OCD sufferers learn to shift gears in thinking

By Nora Firestone

Correspondent

LYNNHAVEN

Little Margie Springman's schoolbooks lay stacked beneath her chair, arranged largest to smallest with precise attention to balance and symmetry.

Assured of that, the fourth-grader could focus on her class work - as the others had already been doing - unless, of course, she noticed a flaw on her paper. Then she'd find it hard to focus on anything else.

Little Margie, now 61-year-old Margie Gummo of Virginia Beach, facilitates a local support group for people with obsessive-compulsive disorder, or OCD.

She is one of an estimated 2.2 million American adults afflicted with the disorder, according to statistics from the National Institute of Mental Health.

Categorized as an anxiety disorder, OCD affects 1 to 3 percent of school-age children in the United States, said Elliott Levin, a licensed clinical social worker at Children's Hospital of The King's Daughters in Norfolk.

Levin also is starting a support group for children with the disorder and their parents.

About OCD

OCD is a neuropsychiatric (brain-based) disorder, characterized by recurrent, unwanted thoughts (obsessions) and the repetitive, ritualistic behaviors (compulsions), designed to alleviate them, Levin explained.

Typical compulsions include excessive checking, washing, confessing, touching and perfectionism. But they can also be mental, rendering the disorder virtually undetectable to the untrained eye.

Persistent procrastination, lateness and doubt should raise red flags, as should lack of focus and the constant need for reassurance.

There's nothing rational about OCD.

For instance, a boy may worry excessively about his mother's safety. In response to these intrusive thoughts, which Levin calls "false alarms," he might silently count to 100 every hour and then tap his desk 30 times in an effort to keep her safe.

To subdue another obsession, he may leave class frequently to scrub his hands.

A teacher may label the child inattentive or disruptive and suggest that he be tested for attention deficit or a behavioral disorder - common misdiagnoses, Levin said.

Punishing or embarrassing a child with the disorder or anxiety can compound his torment.

"These children are suffering so much," Levin said. Often they're "chastised, punished and wonder, 'What's wrong with me?' It's a shame that they're being treated for other disorders."

It's important for parents and professionals to recognize and identify the disorder, Levin said. Research indicates that serious anxiety puts kids at risk for under-achievement, dropping out of school, depression and substance abuse.

Adults with untreated OCD often experience great difficulty within personal relationships and at work.

Once correctly diagnosed, however, the disorder can be managed successfully, often without medication, usually within three to five months of therapy.

A mental hiccup

The difference between a person with OCD and a nonsufferer is a glitch in thought processing, experts say. Some call it a "mental hiccup."

Because of a chemical imbalance, Levin said, folks with the disorder get stuck on a thought that someone else would move right past.

He referred to the book "Brain Lock" and the analogy by author Dr. Jeffrey M. Schwartz.

It's as if the brain's automatic transmission - or the system in charge of shifting gears - is stuck, Levin said. So a person needs to switch to a manual transmission and move the thought process along himself.

A place for help

Levin seeks participants for a new support group designed to enlighten children and their parents about OCD and guide them through a six-week process of cognitive bio-behavioral therapy.

This is Schwartz's extension of cognitive behavioral therapy, which is considered the gold standard of treatment by experts. Schwartz takes the therapy a step further by also addressing the "bio," or chemical imbalance in the brain. He does this by using exercises proven to actually change the brain's chemistry for the better, Levin explained.

Levin will see children and parents separately, in weekly group sessions at CHKD, beginning mid-November.

He'll discuss the causes of the disorder and teach children and parents how to recognize its "bossy" nature, relabel its "false messages" and redirect behavior.

Kids will learn to "move the brain along" using its "manual transmission," Levin said.

"This is the same thing that the brain would do if there was not a chemical imbalance," he said. "They're going to cause a chemical change for the better in the brain by being active."

The group is open to children throughout Hampton Roads, beginning with age 7-9. Parents can inquire now about future sessions geared for older children.

As for Margie, life's been tough. She was finally diagnosed at age 40. Neatness has turned to over-accumulating and two marriages have suffered.

But talking has helped and she's developed ways to manage. She leads a support group that meets monthly at the Virginia Beach Central Library.

"By verbalizing it sometimes you can see your way through to solve a problem," she said.

Nora Firestone, nfirestone@verizon.net