O.C.D. manifests itself in three main categories.
These are obsessive thoughts with compulsive physical rituals, obsessive thoughts on their own or physical rituals on their own. The latter two are fairly rare in children however, this does not mean that they cannot be a problem and we shall deal with them at the end of this category. We shall concentrate on the most usual form found in children, which are obsessive thoughts with compulsive physical rituals. For the purpose of looking at this aspect we shall use its most common form, i.e. thoughts about contamination and compulsive washing. The illness causes the sufferer to think that something is contaminated or “dirty”, either objects or themselves, and so feels a compulsive urge to either wash the objects or themselves excessively or get someone to do it for them. O.C.D. is known as the “doubting” illness because sufferers can never quite convince themselves that “something” is really “safe” and consequently they will wash and wash until the thoughts of contamination ease. It is not unknown for the washing to be repeated hundreds of times per day. The washing affects not only themselves but such things as clothes, shoes, cutlery, etc and anything else you care to name. It may also present itself as only being able to sit or eat in their particular little “clean/safe” area. No matter how much reassurance the child gets, he/she cannot quite believe or convince themselves that something is “safe”. Adults with this illness know what they are doing is irrational but are unable to comprehend that “once is enough”. It is totally different with children as their concept of danger is totally different from that of an adult and their fear seems real.
We would stress that O.C.D. is, like all anxiety disorders, an illness of the nervous system and not of the brain. Children suffering from O.C.D. are not mad, insane, peculiar or anything else nor will their illness ever develop into any form of brain disorder. Their brain reacts perfectly normally but is given the wrong information, by the nervous system, on which to act. O.C.D. sufferers are, almost without exception, very caring people and their O.C.D. is an extension of this caring nature, e.g. some sufferers will wash things hundreds of times to make sure they are safe, thus protecting, as they see it, themselves and their loved ones.