How to Support Kids Going Through ERP

kids Jun 03, 2022

What if instead of telling your kids there was no boogie man, they felt secure that together you could face anything that came their way- boogie man included?

We live in a society that often prioritizes immediate certainty over long term resiliency. Where “it’s going to be okay” and “I won’t let anything bad happen to you” feel like ultimate expressions of love.

But as much as parents may wish and intend to protect their kids from all grief, pain, and uncertainty... that’s not the reality of the world. If it’s not a boogie man, it’s a thunderstorm. If it’s not a thunderstorm, its a pipe bursting in your house. If it’s not a pipe bursting, it’s a lost dog. There will ALWAYS be unlikely scenarios, bad days, and confusing emotions. It doesn’t serve our kids in the long run to teach them that love protects them from these. Instead, we teach them that love CONQUERS all. That they are strong and loved and capable and can face all challenges in their path.

How does that apply to OCD?

That’s what recovery is all about! Helping kids learn that they CAN sit through and manage their emotions.

We do this through Exposure and Response Prevention Therapy.

OCD is characterized by persistent and obsessions and compulsions that cause significant distress or impairment. In other words, threat-seeking (obsessions) and threat-neutralizing (compulsions). ERP works by helping people learn to sit with the distress of their threats without neutralizing them. Embracing the uncertainty of life and reinforcing their ability to withstand difficulty emotions.

How can I help support my kid going through ERP?

Babies start off their existence co-regulating with their primary caregiver. They rely on their caregivers for vocal cues, movements, facial expression, and responses that help them know they are heard and understood. We’ve all seen toddlers fall and then look to their primary caregiver to gauge an appropriate response before crying or continuing on their path. When hurt, hungry, confused, or scared they rely on physical touch, soothing tones, and facial expressions to help them feel secure, seen, and calm. A new puppy may confuse and frighten a baby, but with enough positive cues, hugs, and smiles from their caregiver, they may be laughing and excited at the pup in a matter of minutes.

This co-regulation helps young kids sort through new experiences and emotions and respond appropriately to them. It also helps them trust that others will help them meet their needs. As kids grow up, they eventually learn self-regulation. They learn how to pick themselves up when they fall, practice responding to new moments on their own, and lull themselves to sleep at night.

Rather than offering reassurance or quick solutions to distress, we can instead encourage kids to practice emotional regulation and tolerance in age-appropriate ways.

How does this look?

YOUNG KIDS

Young kids regulate most through co-regulation.

Facilitating this might look like:

Creating meaningful routines of connection with your child such as a bedtime tuck-in, morning cuddle, afternoon snack. Finding ways to connect with your child in ways that speak to their love languages and give an opportunity to process.
Swapping “It’s going to be okay” for “We have done hard things before. Remember last week when we went to the grocery store even though it was scary?”
Modeling co-regulatory responses to big emotions. “Mom is nervous to sing this song. I am going to do it anyway!” “Dad is feeling a little sad today. I am going to draw a picture about it, would you like to draw with me?”
Creating a safe space to sit with your child when they are experiencing big emotions may be important here. A cozy corner with stuffed animals, fidget toys, weighted blankets, and other regulation aids may be useful. Sitting next to the child while they process/play/melt down may be helpful, even if they don’t want to touch or talk.
Kids may have a harder time labeling their emotions, so helping them notice their body cues and their ties to emotions with phrases like “I notice you are extra wiggly today, are you maybe excited for tomorrow?” or “You are more quiet today. Are you missing your friend who is on a trip?” can help them build this skill.
Caregivers might attend therapy appointments with young kids even if all they do is sit by their side.

OLDER KIDS

While co-regulation is still important, older kids are practicing self-regulation more and more.

Facilitating this might look like:

Co-regulation may look more like “Want to go get an ice cream cone?” or “Want to go for a bike ride and pick some flowers?” or other age-appropriate activities of connection. It’s important to still find routine here, and not have these all be sporadic random events. You may not do a nightly tuck-in but maybe a nightly high five or hug.
Swapping “It’s going to be okay” for “You have done hard things before. Remember last week when you went to the grocery store even though it was scary?”
Modeling co-regulatory AND self-regulatory responses to big emotions. “Mom is having a hard day and having a hard time saying kind words so I’m going to go for a drive.”
Creating a safe space for your child to spend some time alone while they are experiencing big emotions may be important here. A cozy corner or bedroom with stuffed animals, fidget toys, weighted blankets, and other age-appropriate regulation aids may be useful. Older kids may ask for more privacy and this should be respected with boundaries ie 10 minutes to wind down privately before revisiting a heated discussion.
Older kids may be practicing labeling their emotions, so pointing out their body cues and encouraging them to tie it to an emotion may be helpful “I notice you are extra wiggly today, do you know why that could be?” or “You are more quiet today. Are there any big emotions behind that?” can help them build this skill.
Caregivers might attend SOME therapy appointments with older kids, sitting outside the door on the appointments without them or showing support in other ways.