on time (and who isn’t?), you can find amazing food that takes only a couple of ingredients and a couple of minutes to make. You can prepare meals in a crockpot that will cook throughout the day and be ready when you come home from work. The health food store may also carry some ready-made foods – but do read the ingredients; being sold in a health food store does not guarantee that the product is calorie wise or even nutritious.

Everything in the Right Time
In addition, try serving your children junk foods and sugary treats (pastries, sugar cereals and candies) in small quantities and ONLY on specific regular occasions (i.e the weekend or better yet, only on one day of the weekend!). Allowing kids to have a little bit of these treats helps reduce feelings of deprivation. No child should have to feel that any one food or one kind of food is too “fattening” to enjoy on occasion in small portions. Remember: feelings of deprivation tend to sabotage any healthy eating plan,leading to eventual weight gain.

Offer Them a Drink Before Meals
One way to get a child to eat a little less during meal time is to give him a tall glass of water five minutes before eating. The extra fluid can make him feel fuller even before he takes a bite. You may also consider giving a healthy snack before bigger meals in order to lessen your child’s appetite.

Serve Smaller Portions
Although there is no need to have your child track his or her calories, there is also no need to serve enormous quantities of food to your family. Kids get used to whatever their parents provide. Try shifting from the buffet, help-yourself style to fixed servings, preparing small portions already set for each member of the family. Or, go with the buffet style but encourage your child to notice how many servings he has had and how large they are. You can say things like, “You can have as much as you want, but just notice how many helpings you’ve taken,” or “Take as big a serving as you like, but just notice how much of your plate it covers – 1/4 or 1/2 or almost all of it.” Asking the child to notice what he is doing gives him the beginning of inner control. Often “mindless eating” – that is, not noticing – is the culprit behind unwanted extra pounds. You may also encourage your child to chew slower and take his time eating. Research has shown that it takes a while for the “stomach is full” message to reach our brains, so chewing slowly can help this message get to the brain before a person takes the next spoonful. Pausing between bites and waiting a bit between courses also allows the “full” message to get to the brain in time to stop a person from grabbing more food.

Exercise and Movement is Also Important
Try to get the family moving. If possible, enroll the kids in physical activities after school – swimming, karate, gymnastics, dance class, hockey and so on. Or, take them to the park to run around and play. Walk around the block with them if possible; walk wherever you can with them instead of driving. Don’t let them just sit in front of a screen all day. Provide a model for them as well: let them see you doing your stretches and exercises in your home. Remember – don’t nag your child or fight with him or her as this can lead to stress – which in turn leads to over-eating. Try to make physical activity fun and normal rather than some sort of punishment for a child who needs to lose some weight.

Consider Mood and Anxiety Issues
Is the increased appetite new for your child? If so, consider the possibility that your child is using food as a way to manage emotional issues. Perhaps the child is going through a stressful transition. Or perhaps she feels insecure about something. Understanding emotional triggers to eating can help parents manage their child’s eating habits by addressing the root causes. In some cases, psychological counseling may be more appropriate than a diet.

Get a Physical Check-up
Increased appetite can be a sign of an underlying medical condition; perhaps the body is starving for a particular vitamin or mineral. Consider taking your child to both a medical doctor and a naturopath for a thorough assessment. Dealing  with physical triggers to excess eating as early as possible may  help prevent more serious health issues from developing.

Your Child Needs Your Help
Kids cannot solve their overeating problems on their own. Their parents must help them – not only because the children may already be “food addicts” overwhelmed by their own cravings, but also because they lack skills, knowledge and ability to manage their own weight loss program. It is up to parents to become knowledgeable – whether that is through self-education or through the assistance of weight loss professionals like pediatric specialists or obesity specialists. You are also the one to see to it that your child gets the help he or she may need. If your own interventions are not helping, try to get your child professional help. Possible sources of help include your child’s doctor, a dietician, a nutritionist, a child psychologist or weight-loss clinic that treats kids and teens.

Kleptomania

People often assume that a thief steals for a reason. However, link the truth is that stealing doesn’t always have a practical purpose and not everyone who steals is a “thief” in the true sense of that word. A child may be caught stealing something he doesn’t really want nor need, pharm something he already has, or something of very little value. A child may also steal for the sake of stealing, not because of a need for attention, a desire for revenge or a show of inadequacy. When someone steals without any obvious gain, it is possible that he or she is suffering from a mental health condition called kleptomania.

What is Kleptomania?
Kleptomania is a mental health condition characterized by a strong urge to steal, and a feeling of relief after stealing. It’s an impulse-control disorder, similar to Obsessive-Compulsive Disorder, where the patient suffers from persistent thoughts and repetitive patterns of behavior. Kleptomania usually has its onset in young adulthood, but there are cases of kids as young as 5 years old with Kleptomania.

Are Kleptomaniacs Criminals?
Kleptomania must be distinguished from the criminal act of stealing, or the willful and knowing theft of someone else’s property. People with Kleptomania steal not because they want to, but because they feel they have to. They experience extreme anxiety when they do not give in to the behavior of stealing, and stealing is the only way they can get relief. They know that what they do is wrong, but they can’t help it. In fact, many kleptomaniacs steal things that have little value, such as paper clips or tissue paper rolls. They may also return what they have stolen afterwards, as they are not particularly interested in the stolen object itself, but rather the act of stealing.

How is Kleptomania Treated?
The dynamics behind Kleptomania point to how the condition should be handled by parents, teachers and helping professionals.

It’s recommended that Kleptomaniacs (those who suffer from Kleptomania) not be punished for their stealing, as they have a mental health condition that needs help and healing – not punishment. In fact, many researchers argue that Kleptomania, like all impulse-control issues, may have a physiological origin. Abnormally low amounts of the neurotransmitter serotonin in the brain may be the cause of Kleptomania.

Counseling is an appropriate first response to a child with Kleptomania. Except for really young children, people with Kleptomania are aware that what they are doing is dysfunctional and they are often stressed, even depressed, about what they are going through. Helping a child vent his or her feelings over the inability to control impulses is a good start.

Cognitive-Behavioral Therapy has been known to assist children with Kleptomania in managing their urges and compulsion. Skills in stress and anxiety management are also helpful, as it is stress and anxiety that often compel a kleptomaniac to steal. Gradually sensitizing a child to the impact of stealing on other people can also be a way to help kids with Kleptomania manage their condition.

When therapy alone fails to cure the condition, psychotropic medicine of the type used for obsessive-compulsive disorder may be prescribed.

Obsessive-Compulsive Disorder (OCD)

Parents may wonder if their child has OCD when they notice that the child seems overly occupied with worries and strange behaviors. If the parent has seen something similar in another family member who has already been diagnosed with OCD, he or she may suspect that this child may also have the disorder.  Other parents have no such frame of reference and are simply perplexed by their youngster’s behavior.

Small children are often anxious and ritualistic – they want their parents to give them 10 kisses at bedtime and stay with them the whole night! It’s very difficult for a parent to know whether such behavior is just normal childish behavior or something that requires professional attention. However, when a child starts demanding 24 kisses – exactly 12 on one cheek and 12 on the other – a parent may become suspicious. It doesn’t “feel” or “sound” right to him or her. The only way to know if the child’s feelings and actions are within the normal range is to obtain a proper assessment.

A  diagnosis  of OCD can only be confirmed or dis-confirmed by a qualified mental health professional. If you are concerned about your child, talk to your family doctor or pediatrician – this person can refer you to a psychiatrist or clinical psychologist for an assessment. OCD will not normally be diagnosed unless the symptoms are causing the child significant distress or unless they are affecting the child’s school life, social life or home life adversely. Even if the child is diagnosed with OCD, there is much to be hopeful about: there are excellent behavioral treatments for OCD. People who receive treatment have a good recovery rate.

What is OCD?
OCD involves obsessions and compulsions (also called “rituals”). Obsessions are “sticky” thoughts – thoughts that just won’t go away (at least not by themselves). A teenager might obsess about whether she remembered to lock the door. Instead of just leaving the house like others do, she thinks about that door, asking herself over and over again if she remembered to lock it. Obsessions can also be sensations – a type of feeling. For instance, a child might pull his sock up over and over again until it hits a spot on the leg that feels “just right.” His mother might say that he is obsessed with getting just the right spot and she would be correct – the youngster cannot tolerate the feeling of the sock being at the wrong spot. Compulsions are actions that a person does that either “undoes” an obsession or ends it in some way. Spending lots of time arranging the socks is a compulsion. The teenager who is obsessing about whether or not she remembered to lock the door, may go back to the house 2, 3, or more times “to make sure.” The ritual of checking is called a compulsion.

A common obsession has to do with the fear of becoming contaminated. This may involve a fear of germs. “I don’t want to touch the money because everyone else has touched the money and it probably is full of germs and germs are dangerous.” Equally common is the ritual of excessive washing in order to clean oneself of germs or contamination. “My daughter washes her hands until they bleed.” This is not normal washing that is meant to remove surface dirt; rather this is OCD washing that is meant to remove spiritual impurities that can harm a person. In fact, in order not to HAVE to wash oneself, OCD sufferers start to avoid being near problematic triggers. For instance, they might only handle money while wearing gloves (so their hands won’t touch the contaminated money and they will then not have to wash off the contamination). Or, they  may not open a door with their hand – they might use a foot or an elbow or ask someone else to open it. Avoidance actually contributes to the illness – the more a person avoids OCD triggers, the stronger the illness of OCD becomes. In fact, the major aspect of treating OCD involves teaching the sufferer to avoid avoidance! A child must be helped to confront and live with his or her worst fears.

Most obsessions center around issues of health, safety, goodness and cleanliness. As stated above, they can also center around certain “right” feelings (like the feeling of having a shoe lace tied up “just right”).

For instance, children and teens can obsess about the idea they have might have made a religious error. To “fix” it they might pray for hours on end (missing school in the process). Some people want to do things perfectly; a child may write something, erase it, write it again, erase it, write it again, over and over and over again – destroying the paper and taking hours to perform a task that other children are completing in minutes. Some people with OCD need to have everything in a certain order – for example, in order from biggest to smallest. Again, trying to get it that way can take painful hours; if the order is messed up by someone else, the person with OCD can become hysterical. These are just some of the common variations of OCD. There are many others and each person can have his or her own unique version of the disorder.

Treatment for a religious obsession might be insisting that the youngster DOES NOT pray for more than the normal few minutes that prayer takes a healthy person. In other words, the youngster must just live with the worry that perhaps she did something wrong. Instead of making that worry go away by praying excessively, she must just have the worry without doing anything to fix it or end it. This sort of treatment has the effect of stopping the worry altogether. Therefore, no more excessive praying is required. No obsession leads to no ritual which essentially is no OCD.

Obsessive-Compulsive Disorder (OCD)
People who suffer from OCD, even kids, usually know that their thoughts and actions are irrational, and they often feel distressed over their lack of control. The obsessions and compulsions, however, feel more powerful than a person’s will. The obsessive compulsive person is trapped in a vicious cycle; he or she needs to behave a certain way (perform a ritualistic behavior) to relive stress and anxiety, but the behavior itself creates more stress and anxiety. This can lead to intense attempts to avoid situations that will trigger the compulsion. For instance, if someone knows that touching a doorknob will create anxiety that can only be soothed by repeated washing of the hands, then he will try not to touch the doorknob. Instead, he might ask someone else to open the door, or he might open it with his elbow or he might wear gloves in order to open it. The time it takes to perform rituals can severely affect a person’s life and the difficulty of avoiding triggers can make a person function in a very odd way. OCD is thus very stressful. Attempts to manage OCD can sometimes lead to other mental health complications, such as clinical depression, other anxiety disorders, substance abuse and/or other impulse-control issues. OCD is sometimes found in people who have other clinical disorders like anorexia, Tourette’s Syndrome or ADD/ADHD.

What Causes  OCD?
Current thinking suggests that that OCD is a biologically- based condition, possibly the result of serotonin deficiency in the brain and other chemical conditions. It has been observed that OCD tends to run in families (that is, other family members have OCD or they may have other anxiety disorders) and therefore it is thought that a vulnerability for the condition is passed on through the genes.  OCD can also occur in a form called PANDAS  (pediatric autoimmune neuropsychiatric disorder) – when it suddenly appears following a streptococcal infection like strep throat. In this case it is believed that OCD is triggered by the same bacteria that causes scarlet fever and strep throat. Again, it might be that a person must have the vulnerable genes in order for the bacteria to have this effect.

What is the Treatment for OCD?
OCD is best treated with CBT – Cognitive Behavioral Therapy. Although some teens and adults can relieve their own symptoms with self-help by reading books on OCD (see for instance, “Overcoming Compulsive Washing” or “Overcoming Compulsive Checking” by Dr. Munford), most people will have the best results by consulting a qualified mental health professional who specializes in the diagnosis and treatment of OCD. Ask your doctor for a referral. Parents should read up on OCD and get professional counseling to know how to best help their child. Uninformed parents often accidently worsen OCD by helping the child AVOID triggers. As we saw above, EXPOSURE to the frightening element is curative – NOT avoidance! Parents need to know exactly how to help their child or teen in the home setting. The earlier OCD is treated, the easier it is to treat. On the other hand, the more one lets OCD fester, the more they will experience its symptoms. It is possible that intense stress causes certain physical conditions in the brain that then trigger the dynamics of OCD. Relieving stress may make it easier to treat the OCD. Therefore, psychotherapy may play a role in helping ease OCD by reducing overall stress and anxiety in the system (much like medication does) so that CBT can be effective.

Natural Treatment for Stress Relief

Bach Flower Remedies are one-ounce bottles of specially prepared water (see below for details). Although they are only water, they can affect the way people feel emotionally. In fact, they can help balance emotions so that a person can release stress, upset, hurt, anger, fear, sadness, irritation, jealousy, impatience  and any other distressed emotion. Indeed,  many people report that they have successfully used Bach Flower Remedies to feel calmer, sleep better, worry less, recover faster from upset and heartache, handle parenting stress and work stress better and so on. Many have also reported that they were able to see a reduction in their child’s tantrums, aggressive behaviors, moodiness  or fears because of the use of the remedies.

But the remedies can do even more than help a transitory bad feeling : they can also help correct the tendency to fall into those feelings in the first place. When the remedies are used to treat a chronic emotional issue (like a tendency to be stubborn or a tendency to be explosive), they might actually be assisting in a processes now referred to as  “epigentic healing” – the healing of the gene that leads one to experience chronically negative emotional states. We now know that genes can be turned on and off and this is what appears to be happening when someone takes a long course of Bach Flower Therapy. This means that a child who tends to be very shy can take the remedies over time to reduce the shy tendency altogether. The Bach Flowers do not change personality, however. What they do is enable a person to be their own best self. A very strong-willed, obstinate child will retain his strength of character but instead of just being difficult to live with he will be his best self: a born leader, a confident person, one who can take appropriate action. When the Flower Remedies help a childhood overcome chronic separation anxiety, they leave the child’s personality intact: it is the same youngster without debilitating fear blocking the expression of his true self.

It’s hard to believe that these little remedies can work and it’s best not to even TRY to believe that they will; rather, just try the remedies yourself and observe how you feel while taking them. Or, offer a remedy to your child and observe the child’s behavior over the next days and weeks to see if there is any difference. Bach Flowers sometimes seem to have a dramatically positive effect on both behavior and mood and other times seem to make little difference. (Of course, there is no medical or psychological treatment either that works equally well for every single person who employs it.) In the latter case, it might be that the wrong mix of remedies is being used, but it can also be that a longer period is necessary before change will occur or even that a particular person is not responsive to the remedies at the particular time that they are being offered (i.e. this could change in the future). It can also be that while the Bach Flowers are having some positive effect, a complete treatment  requires other interventions as well including strategies like nutritional support, exercise, psychotherapy and/or medicine.

How are Bach Flowers Prepared and Used?
Dr. Edward Bach, a prominent physician in Britain who died in 1935, was interested in preventative medicine. In his search for something that could boost the immune system to ward off disease or to help the body recover more quickly and thoroughly from illness, he discovered a water-based method of healing that became known as “Bach Flower Therapy.” Modern physicists use principles of quantum physics to explain how water remedies can affect human emotions. Dr. Bach, however, understood the remedies on a purely intuitive level. He felt their effects and he could see what they were able to do to effectively relieve stress and emotional distress.

Bach Flower Remedies are prepared by taking the head of a certain flowering plant and placing it in a clear bowl of pure water. The water is heated in sunlight or on a stove for several hours (depending on which flower is being used) and then the flower is removed. The water is the remedy. It is bottled (and preserved with a bit of grape alcholol) and – in our times – sold in health food stores throughout the world as well as on-line.

Bach Fower Remedies are a form of vibrational medicine, not herbal medicine. They are NOT medicinal. They do not act on the body at all. They don’t interact with other medicines or foods or health conditions or anything. They are the same as water is to the system. However, if someone cannot have even a minute amount of alcohol in their system, they should look for the newer remedies that are made using glycerin instead. In general, however, anyone can safely use Bach Flower Remedies – babies, children, teens and adults, pregnant women and elderly people. Even plants and animals respond well to the Bach Flowers!

How Does One Take Bach Flowers?
If a person is using only one of the 38 remedies, they can take 2 drops from the remedy bottle in a small amount of liquid. They should do so 4 times a day – morning, mid-day, afternoon and evening.

However, most people take anywhere from 2 to 7 remedies that have been mixed together in a “mixing bottle.” To prepare a mixing bottle, one places water in a glass bottle with a glass dropper – generally a  30 ml  (1oz.) amber bottle. (These bottles are sold wherever Bach Flower Remedies are sold and they are called Bach Mixing Bottles.) Then one adds 2 drops from each desired remedy bottle. If a person was using 7 remedies, they would be adding 14 Bach Remedy drops to their mixing bottle. To ensure that bacteria does not grow inside of the mixing bottle, a teaspoon of brandy or apple cider vinegar should be added to the bottle.

This Bach Flower Remedy Mixture is then taken, 4 drops at a time, in hot or cold liquid, with or without food. Ideally, these 4 drops are taken 4 times a day, for a total of 16 drops daily. A person takes them in the morning, mid-day, afternoon and evening.

Adults can put 4 drops of their Bach Flower mixture into coffee, tea, water, juice, soup or any other liquid. Children can take their drops in water, chocolate milk, juice, cereal or any other beverage.

A person takes their mixture until they start forgetting to take it and they no longer need it. (Or, parents give a mixture to a child until the child’s behavior or mood issues have resolved to the point where the parent is now forgetting to give it to the child)  If symptoms return (and they most likely will), the person starts taking the remedy again. In fact a person may end up using the remedy off and on for a year or two (less time in children) before the problematic tendency  disappears completely.

How Does One Know Which Remedies to Use?
Dr. Bach wanted to keep his healing method very simply. A person should be able to read the description of the 38 remedies and decide which ones he needs. Of course, some people feel that they need all 38! However, no more than 7 should be used at a time.

A person could pick up a book on Bach Flower Remedies and decide which flowers they need based on the description of who the remedy is for and what it can do. Also, most health food stores have a pamphlet that explain what the remedies can too. Alternatively, a person can make an appointment with a Bach Flower Practitioner who will be pleased to help them design a remedy for themselves or their child.

Child Hurts the New Baby

It is common for toddlers and small kids to be rough with a new baby.  They sometimes hug the infant a little too long or a little too hard (or both). Sometimes they pinch, squeeze or even hit the poor little baby. What prompts them to behave this way? What can parents do about it?

If your little one is hurting the new baby, consider the following tips:

Don’t Ask Why
Toddlers don’t know why they hurt the baby, so don’t bother asking them why they are being so rough. For instance, don’t say, “Why do you do that? Don’t you love your new sister?”  Your youngster has no insight into the matter. In fact, when your child approaches the baby to touch her soft skin or look at her big eyes, he generally has no intention of hurting her. However, within moments, “something” overtakes him and his arms lash out as if they are running on their own power. When his parents start yelling at him for hurting the baby, he is often genuinely surprised at the sudden turn of events. Why is everyone mad at him again? Why did his arms do that?

Inner Conflict
Since it isn’t the conscious mind that is misbehaving, there is really no point in talking to the toddler’s conscious mind. That is, don’t waste your time telling him to be nice to the baby or not to hurt the baby. Don’t ask him why he is hurting the baby. None of this will help at all.

Instead, it’s more helpful to work with the unconscious mind. The toddler’s behavior is showing what the unconscious mind is feeling: anger. The youngster has been replaced with a special little bundle that is demanding everyones attention. This is making the toddler feel displaced, ignored, neglected, sad and jealous. But it is also making him mad. He wants to get rid of this intruder who is ruining his party.

Parents can speak directly to the unconscious mind by naming the anger. “Oh, I see that there’s a part of you that is mad at Baby Jenny.” (This statement is very true. Only part of your toddler resents the baby. Other parts of your child are both loving and intensely protective of the infant.) After naming the feeling, you can try to help the mad and hurting part: “We can’t hurt the baby. What we CAN do is make your mad part feel better.  Would you feel better if you could sit in Mommy’s lap for awhile? Do you need some more stories or maybe a treat?” and so on.  Acknowledging, accepting and addressing the pain of the hurting part helps the hurting part to calm down.

Avoid Punishment
Interestingly, direct interventions like punishment generally have no positive effect on rough toddler behavior. In fact, the more the parents punish a toddler for hurting a baby, the more the toddler tends to hurt the baby. Sometimes, giving positive attention for GENTLE behavior can be helpful in reducing rough behavior. Try using the CLeaR Method – comment, label, reward (see Raise Your Kids without Raising Your Voice for details). “You’re touching the baby so softly. That’s so gentle of you – what a good brother you are. I think that deserves a big kiss/extra story/etc.”

Help the Child Bond with the New Baby
Allowing your older child to still be a baby can help reduce feelings of anger, insecurity and jealousy. Refer to your little ones (the new baby and the other children) as “little ones” – as in, “Good Morning, Little Guys! How are all my little people doing this morning?” By linking the other small children with the baby, the children feel that they haven’t lost out – they are still loved in that special baby-love way. In fact, be careful not to promote the small children to “big boy” or “big girl” now that the baby is here – unless they’re teenagers, they aren’t big yet! Let the whole group be little and you’re more likely to see a strong, loving bond forming between the children and the baby and a little less likely to see physical aggression.

Interestingly, it’s best NOT to give an older child more individual attention at this time because this behavior sends the message that there is not enough love to go around. Instead, try to include the older ones with the baby in one big, happy family. “Let’s take the baby to the park with us,” or “Let’s let the baby read the book with us,” or “Let’s let the baby watch us bake today” are all inclusive statements that show the child that you will not abandon the baby and you will not abandon him. Inclusiveness increases the older child’s sense of security and reduces his feelings of insecure competition with the baby.

Consider Bach Flower Remedies
Bach Flower Remedies can often help reduce aggressive and jealous behaviors. Just add two drops of this harmless tincture to a bit of liquid (juice, soda, water, milk, chocolate milk or anything else), 4 times a day until the behavior is no longer a problem. The remedies are available in health food stores and on-line. Of the 38 Remedies in the Bach system, try  Holly (for jealousy) and Vine (for aggressive behavior). If you like, you can mix both together in a Bach Mixing Bottle (an empty glass bottle with a glass dropper, available where the remedies are sold). Put two drops of each remedy in the small mixing bottle along with water and about a tsp of brandy (to help prevent bacteria in the bottle). From the mixing bottle, drop 4 drops in liquid, 4 times a day until the behavior is no longer a problem. Read more about Bach Flower Remedies on this site, online and through self-help books. Alternatively, call a Bach Flower Practitioner to help select individually tailored remedies. Bach Remedies are excellent to try when you are worried that your toddler may really hurt your baby – particularly because toddlers are usually too young for therapy.

What to Do In the Moment
Speak slowly and firmly when correcting your youngster, but refrain from showing real upset. Of course, protect the baby! Try not to allow the older child to be alone with the little one. However, as you probably know all too well, your toddler can hurt the baby even while the baby is being held in your arms! When that happens, stand up and move out of the child’s reach without saying a word.  Withdrawing attention by this quiet move is more effect than looking the little one in the eye and shouting “NO!” Don’t actually ignore your child – just lightly remove yourself and the baby for a few moments. You are trying to keep the infant safe while you are minimizing negative attention to the older one. Make a simple rule and repeat it as necessary: “Gentle with the baby.” Refrain from the negative version (“We don’t hurt the baby”) because this is likely to get translated by the toddler’s highly emotional brain as an instruction TO hurt the baby!

Patience is Required
It’s unpleasant but normal for toddlers and preschoolers to hurt a new baby. Showing your understanding is an important way to help start building your child’s emotional intelligence. Although a child’s rough behavior is very upsetting to parents, it’s important that parents not make matters worse by showing anger or becoming very punitive. Patience is required! With your gentle approach, chances are that your toddler will move through his upset feelings and aggressive behavior much more quickly.

Over and Over Again

When a child or teen repeats actions for no obvious reason, there is often a reason! In fact, there are many reasons why young people might repeat movements or actions. Let’s look at the more common ones.

  • Pervasive Developmental Disorders (PPD): Some mental health disorders like autism, Asperger’s Disorder and PPDNOS (pervasive developmental disorder not otherwise specified) may have repetitive behaviors as part of their symptom picture. For instance, there may be rocking or rhythmic movements, hand flapping or twirling. Such behaviors in and of themselves do not indicate the presence of a pervasive developmental disorder – many other symptoms must be present for a diagnosis to be made. Behavioral Therapy may help reduce these kinds of repetitive behaviors.
  • Simple Nervous Habits. Some children kick their legs back and forth when seated or rock back and forth, or twirl their hair or even crack their knuckles.  This sort of repetitive behavior may just be a discharge of “nervous energy.” Unless these behaviors interfere with functioning or cause distress, there is no need to treat them. However, some people find that giving their children Bach Flower Remedies (try “Agrimony”) may help reduce nervous habits. Consult a Bach Flower Practitioner for an individually designed remedy most appropriate for your child’s needs.
  • Tourettes Syndrome. Tic disorders are, by definition, repetitive behaviors. SImple Tic Disorders such as Transient Tic Disorder (common in 7 – 9 year old children) may consist of one repetitive behavior such as blinking or twitching a shoulder or clearing the throat. In simple Tic disorders, the particular behavior may change from time to time, or, there may be more than one movement or sound involved. These sorts of tics usually disappear on their own within a year or so, although in some children they can last years or right into adulthood. In Tourette’s Syndrome, the child has BOTH repetitive movement and repetitive vocalization occuring, and there can be more than one of each kind. Bach Flower Remedies have helped people with Tic Disorders. There are also medications that your doctor can presecribe. In addition, there are behavioral therapies that can help bring tics under control.
  • Obsessive Compulsive Disorder (OCD)When a child feels compelled to repeat certain behaviors and very anxious if he is prevented from doing so, he may be suffering from OCD. OCD is an anxiety disorder that consists of worries (obsessions) and rituals (repeated behaviors). Sometimes the child is aware of the worry (i.e. he is afraid that someone in his family will become sick) and sometimes he just feels anxious without knowing why. In either case, he discovers a series of repetitive actions that makes him feel temporarily calmer. For instance, he may count numbers in his head, or take a certain number of steps forward and backward, or wash his hands a certain number of times or write and rewrite and rewrite his schoolwork. There are many variations of repetitive behaviors that those who have OCD may perform. If the child’s behavior interferes with his functioning at home or school or if he is very distressed by having to do them, it is highly possible that OCD is the culprit. However, only a professional child psychologist or psychiatrist can make an accurate diagnosis and prescribe an appropriate treatment plan (usually consisting of cognitive behavioral therapy -CBT and sometimes, medication as well).
  • Physical Disorders and Medications. Occasionally repetitive behaviors can be symptomatic of a medical condition or a reaction to medication. Your pediatrician or GP can do an assessment for you.

Habits

What’s the difference between a bad habit, a nervous habit and a compulsive habit? When should a parent be concerned about a child’s habit?

Bad Habits
Everyone has bad habits. Leaving one’s dish on the table is a bad habit – one that many kids (and adults!) have. Calling a sibling “stupid” or some other insulting name can be a bad habit. Slamming the car door too hard can also be a bad habit. A bad habit is any repetitive behavior that needs improvement. That behavior can be a small, annoying behavior or it can be a more serious problematic behavior. For instance, a teen might have a bad habit of calling home past midnight to say that he’ll be out later than expected, or, he might have a really bad habit of forgetting to call home at all and just showing up at 3 in the morning.

Parents can help their children overcome bad habits by using normal parenting techniques like teaching, rewarding and disciplining. If the child’s bad habit is interfering with his health or functioning, however, then professional intervention is a good idea. For instance, a child who is chronically sleep-deprived due to going to bed too late or who is doing poorly in school due to chronically getting up too late, may benefit from counseling or other appropriate therapy.

Nervous Habits
Nervous habits are bodily behaviors that aim to discharge stress or tension. Twirling one’s hair, biting one’s nails, rocking back and forth, shaking one’s feet while seated – all these actions are examples of nervous habits. Talking rapidly, running to the bathroom urgently, gulping down food, giggling inappropriately – these, too, can be nervous habits.

If a child has a nervous habit he or she may benefit from learning better techniques for stress reduction. There are children’s classes and groups for yoga and mindfulness meditation that can be helpful. Alternative therapies can also help. For instance, herbal medicine can come the system down and Bach Flower Therapy can relieve stress and tension. Parental nagging to stop the nervous habit, on the other hand, does not help at all – if anything, it might increase the nervous habit. If the habit is bothering the child or parent, a consultation with a mental health professional may be helpful.

Compulsive Habits
While bad habits and nervous habits occur to some extent in almost everyone, compulsive habits occur only in those who have various mental health disorders. Eating disorders often involve compulsive activities like weighing oneself or cutting food into tiny bits. Certain kinds of psychotic disorders also have compulsive symptoms.

Compulsive habits are most characteristic of the anxiety disorder called obsessive-compulsive disorder (OCD). This sort of habit is more ritualistic than the habits we’ve discussed so far. For instance, someone with a “nervous” habit might tap her feet while waiting in a long line. However, someone with a compulsive habit might tap her feet exactly 13 times – not because she is tense, but because she is attempting to reduce truly anxious, troubling feelings. Tapping exactly 13 times – not one less or one more -is a compulsion. A compulsion is a specific action whose purpose is to calm the anxiety associated with troubling obsessions (thoughts or sensations). There are many, many types of compulsive habits. Washing one’s hands a certain number of times is a common compulsive habit that often results in red, chapped, even bleeding skin. Counting steps, saying certain words or numbers, checking things repeatedly, praying in a specified way not characteristic for others who practice the same religion – all of these can be compulsive habits. The child who engages in these or other compulsive habits is a slave to the habit – he or she MUST perform the action or else suffers overwhelming anxiety.

Compulsive habits do not tend to go away by themselves. Instead, they get worse and worse over time and spread into more and more styles of compulsive habits. The sooner a child receives professional treatment for compulsive habits, the sooner the child will be able to lead a normal, healthy, compulsion-free life. If you think that your child’s habits may be compulsive in nature, arrange for an assessment with a mental health professional (psychologist or psychiatrist). Treatment can help!