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July 13th, 2011

OCD and Kids – Compulsive Hand Washing

When most people think about Obsessive Compulsive Disorder in children or adults, the symptom of compulsive hand washing is what comes to mind. Although this very famous OCD symptom is one of many possible
OCD problems, it has become the worldwide trademark of this disorder. The chapped hands, dry skin, and red knuckles which come from excessive hand washing are often the first clues that a child may be suffering from obsessive compulsive worrying.

Hand washing develops in this way. Children with this OCD symptom have an obsessive thought that something bad will happen if they do not clean their hands perfectly. The something bad can be different for different children. For example, some children worry that their hands have bad germs on them, others may fear that they will be responsible for making their families sick if they don’t get their hands perfectly clean.

To relieve this OCD worrying, children develop the compulsion to wash their hands over and over. They wash more frequently and for longer times than is necessary for proper hygiene. Often, they have precise routines that they feel they must follow. For example, they may feel the need to use a certain amount of soap, wash for a certain amount of time and in a certain pattern, followed by a certain amount of rinsing for a certain amount of time. Drying of hands in a particular pattern and for a particular amount of time can also be involved. If the routine is not followed precisely, the child may feel that the entire routine must be repeated from the start and performed perfectly. Kids feel better for a while after they do their hand washing routines, but the anxiety always returns, and the child feels a sense of urgency to do the hand washing routine again. OCD routines characteristically grow, – the hand washing routine that makes a child feel better at one time often becomes insufficient to relieve the anxiety in kids and the routine must be extended to give the child a feeling of relief.

OCD in children, and specifically, excessive hand washing CAN be helped. Children with this OCD symptom can be taught to resist the urge to perform the compulsion. Cognitive Behavior Therapy teaches children thinking and behavior skills designed to relieve the anxiety from the obsessive thoughts, and the heightened anxiety they feel when they say No to compulsive hand washing.

If you would like to learn more about Obsessive Compulsive Disorder in Children, you may find these previous articles helpful:

OCD and Worry in Kids
Checking and OCD in Children and Teens

To learn more about thinking and behavior skills to reduce worry and anxiety, check out the Outsmart Your Worry Tool Kit for Kids®.