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Thread: Intrusive thoughts exacerbated by literature, films and videos?

  1. #1
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    Default Intrusive thoughts exacerbated by literature, films and videos?

    My 11yo (TS, ADHD, anxiety and tourettic OCD) has had problems with recurrent, obtrusive thoughts. When he hears about something bad having happened to someone, he vividly imagines himself in that picture, and then the needle gets stuck on the record at that point. This is more pronounced the more realistic the book is. It's worse with films and videos. Films swallow him up and bring him into the world of the film. Tense music or a sensationalistic narration style makes it much worse.

    He started treatment with a kind psychologist last May and his sleeping is getting better. But we live in a small town and haven't found a therapist here who knows how to focus specifically on the OCD. Even if we do, won't it take some time to make real progress?

    My question is about novels that are assigned in school. Suppose an assigned novel has pervasive fear felt constantly by the main character. Or suppose the whole community has a generalized backdrop of fear, an undercurrent throughout at least half the chapters of the book, because two children in the community were murdered. Other examples: video of the Maya showing an animated beheading at the end of a three day team ball game. A character freaking out because of a big spider in the classroom and other children behaving in an insensitive way to the character with the phobia. (My son's major phobia is around spiders.) A character is bullied by his foster family; he sees a loaded rifle sitting out in plain view in the kitchen and fantasizes in detail that he goes upstairs and kills the bullies while they're sleeping. My gut instinct as a parent is to protect my child and ask for alternative assignments. For one thing, because when he has nightmares and insomnia, he wakes me up crying because he hasn't been able to sleep for several hours. For another, lack of sleep makes all his symptoms worse.

    But would this be an example of a parent over-accommodating?

    I try not to perform my son's tics. I tell him I'll do my best to tolerate his tics, but they're his tics, not mine, so please don't expect me to perform them too. For example, when he hangs up the phone, he has to press "End" twice, so that the time of day re-appears on the little screen. He wants me to do it too when I hang up the phone.

    Am I adopting his obsessions by asking the school not to assign him novels that align with his specific sensitivities?

    His therapist is leaving town in a month and we haven't found another therapist definitely yet (although we have a good lead).

    For a borderline novel, I was thinking maybe we could read the novel together at home, starting with a dry synopsis, so he knows what's to expect, and so he knows that all the main characters survive just fine. If the book perpetuates the stigma of mental illness, maybe we could critique the author's attitude and laugh each time we encounter another example....

  2. #2
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    Default Re: intrusive thoughts exacerbated by literature, films and videos?

    Hi aparent001. I have some thoughts on how to frame this in your mind as you deal with it. Others will probably have better information on specific programs, techniques, and other things that can deal with specific problems. I'll try to offer something good here as well though.

    I am familiar with recurring and obtrusive thoughts. They give me problems sleeping a significant amount of the time. The first thing I would say is to keep in mind that a mental tendency for certain things to enter the mind more often then others is a natural thing and even a desirable thing. But here of course the problem is with that occurring in ways that cause your son distress. I'm also familiar with what might be thought of as "excess personalization" where you can't help but put yourself in an emotional situation that you hear about. For me on of the the worst ones is scenes involving public embarrassment in movies.

    I would say that anything from any source that arouses the emotions can potentially trigger unwanted and excess rumination and personalization. ANYTHING. Both positive (emotions thought of as good) and negative emotions. I think that it's important to consider the positive emotions as well because those can indirectly cause problems if we daydream for too long when we need to be thinking about or paying attention to other things. One of the more amusing papers I have read involves watching people with TS while they are watching a movie. Some things capture more easily than others though and the negative emotions or anything that causes stress can do that.

    My question is about novels that are assigned in school. Suppose an assigned novel has pervasive fear felt constantly by the main character. Or suppose the whole community has a generalized backdrop of fear, an undercurrent throughout at least half the chapters of the book, because two children in the community were murdered. Other examples: video of the Maya showing an animated beheading at the end of a three day team ball game. A character freaking out because of a big spider in the classroom and other children behaving in an insensitive way to the character with the phobia. (My son's major phobia is around spiders.) A character is bullied by his foster family; he sees a loaded rifle sitting out in plain view in the kitchen and fantasizes in detail that he goes upstairs and kills the bullies while they're sleeping. My gut instinct as a parent is to protect my child and ask for alternative assignments. For one thing, because when he has nightmares and insomnia, he wakes me up crying because he hasn't been able to sleep for several hours. For another, lack of sleep makes all his symptoms worse.
    Can I fairly summarize your concern as "how do I handle educational situations and assignments that may emotionally capture my son"?
    On one level you do want your son to to be able to handle things like this. I have a couple of general rules that I think are strongly implied by brain science and a good one for people with TS is "you are what you do". This can be especially important because children are literally going through developmental processes that will result in behavioral hard-wiring that lasts for life. But on another level your son will not be able to learn to handle something that he is not yet prepared for a variety of possible reasons including: intolerable emotinal intensity, lack of control over the effects of the emotion, too early in cognitive development to handle the issues causing the emotion and more.

    Please correct me if I'm wrong, but I'm going to assume that in this case he is sensitive to particular things due to personal history, and that the only complicating factor is the TS. So his emotions hit harder, he has a history of established ways of responding to particular emotional triggers (habits), and coping mechanisms that are either absent to insufficient. One benefit of TS is that while our too easily triggered habit systems are often the cause of our problems, they are also often the means of our solutions. The goal is for your son to eventually handle the negative emotion through healthy habits in relating to and dealing with things that cause the emotion. But he might not be able to handle every single thing right away so you are not necessarily over-accommodating him on every example. Practice with the smaller things to learn to handle the larger ones. It can take longer than it does for other people because for us old habits die very hard, but in time your son can overwrite old habits with new ones.

    Emotions can be thought of as the brain's "recognition and response selection" system for what we experience and perceive. They tag perceptions with connections to responses. An emotion is ALWAYS attached to a response even if that response just to watch and collect more information. Left to random chance and society, without awareness we can develop all sorts of reaction and perception habits that end up unhealthy or unwanted. We have two basic ways of responding to things: fast, unconscious, reactions, and slow, deliberate, responses (See dual process theory). In TS we tend to specialize in that first system over time, but that slower system is how we make new responses for the first system. The way that works is roughly,
    Perception (specific trigger) > emotional response > habits (actions or thoughts) tied to the emotion + percept.
    Solving the problem will involve a planned effort to create new habits in each of these areas.

    I'm hoping that this will be consistent with anything that a professional will want to have you do, but if I conflict with a professional do what the professional says. This is not exhaustive, people are individual and there are always complications. This is a general idea of what solving the problem looks like and a professional will have a series of things like cognitive behavioral therapy that is designed for different steps.
    *What you and your son need to do first is to try to organize just what sorts of things are triggering him. Try to have the themes and emotions as well recognized as you can. (Identify specific perceptual triggers and associated problematic emotions).
    *After that you can figure out which ones are worth attacking first. (Intensity of emotional response is a variable).
    *After that a professional will have you and your son practice ways of becoming familiar with the emotions in an unbiased manner. Think of it as creating well-developed lights and dials for his emotional "heads up display". This can have the effect of making the emotions or intensity easier to bear, but time and new experience may have to fix that.
    *With a good handle on sensing and feeling in detail, new habits are carefully created and practiced until they become routine. There is an element of "fake it till you make it" because your brain does treat faking it as practice. Specific new routines are a thing that will require details about the problems and that is likely better for professionals. These can be designed to reduce excess personalization through habits that encourage looking at things in a more accurate perspective, and things that can overwrite intense emotionally connected habits with more deliberate responses with better emotional content.

    Otherwise good sleep hygine and calming activities before bed are also good things to work in.

  3. #3
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    Default Re: Intrusive thoughts exacerbated by literature, films and videos?

    1. Is your son taking any medications currently? If so, what?

    2. I would recommend you take a look at the Psychlinks section on Obsessive-Compulsive Disorder :: OCD and in particular the thread titled The Four Steps - Dr Jeffrey Schwartz - Brain Lock, which is particularly relevant for coping with intrusive obsessive thoughts.

    3. Also see the book, Amazon.com: Brain Lock: Free Yourself from Obsessive-Compulsive Behavior (9780060987114): Jeffrey M. Schwartz, Beverly Beyette: Books

  4. #4
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    Default Re: Intrusive thoughts exacerbated by literature, films and videos?

    My 11 year old son also has TS+OCD and anxiety/anger related to this. Your life, as mine is, is a series of non-stop coaching moments to enable him to reinforce habits that allow him to rise above the tedious and often intrusive workings of his wonderful mind.

    My wife and I have adopted a strategy of helping him recognize and differentiate between a regular worry and an abnormal TS based one. We first point it out like "whoops, there goes that thing in your head that is telling you this is worse than it is or that you have to do this" Then we use language that empowers him.

    For example, when your son wants you to push the end button twice after a phone call as he does, I would say something like " C'mon <insert sons name>, we both know you are stronger than that. You can do this. You can hang it up without pressing it twice. I have full confidence you can do this. Sorry pal, I am not going to do it, I have to set an example for you. I know its tough but we can beat this"

    Often times it is far easier to succumb to their wishes to preserve peace, especially for something as seemingly innocuous and harmless as pushing a button an extra time. But, it is not achieving the goal of helping him form the skills he needs to get along on his own. You and I have about 3-4 more years with him where his full attention is with us. Beyond that we will lose him for awhile to the revolting teen years.

    My position is I am going to spend this time equipping him as best I can.
    Last edited by Steve; November 10, 2014 at 06:33 PM. Reason: format

  5. #5
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    Default Re: Intrusive thoughts exacerbated by literature, films and videos?

    Thanks, everyone.

    Current med plan: Tenex 6 mg / day, in 3 divided doses; 0.5 mg Ativan / day, in 3 divided doses; Zoloft 75 mg / day; melatonin 3 mg at bedtime

    I'm picking my battles right now. The end button on the telephone is not a high priority battle. I've even given up on asking him to read at bedtime, because his fake NYC Italian accent gets on my nerves. I read to him. (He's a strong reader, so this won't damage him academically. The main purpose of the bedtime reading is to spend some nice time together and wind down in preparation for sleep.)

    John, how does your son do with scary books assigned at school, or scary videos shown at school?

    We don't own a television set.

    When I stand firm and tell the school not to show him things that set off his phobia and fears, am I over-accommodating, or am I protecting him from spinning out of control again? Last year every time he started making progress, they would set him off again at school with something he found terrifying, and then he would be up a lot at night, sometimes half the night, sometimes most of the night.

    In case I didn't give you this example yet -- he was shown a video of the assassination of MLK, and he came home believing he himself would be shot.

    The big progress he's made in the last few months is that he now sleeps (mostly) in his own room.

  6. #6
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    Default Re: Intrusive thoughts exacerbated by literature, films and videos?

    Please bear in mind that I am only another parent who is trying to do right by his son. I have no professional background in this field. However I do feel that over the last couple years I have left no rock unturned in terms of seeking practical ways to deal with this. Our sons will differ in presentation and severity but to answer your question, I agree with Flutterguy in that this IS something he must learn to deal with. In other words, if its not the school, its somewhere else he will be exposed to alarming or frightening images/ideas. WE need to provide him with what he needs as we will drive ourselves into an early grave trying to control the uncontrollable.

    For example, we went through an episode where he heard about hijackings through school. As someone with a son who is similar, you can probably picture us as we began the intellectual dance of convincing him of just how remote the possibility of him being on a hijacked plane was. We describe the sheer volume of flights that occur daily and then blend in the airline and country differences for a fairly convincing argument, But as you know left brain thinking doesn't work with hard wired OCD anxiety. You likely fared the same or worse in convincing your son he would in fact not likely be assassinated as a black civil rights leader in 2014 or anytime soon. This fear lasted for many weeks at bedtime where we had to talk him down before there was any hope of settling. However, by repeating this process and using the right reassuring words and talking about the feelings, validating but not agreeing with the feelings, we eventually made progress where we thought there may be none.
    We have had some success through persistently coaching him and attempting to equip him with the perspective he needs to build his lagging skills to cope. It was long hard work, especially after a long day at work. As you are well aware there is little as draining as getting up early, working hard all day, dealing with a TS child all night and then having to be more resourceful and patient than you have all day at your weakest and most fatigued moment!

    I like your strategy of reading the novel together and how you are letting him know upfront that there definitely is a great chance there may be some fairly alarming or disturbing things at first glance but that 1) those feelings are very normal and 2) those feelings are very expected. What we can't do is give them more credence than they deserve so your idea of using laughter to diffuse and refocus is a great idea. Keep plugging away and he will learn. Every kid will have different capacity to adopt these skills but I believe they can all make progress.

    You definitely need to share the strategy you are using with your therapist so that their work is complimentary. They can also likely provide you with some valuable coaching along these lines. I have been fortunate enough to have sought out and found some really great doctors who have helped me immensely. Believe me when I say it was crazy challenging to find them and get access, and I had to kiss a lot of frogs to arrive to where ever I am right now, but a good support structure has been very important for us.

  7. #7
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    Default Re: Intrusive thoughts exacerbated by literature, films and videos?

    This observation is more from personal experience than clinical. I sometimes think of this as the 'brain bully'. Not exactly a technical term, but it has always felt a lot like there is a piece of the brain that tries to make the aware 'self' feel as bad/upset as it can. The more intense the emotion incited (especially negative emotions), the more the image or intrusive thought seems to get replayed. Likewise, the more someone actively tries to oush the thought away or suppress it, the more it comes back. ( I have noticed tics often start similarly; there can be some iritating sensation such as a runny nose, an itch; then the physical response - the sniff, the shoulder shrug...and we're off).
    It might be useful, to continue the analogy, to help to recognize that the thought is just the thought; it means nothing about the person, and that to push away or pay too much attention to the 'brain bully' gives it more power...it really helps (although it is not easy just starting off) to simply acknowledge the thought/image, recognize that it is the 'bully' and not the self, hold it in mind without pushing it away for a minute while tolerating the anxiety, become 'ok' with the idea that it is separate from the self...and then tell the 'bully' to take a hike.
    I have thought of it in this way since I was at least in my teens, and I think it has helped a lot over the years.
    Hopefully it makes sense to someone other than myself

    Gina

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    Default Intrusive thoughts exacerbated by literature, films and videos?

    You are exactly right, Gina. The key is to acknowledge it as OCD thought, just a thought, no need to act on it, or fight it, just let it go past you like a train and let it vanish into the distance.

    The book I recommended above, The Four Steps by Jeffrey Schwartz, helps you to do that.


    Sent from my iPhone using Tapatalk

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    Default Re: Intrusive thoughts exacerbated by literature, films and videos?

    Our Forum contains an extensive thread describing Brain Lock..The Four Steps by Dr. Jeffrey Schwartz

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    Default Re: Intrusive thoughts exacerbated by literature, films and videos?

    Thanks, everyone!

    Update: we compromised, and accepted one borderline novel and rejected one novel that had terror-inducing material in almost every chapter.

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