The eighth season of Love is Blind has come to a close, and now we just have to wait impatiently for the next season of Denver singles to air. While this cast of characters has gotten some flack for being a total snooze-fest, the weddings were certainly not short on drama. And sure, maybe some of the older seasons were spicier, but one moment of Season 8 really stole the show for me.
In Episode 7 of Season 8, Joey and Monica are at dinner in Honduras when he points out a fireplace design in which the hearth is a little off-center. “Does that bug you?” he asks Monica, who laughingly says she wouldn’t have noticed it before, but now, maybe it bothers her a little. Here we go again, I thought, and waited for him to mischaracterize OCD like so many people do. “Oh, I’m so OCD; everything has to be just so.” But that never came.
Instead, Joey shared that as a child, he counted everything, from the steps he took while walking to how many times he took a sip of his drink. He even touched things systematically, making sure his index finger was always the last to make contact with whatever he reached for. He had to use his right foot first when stepping out a door. He knew it was “weird,” he tells Monica, but even so, he still had the urge to do these things. His description might have sounded weird to the uninitiated, but I was glued to my TV, hand thrown on my husband’s shoulder. (I couldn’t find a clip of this conversation anywhere online, but it’s at timestamp 46:50 in Episode 7.)
I couldn’t believe what I was hearing, because I’ve never heard of anyone else who did these things as a kid. I, too, was once a 10-year-old who counted her steps, changing my stride so the walk from my bedroom to the kitchen for a snack would end on an even number. If I touched something with my left hand, I felt an intense urge to touch it in exactly the same way with the right. Every time we drove past an oncoming car on the other side of the road, I had to blink twice at it. There were no intrusive thoughts I was aware of driving these compulsions, but they hounded me anyway.
How common is OCD in children?
OCD as a diagnosis is fairly common, generally occurring in one in 100 adults and one in 200 children, says Dr. Shivali Sarawgi, pediatric psychologist and assistant professor of behavioral medicine and clinical psychology at Cincinnati Children’s.
It turns out, childhood and adolescence are commonly when OCD manifests. “Although OCD can develop at many points in life, for most, it has roots in childhood and adolescence. In fact, there are two developmental periods where onset of OCD is the most common: age 10 and age 19,” says Dr. Izabela Milaniak, psychologist in the Anxiety Behaviors Clinic at the Department of Child and Adolescent Psychiatry and Behavioral Sciences at Children’s Hospital of Philadelphia.
Joey said he felt like OCD was his brain’s way of controlling something amid the chaos of having a sister who was ill and hospitalized often. My habits also manifested during a major upheaval in my life: my parents’ divorce. Experts say periods of stress can make OCD symptoms worse, but they’re not necessarily the cause.
“OCD is different than some mental health concerns in that it has more of a biological basis. There’s a heritable component,” says Sarawgi. “That’s really important for families because I think a lot of caregivers tend to blame themselves. For pediatric-onset OCD, it can happen at a very, very early age, and it’s not necessarily anything that anyone did wrong.”
Symptoms of OCD in kids
One of the most common signs of OCD in kids is reassurance seeking, says Dr. Rachel Mathews, pediatric psychologist and assistant professor of behavioral medicine and clinical psychology at Cincinnati Children’s. “Parents will come in and say, ‘I tell him over and over and over and over that I’m going to drive safely.’ Or, ‘I tell him over and over and over that no one’s going to break in,’ and it’s like it doesn’t sink in.”
According to the International OCD Foundation, common obsessions (intrusive and unwanted thoughts or urges) for kids include:
- Extreme fears about bad things happening or doing something wrong
- Feeling that things have to be “just right”
- Disturbing and unwanted thoughts or images of a sexual nature or about hurting others
- Worrying about germs, getting sick, or dying
Common compulsions, or behaviors the child feels like they must do to stop the obsessions, include:
- Repeating actions until they are “just right” or starting things over again
- Ordering or arranging things in a specific way
- Frequent confessing or apologizing
- Saying lucky words or numbers
- Excessive reassurance seeking (like, “Are you sure I’m going to be OK?”)
- Excessive cleaning or washing
What should you do if you notice your child exhibiting OCD behaviors?
“I think if we’re seeing some of the symptoms, but they’re not interfering with functioning or daily life, I usually will say let’s keep an eye on them,” says Mathews. “If it’s at a point where it’s causing interference, if it’s getting in the way of the things that we want to do or need to do, that is typically when I would suggest seeking treatment.”
If your child’s OCD is bad enough to interfere with their daily life, it is likely to become “chronic and unremitting” without treatment, Mathews adds. If you’re trying to gauge whether your child’s habits are “clinical” level, Milaniak says to ask yourself if a behavior is a preference for them, or a need. Can they function if they don’t do it, or are they totally distressed, dysregulated, or stuck? There are many kids who demonstrate some OCD-like tendencies who do grow out of it, she says, but it’s best to get an expert opinion.
What are the treatment options?
When Monica asks how Joey got through his OCD, he says exposure therapy. Sarawgi confirms that its full name — exposure with response prevention — is the “gold standard” of treatment for obsessive-compulsive disorder. As Milaniak notes, “It is one of the most effective behavioral treatments we have for any mental health condition.”
While Joey wanted to try exposure therapy before starting meds, taking medicine to help with OCD is not a personal failure, Milaniak says. “It’s great that behavioral treatment alone was successful for Joey. Medication, in addition to therapy, may be necessary, especially if OCD is severe, longstanding, or co-occurring with other psychiatric conditions. In fact, studies consistently show that a combination treatment is most effective than either medication or therapy alone.”
If you want to find a therapist who offers exposure with response prevention, start by searching the Find Help tool on the International OCD Foundation’s home page.
OCD isn’t always about order or counting, and we need to talk about that more.
If your child’s OCD looks different from Joey’s — specifically, scarier — that’s OK. “My ultimate want for OCD portrayal in media is more diverse representations of obsessions and compulsions. Some obsessions can be stigmatizing, and we know these types of obsessions are the ones that children and adults often hide due to shame and fear of people’s reactions. I would love kids to learn that brains are weird and sometimes they come up with the most random, scary, or disturbing thoughts and images, and it’s nothing to be ashamed of.”
While maybe we weren’t happy with him at the reunion or wish he and Monica could’ve ridden off into the sunset together, I, for one, am grateful he was willing to be vulnerable about his OCD on camera. If one kid’s parents notice their symptoms sooner because of him, he’ll have done them a huge service.
