Anxious Parenting Practicalities Part 3/10: Poop, Parenting and OCD
Let's face it: newborns produce some fairly…er…off-putting substances. Now, obviously, there's absolutely nothing wrong with that. In fact, as any new parent will tell you, regular excretions are a necessary sign of infant vitality. Still, that doesn't mean we have to think of poop, pee and vomit as pleasant. I certainly didn't, anyway. I even remember hearing someone say they thought newborn poop actually smelled a little bit sweet…I think that person might’ve been more full of poop than my newborns.
In any case, the question of poop, pee, drool, spit-up, freshly chewed-and-spewed food, and the like are a big question mark for people with OCD. Or, to be more accurate, those things are a question mark for some people with OCD who struggle with contamination-based obsessions. Like so many aspects of parenting, contamination obsessions fly directly in the path of the duties you need to perform most often, and most consistently. It’s a frustrating dilemma, and one that can be an endless source of frustration, exhaustion and even despair. So, in an effort to ease the perils of pervasive poop and pee protocols (I could’ve also coined a double-meaning phrase using the word ‘duty’, but even I have limits on my Dad jokes), let’s discuss some pointers and strategies for managing contamination obsessions while parenting newborns.
Note: this article will mainly discuss diaper changes and bodily fluids. There are other kinds of contamination obsessions that parents can have, such as exposure to bacteria on an unclean surface, contaminated toys or dropped food, but that’s a whole other topic that warrants a separate discussion. Please stay tuned for an additional post about that in the near future.
How do I know if I have a problem?
For many parents, diaper changes are a necessary part of baby care, and nothing more. For others, diaper changes are downright gross, but they do them anyway because they’re loving parents. Honestly, there’s nothing wrong or abnormal with either of those perspectives. Where things can get truly difficult, however, is when unwanted, intrusive thoughts about contamination from bodily excretions appear and persist to the point of impaired functioning. The term ‘impaired functioning’ is inherently subjective, and therefore difficult to fully describe, but in general, it might refer to one or more of the following:
Resistance or utter unwillingness to perform diaper changes or clean bodily fluids
Compulsive hand-washing after performing diaper changes or cleaning bodily fluids to the point of causing personal harm or neglecting important duties
An obsessive need to perform repetitive and/or unnecessary cleanings of your child (ie. re-cleaning your child as a checking measure to relieve anxiety)
Unwanted, intrusive thoughts about you and/or your child contracting a serious illness due to contamination from bodily excrement
Rigid or obsessive behaviors about the way others clean your child, or refusing to allow anyone else to clean your child
This isn’t a comprehensive list by any means, but it gives a general idea of how OCD can affect parenting. In my case, intrusive thoughts about my kids getting sick were a serious problem when they were first born. I had no problem doing their diaper changes, but if I thought, even for a second, that the content of my boy’s diapers had touched any part of their bodies other than where it came from, I would spend the next 24 hours in a spiral of intrusive thoughts about my boys contracting Hepatitis A, or some other life-threatening disease. It was only after completing imaginal exposures with the help of my therapist and some cognitive behavioral therapy (CBT) exercises in a group therapy setting that I was able to think more rationally about contamination as it related to my kids. Here’s what I learned from those exposures and exercises:
It’s okay to make accommodations for yourself.
Some parents wear surgical gloves when they do diaper changes. Seriously. They do. You might think that’s strange at first glance, but ask yourself: what’s wrong with it? Think of it this way: would you rather meet a parent who struggles with OCD but does what they have to do to take care of their child, or would you rather meet a parent who lives in shame and despair because they have a debilitating obsession about contamination that they don't feel comfortable confronting? Personally, I admire any parent who does what they need to do to be a good caregiver. If you want to see a particularly famous example of this, I highly recommend Howie Mandel’s book ‘Here’s The Deal: Don’t Touch Me’. It contains lots of great examples of how someone with OCD can parent unconventionally, but successfully.
Imaginal exposures work.
I’ve written a fair bit about imaginal exposures (see this article and this article for examples), and they apply in this instance as well. It’s important to work through any obsessions and compulsions that are interfering with your ability to take care of your kids, but contamination is a difficult topic for parents because, obviously, no one wants to test their contamination obsessions on their kids to see if they’re really valid. That was certainly the case for me, but thankfully I discovered the power of imaginal exposures, and here’s the thing: they really work. When you actually sit down and write out your feared scenarios (with the help of a trained professional, or after some initial training, of course!), and then sit back and really study them, the power of your contamination obsessions starts to weaken. Over time, I truly believe that many contamination obsessions that focus on kids can be reduced or completely remedied. Again, though, do your reading and talk to a professional.
Managing OCD as a parent isn’t an all-or-nothing process.
We used to have a saying in my therapy group: if you expose yourself to an OCD trigger once, it’s likely to feel scary and uncomfortable. If you expose yourself to that trigger a hundred times, it’s likely to feel easy and boring. My own experience with CBT and imaginal exposures certainly proves that point, but it’s important to note that I didn’t jump right into my scariest OCD triggers. To truly progress through OCD symptoms, you have to put your obsessions and compulsions in order from least distressing to most distressing, and work your way up (read more this here and here). In the context of parenting and contamination, I found it useful to put my obsessions into four categories and work on them in advance of the trigger situation. Here is an example of a chart I created for working in the garden:
Comfort Level and Limitations with Trigger Stimuli
Specific Example of a Trigger From Real Life
This thing bothers me to the point where my reaction would be overwhelming
Handling raw compost with my bare hands
I can’t do this thing now, but I can work towards it later
Handling raw compost with gloves on
I can do this thing and accept the stress that comes with it, even if the stress never totally goes away
Digging in the dirt with my bare hands
I can do this thing with little or no stress
Dig in the dirt with gloves on
This chart can be adapted to fit any contamination situation, especially situations involving kids, and that leads us to the final and most important point of this article:
Don’t be ashamed of your contamination obsessions.
Remember: OCD isn’t a disease of causing harm; it’s a condition of trying obsessively to ensure you don’t cause harm. If you’re struggling with contamination obsessions to the point where the stress is interfering with your parenting, don’t despair, and don’t turn your frustration inward. OCD provides us with a never-ending array of maladaptive behaviors for responding to otherwise-normal fears, and some of us just need more help figuring out more effective ways to manage those behaviors. It’s okay. More importantly, it doesn’t mean you’re a bad parent. Furthermore, if you’re reading this article (and especially if you’ve made it this far), it means you’ve recognized a concern, and you’re doing something about it. Well done to you for that.
So, where do you go from here? Personally, I encourage you to think of some immediate steps you can take, and some future steps you’re going to take. For now, your kids need care, so if you have to wear gloves and a surgical mask for diaper changes, wear gloves and a surgical mask. In the longer term, however, you may see your obsessions about contamination as something you want to change, and that’s a great thing. More than anything, I recommend seeking professional help. There are some amazing folks out there who spend their entire working lives helping people with OCD. Find one in your area and get in touch. If you’re looking for additional resources, you can always check out my OCD Resources page, or contact a reputable OCD organization, such as the IOCDF. Regardless of which step you take, you’ll be making progress, and that feels damn good.