chapter  Chapter 7
12 Pages

Early Childhood Case Study—Child With OCD

WithSusan C. Parente

This case study illustrates a course of psychotherapy with an 8-year-old boy, Joey, who had been previously diagnosed with Obsessive-Compulsive Disorder (OCD). The Multiple Self-States Drawing Technique served as the clarifying foundation and creative framework within which to implement a Cognitive-Behavioral Therapy-based treatment approach. It seemed reassuring to the parent and empowering for Joey to come to understand his symptom profile through the lens of the multiple self-states model. Rather than labeling and attributing his problems to the “whole child,” Joey and his mother could reconceptualize OCD symptoms as aspects of a dissociated, dysregulated emotional state—“The Worried Self.” This perspective reduced shame and lent compassion and humor to the treatment process. The case study describes the ups and downs of this courageous youngster’s earnest efforts to learn to identify the “irrational” and obsessive thoughts and anxieties of his OCD-ridden self-state. With the support of his mother, who had gained new understanding of the notion of family accommodation, Joey came to engage in healthier self-regulation strategies. He learned to access the more confident constellation of thoughts, emotions, and sensations of his regulated “Happy Self” state of being in order to cope better with his anxieties and minimize his compulsions.