Instincts and obsessions: is there a difference?
I received a diagnosis of OCD for the first time when my boys were just over two months old. Until then, I never suspected I had OCD, mostly because I always figured a certain level of anxiety about my kids was normal. What parent, in their right mind, didn't worry about SIDS (Sudden Infant Death Syndrome) for hours, days, and weeks on end? What parent, again, in their right mind, didn't worry about things like whether their three week-old kids will be safe around water, or what kind of hazards they might encounter one day as they break out and take risks with their friends?
Well, as it turns out, most parents do worry about those things, but those worries don't necessarily present or persist the same way as obsessions and compulsions. Learning to tell the difference between those two things - healthy parental instincts and obsessions about my kids - was one of the longest, most arduous challenges of my therapy journey, and I'm sure I'm not the only one who's felt that way, so while I make no claims to universal truths in this matter, I do think it's worth starting the discussion. So, let's start!
Measuring Your Reactions: 3 Criteria
In my experience, it's possible to tell the difference between healthy parental instincts and unwanted obsessions using three metrics: frequency (how often the intrusive thought occurs), severity (how distressing the thought feels) and duration (how long the feeling of distress lasts after the initial thought). Let's delve into each of these terms individually:
Frequency
One of the first and most important lessons you learn when researching OCD is that unwanted, intrusive thoughts happen to everyone (yes, everyone). For an obsessive-compulsive, however, unwanted, intrusive thoughts occur more frequently and more vividly, partially because of how severely we tend to react to them (more on that in just a minute).
So, to put this in the context of parenting, it's completely normal to worry once or twice about, say, whether you sufficiently cleaned your child's bottom and body after a particularly ghastly poop explosion. It's not normal, however, to have thoughts of your child contracting Hepatitis A and/or a fungal rash every five minutes for the next twenty-four hours after the poop explosion, even if you can clearly recall cleaning and bathing your child. One of the first questions you'll see in just about any OCD questionnaire (or anxiety-related questionnaire, for that matter) is how often you feel distressed or anxious by a particular thought. If that number is so high that it disrupts your day-to-day functioning (ie. the thought pops up innumerably, or it comes up so often that you lose concentration and focus during other times of the day, such as work or driving), it might be worth speaking to a professional to get a clearer sense of the problem.
Severity
'Alright,' you might say, 'fair enough...I get that intrusive thoughts shouldn't happen all the time, but there are some worries I do have all the time that relate to my kids; saving money for their education, keeping them safe, being a good example. Those thoughts happen all the time. Does that mean I might have OCD?'
Honestly, that's an excellent question. The truth is, I can't say for sure, but I encourage you to consider how severely those thoughts are affecting you. Consider these two scenarios:
Scenario 1: a Dad is driving to work. He merges onto the highway and immediately gets passed by a bright yellow Lambourghini. The Dad thinks to himself, 'man, I wonder if the person driving that car can afford it...oh, wait, that reminds me, I need to check in with my boss about my bonus so that I know if I can make our education fund contributions this month...ugh, I hope we can, my boys need to be able to go to school.' The Dad makes a mental note to ask his boss about his bonus, then merges into the fast lane and drives to work.
Fairly typical, is it not? Now, consider this scenario:
Scenario 2: a Dad is driving to work. He merges onto the highway and immediately gets passed by a bright yellow Lambourghini. The Dad thinks to himself, 'man, I wonder if the person driving that car can afford it...oh, wait, that reminds me, I need to check in with my boss about my bonus so that I know if I can make our education fund contributions this month...ugh, I hope we can, my boys need to be able to go to school...wait, something doesn't feel right about this...why am I worried about my bonus? I've gotten one every year, but this year I have a weird feeling...something isn't right...does this mean I don't get a bonus? Is my boss going to fire me? Am I going to end up driving home today, no job, no income, telling my kids I have to cash in their education fund and sell the house so that we can eat? Why am I having these thoughts? Does this mean something bad is going to happen? Am I forecasting my future?'
The Dad spins and spins in this cycle of repetitive thoughts, and he arrives at work anxious and emotionally exhausted. He decides not to check in with his boss out of worry that he might be manifesting his worst fear.
Spot the difference? Same thought, massive variation in the severity of the reaction. This is one of the true hallmarks of OCD. Remember: everyone has intrusive thoughts from time to time, and most people shrug them off, but obsessive-compulsives react to them with crippling anxiety. In the context of parenting, a similar comparison applies: if you find yourself worrying about your kids from time to time, that's normal. If you find yourself unable to concentrate because the thought of your child getting hurt is so overwhelming that you can't perform the necessary functions of day-to-day life, it might be a signal that you need help.
Duration
In many ways, this criterium has already been covered, but just to be clear, I invite you to consider the scenarios above one more time. Notice that, in the first scenario, the intrusive thought lasts less than a minute, whereas the Dad in the second scenario fights his intrusive thought for his entire commute, and then veers from his original plan to approach his boss because the thought is still overwhelming when he gets to work. That's an unsustainable level of attention for an intrusive thought because it clearly disrupts the Dad's ability to function. In other words, it's a thought that stretches well beyond the parameters of typical worrying.
The human brain processes thousands of thoughts each day, and most are so fleeting that we don't even notice them. If one of those thoughts is sticking around for hours on end, or if it persists throughout multiple phases of the day (work, home, leisure), you might be having maladaptive reactions to an unhealthy thought.
So, with all that said, it's worth asking: is there a surefire, one-shot algorithm for differentiating between OCD symptoms and healthy parental instincts? Unfortunately, I don't believe there is. That said, I do think there are criteria that we can use as a benchmark for assessing our individual realities: frequency of intrusive thoughts, severity of reactions to those thoughts, and the duration of both the thought and the reaction. Very few thoughts have cause or ability to derail our day-to-day lives. If such a thought is affecting you to the point where you can't function the way you want, consider reaching out to a professional, performing further research, or at least getting your thoughts out and into a journal. Seriously, I'm not joking about that last suggestion. You'd be amazed how much clarity you can find in your thinking just by getting your thoughts onto paper and re-reading them at a later date. It's one of the practices I promote most in my book.
Speaking of which, if you'd like to know more about how I used journalling to help reduce the frequency, severity and duration of my obsessive thoughts about parenting, feel free to get in touch using the contact page, or head on over to the main page and order a copy of my book. Regardless of whether you buy a book or not, I sincerely hope you find the help you need.
Jason