Alka Mansik Pramarsh Foundation Clinical Psychologists-Family therapists Indore 0731-4263087,9179383554

How to help the child 
Parents definitely   are worried and  seriously concerned in such a situation. They will want their    young child suspected of  ODD  seek an      evaluation   by a professional psychologist . The evaluation process can only tell whether their  child is actually a thought so   “bad child, or a   poor  “sufferer “. By the process of psychological assessment and   evaluation a  parent will be able to appreciate the interactive  cerebral  aspect of the child’s problem . The parent then should  look for ways to help the child. The psychological help and counselling can  help a  parent    understand , attend   to  and respond better to the actual need  of the child .

Once  the psychologist/psychiatrist  has been able to diagnose the problem as ODD , the child can be  recommended and provided  a combination of  different  therapies for ODD  in order to help him and the parents deal with unfortunate situation.  The  following  programs/ therapies can be  worked out depending on the convenience and the need of the  family .

Parent Training Programs the psychologist can help the  parent through formal  parental  training program. In the  parental  training   sessions, parent are taught  strategies for managing their child’s behavior. The psychologist will provide the parents undergoing counseling   training into  negotiating skills, techniques of positive reinforcement to help them in managing the behavior of the child with ODD and reduce  disagreement and defiance  .

Individual Psychotherapy  through the  therapeutic phychotherapy a  trained psychologist  can provide the difficult child with platform and an outlet  to explore his feelings and behavior. The psychologist  will  help the child deal more  effectively with  anger and in some manner bring down the incidence of the  defiant behavior  by the child.  The psychologist will make use of  the  techniques of cognitive behavioral therapy to help and guide  the child . The technique so deployed will help  the child  deal effectively   with problem solving skills and in identifying solutions to interactions that seem impossible to him or her . The   psychological support provided to the child  through therapy is very valuable in counterbalancing the frequent messages of failure to which the child with ODD is very often subjected to .

Family Therapy    in these family sessions   the psychologist will  address all those problems that may occur in dealing with the child in  family interactions .   The  psychological therapeutic sessions will help explore  family  relationships and structure,  understand the strategies for handling difficulties, and the ways parents should handle effectively all kinds of  noncompliance  by the child .The psychologist  can address   the problems of managing the  family stress  generated by living with an  ODD  child .

Cognitive Behavioral Therapy is undertaken by the psychologist   to  teach  child deal effectively  with ODD   and  how to manage self control, self guidance, and  effective problem solving strategies.

Social Skills Training the psychologist   will also provide the child with social skills training .  The social   skills become  effective in helping child manage his   social behaviors . Social skills training will help the  child develop     positive behavior.

Finally   a healthy combination of counselling coupled with  meditation  will    be used to bring about a sense of belonging and a peace of mind to the   anxious ODD child.

A young lad  or lass in his or her teens  need to be paying attention to  the school curriculum and playing with the mates but instead if a child of this age become a problem for the family and the school , there is bound to be a cause and consternation amongst the family, teachers and the  well wishers of the child and the family.

We have recently   been getting some   cases   of   young children behaving oddly in the families . The young ones  defy  their parents even for small errands .   They insist   on not going to schools . These children  refuse to listen to their parents. Some of them  go even to the extent of fighting   back with  their parents. The parents have to understand that  children   usually are    defiant .They like to  oppose their parents  for many reasons. Obedience may not always be expected too.  We all will like to have independent thinking , self decision making children if the  decisions made by them meet our expectations.   During their  normal   growth and development  ,   individualism of human nature  does exert itself at times  when oppositional behavior  against the order and the expected  gets  expressed even by the young. The  young children  want to grow up and their   desire to gain freedom  from control   gets  intense, around the ages of two and three,  and again  in early adolescent   years . For  any parent however an uncooperative, disobedient   and aggressively hostile  behavior  of their  ward  becomes a serious issue when it is frequently ,  fiercely and arrogantly  expressed by the child. Opposition of any kind  by the child becomes glaringly visible  when  it is  compared with other children’s    visible  obedient and docile  behavior . This kind of  defiance and disobedience  gets very strainful  and stressful    for  the parents and other members of the    family.  It affects    the academic life  of the child in addition to being counted as an unsocial child within and outside the family circles .

Looking for the  the signs of  Oppositional  Defiant Disorder :  It’s not easy  for any parent to notice   differentiation   between normal defiance and the  oppositional defiant disorder (ODD) from age related  normal defiant  behavior by their children  . Symptoms of the disorder start appearing , in noticeable happenings on various occasions. Child and parental conflict related   problems   are common in  families. Families have various levels of tolerance for the opposition by their children . In some, a disgruntlement to the  the rules produces major stress for the parents , while in more friendly , social and  tolerant families , opposition by children and occurrences of bad behaviors  by the kids  are largely overlooked till such times as  they cause relationship  problems . In children  affected  with ODD,  a  systematic pattern of , anger,  aggression and the uncooperative, defiant, and aggressive  behavior toward authority can be seen. Such opposition by the young ones  regularly hampers  the  day to day functioning within the family . The children suffering get flayed tempers at times. These  children become hot headed and short   tempered. They  argue with adults. They take pleasure in fighting back against  adult rules.They refuse even minor  adult requests. They look for opportunities to   deliberately annoy others. The same defiance continues – at home, in school, in the neighborhood . Such behavior is not necessarily the  result of a conflict with a particular parent or teacher. They begin with holding  others responsible for their mistakes.They   become grumbling kind and they often behave  touchy, arrogant , resentful, spiteful and  vindictive. Some children engage in mild physical aggression and fight back physically too . Their language   becomes  aggressive, abusive and  obscene. A kind of  power struggle within the family  begins  with these children.   Their  struggle may be noticed in terms of food for choice, clothes to wear or simply in selecting a place to sit too.  During infancy  oppositional episodes must have occurred at the time of their  feeding,    eating, toilet training, and sleeping  etc. , but went unnoticed because of motherly love and affection . Children   with ODD regularly insist on postponing the work in home and at school and   they find strange reasons to  procrastinate. They  ignore parental directions and their teachers orders. They would often   pretend  to forget or fail to hear . They are often referred to for memory exercises but we have to understand  that it is not the memory or hearing problem but the problem relates to   obeying what was expected of them. As the child grows up the issues such as  keeping the room neat,  taking baths, doing home work on time , not watching television for longer times, not interrupting  while elders are talking or talking back, crop up. In all such small    small quarrels and fights , winning becomes the most important aspect of their  struggle. At times a child with ODD will deliberately forego and rather lose  cherished privileges, in order to prove a point and win  the argument. The child will   exhibit .continuous opposition within the home environment. He or she will act completely  resistant and uncooperative  in the class room . On a serious side   the child continues with his or her defiance towards the established  authority . The child may not be in a position to understand the  difficulties or even get an inkling of his or her being in the wrong. Such children as said earlier look for the reasons of their  troubles in others   behavior and in the other circumstances. external circumstances. There is always an inherent scant respect for the   the rules and discipline.  The child enjoys  challenging anyone who exhibits some kind of authority.

Cognitive-behavioral therapy  has often been used and found very effective   for  treating obsessive-compulsive disorder.The treatment of the counselled is generally handled on two  fronts i.e. at the level of prevention of the anxiety by repeatedly exposing the counselled to the source of obsession and on the other front by preventing him or her to perform obsessive compulsion by advising positive and healthier responses to the urge for compulsive behavior.

1. Exposure and response prevention  will mean preparing the counselled  for  repeated exposure to the source of   obsession. The counselled is  advised to    refrain from the compulsive behavior that he or she would  perform to reduce the  anxiety felt .
2. Cognitive therapy focuses on the catastrophic thoughts and exaggerated sense of responsibility felt by the affected . Major  part of cognitive therapy for OCD is teaching the counselled , positive, healthy and effective ways of responding to his or her  obsessive thoughts.
3. The use of effective counselling and quality time spent by the counselor is more important than the medication.

we have often  found  that the   most useful and effective  treatment for O.C.D  is  cognitive-behavioral therapy. Antidepressants may   sometimes be used by some in addition to the   cognitive   behavioral therapy, but  medication alone    in the long run has proved counter effective on many occasions  and  has done more damage .  The benefit   to the counselled can occur on a healthy combination of meditation and  of  the  behavioral  counselling.

Cognitive-behavioral therapy for obsessive-compulsive disorder (OCD )

Behavioral  therapy for obsessive-compulsive disorder works on the strength of  two components:

1. Exposure and response prevention: repeatedly exposing the obsessed to the source of obsession . The person may be counseled  to refrain from the compulsive behavior that he or she would  usually perform to reduce the  anxiety. For example to  a compulsive hand washer, he or she should be advised  to touch the door handle in a public restroom . the counseled should be  then be prevented from washing the hands . As the individual deals impatiently  with his or her  anxiety, the urge to wash may diminish with the passing of time. it is possible that it may gradually begin to go away on its own.
2. Cognitive therapy focuses on the negative and fearful  thoughts and more than necessary  sense of responsibility counselled  may feel  . A big part of cognitive therapy for OCD is teaching the counseled  , positive , effective and  healthy way of accepting obsessive thoughts and responding to them  positively  without resorting to compulsive behavior.

Four Steps for Conquering Obsessive Thoughts and Compulsive Urges

Psychiatrist Jeffrey Schwartz, author of Brain Lock: Free Yourself from Obsessive-Compulsive Behavior, has advanced the following four steps for dealing with OCD:

• RELABEL –  the person may be trained to believe that the ritual of obsessive behavior is a weakness and he or she has the strength to conquer it. the counselled may be trained to  to say, “I don’t think or feel that my hands are dirty. my hands are clean , I do not need to wash them .” Or, “I don’t feel that I have the need to wash my hands. they are fine.
• REATTRIBUTE – Realize that the intensity and intrusiveness of the thought or urge is caused by OCD; it is probably related to a biochemical imbalance in the brain. Tell yourself, “It’s not me—it’s my OCD,” to remind you that OCD thoughts and urges are not meaningful, but are false messages from the brain.
• REFOCUS – Work around the OCD thoughts by focusing your attention on something else, at least for a few minutes. Do another behavior. Say to you, “I’m experiencing a symptom of OCD. I need to do another behavior.”
• REVALUE – Do not take the OCD thought at face value. It is not significant in itself. Tell yourself, “That’s just my stupid obsession. It has no meaning. That’s just my brain. There’s no need to pay attention to it.” Remember: You can’t make the thought go away, but neither do you need to pay attention to it. You can learn to go on to the next behavior.
• How can we help you: Mansik Pramarsh program for managing OCD is supported to help  overcome the symptoms associated with OCD by our regular daily counseling sessions/mental exercises/ preksha meditation and Kayotsarg. Hundreds have benefited, it is your /your child’s turn now.  Call 09179383554 or email: mansikpramarsh@gmail.com.

 Obsessions occur to the suffering individual involuntary. Such obsessions are irrepressible belief, imagery, or impulsive imaginations that come to the mind repeatedly. The individual   is unable to avoid such thoughts even though he or she does not want to have such thoughts .it is not possible for him or her to obliterate such thoughts. Obsessive thoughts   can cause havoc in the individual’s    day to day routine works and the peaceful and normal living of the individual becomes    difficult.

Compulsions on the other hand are such performed behaviors or rituals that he or she will be compelled to act out in order to make sure the obsessions are carried out and the peace of mind can be attained .  For example, if someone is afraid of catching some kind of disease and infection, he or she might develop obsession for cleaning everything .the person will be afraid of touching anything with bare hands. The person ends up repeatedly washing and cleaning hands.  The psychological counseling can help the obsessed persons over a longer period but the   counselee generally does not sustain long and repeated sessions. He or she drops out of the sessions mid way and the obsessive thoughts can be back again in a much stronger way,  causing anxiety and the  compulsive acts become more compulsive, demanding and unavoidable .

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