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My 15-year-old son has developed unusual obsessive behaviour

Many people use rituals to manage worry or to prepare themselves for a task

Question: We are looking for advice on how to deal with our 15-year-old son with regard to his unusual behaviour, which we noticed in the last couple of months.

He has started to go up and down the stairs twice, in and out the door twice and now starting tipping things twice. He has also said that he doesn’t like one-way systems as he likes to go back the same way he came (please note that this is just with us – in school and shops he follows the rules but just doesn’t like it).  He will actually turn around on a walk rather than do a loop.

Also he has this idea that one item of clothing is lucky for him.  He plays loads of sports from GAA to soccer to athletics and he is used to both winning and losing, but now he does not want me to wash certain item of clothes in case I wash away the good luck! When we pointed out that he has won before without wearing these, he says they won even though he was not playing at his best – so there was no convincing him.

Otherwise, he is a happy enough, gets on well in school, plays sports and gets on with his two younger sisters. Can you please give us some advice and how to convince him that he is in charge of his own thoughts and behaviour and that doing things twice or not washing/wearing specific clothes does not have any bearing on his good luck.

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We don’t want to ignore his behaviour in case it gets worse and then harder to change nor do we want to be nagging all the time so maybe advice on what to do would be great.

Answer: Many people use rituals to manage worry or to prepare themselves for a task, whether is going through a special routine in the morning or getting dressed in a certain way. Many people also have "magical beliefs" that certain objects bring them good luck or are associated with good fortune such as items of clothing in the case of your son. When these rituals and beliefs play a minor part in a person's life there is no problem and they are just part of the normal range of eccentricities a person might have.

However, when they become dominant and restrict a person fully participating or enjoying their life, then they may be developing Obsessive Compulsive Disorder (OCD). Your son’s habits of tipping things twice, having lucky clothes or avoiding one way systems, strike me as mild traits of OCD.

They might know on some level that their obsessions and worries are irrational but they still can't control them

OCD, consists of repeated obsessions or worries that compel a person to act in certain rigid way. In your son’s case he might be managing an obsession/ worry about his football performance, by insisting he wears he wears his ‘lucky’ clothes. Or he might use the ritual of tipping things twice as a means of managing a worry that something bad might happen.

In helping your son, it is important to respond compassionately and empathically. People with OCD ( however mild) are often embarrassed about their behaviours and are reluctant to talk about them. They might know on some level that their obsessions and worries are irrational but they still can’t control them and feel alone dealing with them Helping your son talk about what is going on for him will help him a lot. Rather than just challenging that what he’s doing is irrational, it is important to first help him talk about what is going on in his mind. When you notice his tipping behaviour you might ask with a non- judgemental tone ‘I notice you are tipping the door handles twice . . . what is the thought in your head that makes you do that?’

Once he opens up and you can discuss whether the pattern is like OCD. As he is 15, he might appreciate that you are up front about your worries – for example you could read together some information online or watch a video on the subject. There is good information for both parents and teens supplied by the International OCD Foundation and also verywellmind.com. The comedian Jon Richardson who uses OCD as the centre piece of his stand up was involved in a great documentary 'A little bit OCD' – it could be useful to watch something like this with your son to break the stigma and normalise his experience while empowering him to think through the issues.

If your son is open to it, you could consider getting a professional assessment and seek a referral to your local primary care psychology or adolescent mental health service. After doing an assessment a good mental health professional will be able to coach your son to use strategies to reduce the impact of his obsessions. The basic technique that you son can learn is exposure and response prevention or ERP. Using ERP your son can learn to face up to his worries and obsessions, while breaking the habit of using compulsions to manage them. To do this he might learn new ways to manage his underlying anxiety such as relaxation or positive self-talk as well as new positive habits that are the opposite of his compulsions.

- Dr John Sharry is a social worker, founder of the Parents Plus charity and an adjunct professor at the UCD school of psychology. See solutiontalk.ie