Anxious 6 Year Old Spits Compulsively - Normal or OCD?
My daughter is almost six years old and has developed this need to spit when nervous or being "grossed out”. She has told me, upon my insistence that she explain, that she needs to spit if she sees the toothpaste on toothbrushes in the bathroom, a junk drawer full of stuff, a messy dresser. This happens several times a day.
But also recently when she was playing violin for my parents I noticed that she had a mouthful of spit and went to spit it out right after she finished playing (that's why I am including nervousness as a cause as well).
She spit the other day and I insisted on her telling me why and she confided that it was my dresser. I asked her to come over to my dresser and look at it--she got a tissue, in case she needed to spit, and I said, wait, wait, don't spit just yet--I want you to see that this dresser is just fine--feel the wood--not dirty, I handed her some objects off it and then we opened the “messy” drawer-- I took out some objects that were in there, a wrapped cough drop, some hair ties, some balm, and asked her just to hold them and see that they were not anything "gross"--she did, but clearly just wanted me to shut the drawer and also was spitting in her tissue.
I am also concerned that she is now nervous about spitting in front of me. I have not reprimanded her--only insisted a few times that she let me know what it was that was bothering her--not in an angry way, but perhaps not being able to disguise my deepening concern.
She does have one other "tic". When she gets wound up with an imaginary story where she is telling it or drawing it, she sort of needs a "stick" or magic marker or something to hold onto, which she twitches back and forth.
Other than that, she is outgoing, loving, trusting, confident, with the “normal” bouts of the opposite of all of those traits! But I do not know if what I am doing is a correct approach or not--or if we need to see someone professionally--please help!
I’m glad you wrote. The bad news is that what you are describing may be symptoms of Obsessive Compulsive Disorder, which requires professional intervention. The good news is that most kids who receive cognitive behavioral therapy for OCD in childhood outgrow their symptoms, or at least learn to manage them, by the teen years.
Here’s how OCD works. We all get anxious many times a day. Anything that provokes a disgust reaction -- anything we consider “gross” – makes us anxious. Generally, we learn to tolerate our anxiety, and we do something to make ourselves feel better. For instance, if it is someone’s messy drawer, we might reassure ourselves that there is nothing actually gross in it, or at least that it is not our drawer. If it is actually gross – an unflushed toilet – we might take the action of flushing the toilet and then washing our hands. This decreases our anxiety about the situation, and we move on with our lives.
However, some kids find the anxiety intolerable and they develop a physical reaction to manage their anxiety. Compulsive hand-washing and spitting are the most common. Unfortunately, these behaviors don’t get at the root of the problem, which is the anxiety, and since anxiety tends to feed on itself and makes the person more anxious, the number of things that disgust the child and/or make her anxious tend to increase over time, setting up a vicious cycle.
That your daughter is expressing great anxiety in response to her disgust reactions, and that she is spitting both then and when she gets nervous for other reasons (such as her violin performance anxiety) suggest that she should be evaluated by a psychologist who specializes in OCD. (I should add that I obviously cannot diagnose any condition from a letter, but am theorizing the most likely reason for your daughter's behavior.)
Cognitive behavioral therapy (CBT) is the most effective treatment for OCD behaviors such as compulsive spitting. The child is slowly exposed to objects that cause anxiety and is helped to tolerate the anxiety without resorting to the compulsive behavior. Learning to manage their anxiety gives them an essential tool they can use in daily life, which reduces the number of times they feel anxious and/or disgusted, as well as the need to spit.
There are also medications that are sometimes prescribed for kids with severe OCD symptoms who don’t respond to cognitive behavioral therapy, but from your description your daughter’s symptoms are mild and most likely would not require medication.
As for your daughter’s other tic – holding the marker – I wouldn’t worry about it by itself. It is just an indication that she finds it challenging at times to manage her anxiety.
I want to add that your handling of this has been totally appropriate, i.e. showing your daughter your dresser drawer and asking why she is spitting. It may have temporarily increased your daughter's anxiety, but was necessary for diagnosis. At this point, in addition to finding an experienced therapist, you’ll want to focus on ways to help your daughter notice her anxiety and learn to manage it. Your early attention to this issue is terrific and will hopefully help your daughter to put it behind her quickly.
Ask the Doctor RSS
He has had many other habits as well blinking really hard- stemming from my wife having dry eyes from her contacts, and making mean eyes with his eyebrows wich led to him having head aches from stressing these muscles. He eventually stopped these habits when we simply ignored them, however the spitting has gotton worse. We do not know what to do would this be considered an OCD as well?
I can't diagnose from a letter, but persistent spitting usually indicates a child who is having a hard time handling his anxiety, and could certainly suggest OCD, particularly when this child has had other persistent physical habits as well.
My suggestion would be to work with your son to help him handle his anxiety. Give him a squeezy ball to squeeze when he gets anxious. Help him to put his worries into words. Tell him that everyone gets anxious, and these are appropriate ways to handle his anxiety so other people don't make fun of him. If he has an anxious disposition, these skills will be very helpful to him as he grows up.
If teaching your son to manage his anxiety better doesn't stop his spitting, then taking him for an evaluation would be warranted. You do want to intervene early before the habit gets him labeled in school.
Good luck!
again, As he is learning to ride his bike without training wheels. My son admits to being nervous about it. Do you recomend therapy or should I just let nature take its course?
or I would say, I learnt to live with it. But I am still very interested in finding the root cause of OCD. Very recent study on OCD says that OCD could be related to "tonsillitis" or "strep throat". 80% OCD children had strep throat history. I think you should
check if your child has long history of uncured strep throat. Hope this helps your child. Best wishes.
and then ran outside and spit. After that episode, I often felt that I had something dirty or nasty or hair like in my mouth, and I would either go spit, or if I was in a situation when I couldn't immediately, I would hold the spit in my mouth until I could
go and spit. I eventually outgrew that. Now, as an adult I have a picking problem, wherein I cannot allow a scab to heal. I imagine that the spitting and picking are related.
holding it in her mouth for an extra minute or so. Is this OCD? Please help because I don't know what to do.
child needs your help to manage their anxiety. Please intervene immediately yourself to help as I suggested above, and also get your hands on Tamar Chansky's book on OCD (Freeing
Your Child from Obsessive-Compulsive Disorder: A Powerful, Practical Program for Parents of Children and Adolescents
). If you don't see immediate improvement in your child, please get professional help. Chansky's book will suggest how to find an effective therapist for OCD.
with Tourette Syndrome, which is a neurological "disorder". It's actually quite common as it occurs in three out of every hundred people. Unfortunately, our society may have an extreme perception of Tourette Syndrome. Our son used to spit where he was, regardless
of the inappropriateness of the location. I reinforced him to spit in the bathroom. Kim