Recently, after more than three years of Blake refusing treatment for his OCD, and for the depression that ensued later, the hubby and I made the decision to return to treatment. We didn’t give Blake a choice; we just told him we had an appointment with a specialist who might help us all find a way to do things in a better way. He entered the room on his own, but left in a rage after the therapist called us in to plan together (actually, he left when the hubby and I agreed to a plan the therapist had suggested). When Blake refused to return, the hubby and I became the patients, with the therapist directing us on how to shape our son’s behavior.
The first step was for the hubby and I to make a list of what Blake was not doing – where he was falling down in functioning (like sleeping all day and being up all night). We were also to list the things he was doing (for example, serving as a moderator for a special interest website) and, interestingly, what OCD behaviors we saw that he still had. That last part was odd to us. We hadn’t come to therapy to address OCD. We were more concerned that Blake was depressed and was barely carrying out the basic tasks of living. The therapist wasn’t as sure as we were that OCD wasn’t important.
When we showed up with our lists, he took time to review them.
“Let’s start with something Blake can be very successful at, like getting to the dinner table on time,” he suggested. “Now to chose what happens if he doesn’t make it on time. Hmmm… How bothered is he by the dogs?”
“Just a little,” we noted. “He always washes after he touches them, but it’s not like he runs to do it.”
“Okay, how about this? If he is late to the dinner table, you are going to rub a tissue on the dogs. Then you will break it into several pieces and place them on his bedroom floor.”
“What? How is this related to not getting out of bed?” the hubby wanted to know. “Why are we focusing on the dinner table and his dog contamination stuff when we want him to get out of bed? And how does rubbing a tissue on the dog even relate logically to getting to the table on time?”
“Then why are we doing it? Shouldn’t the consequence be logically tied to the behavior?”
“Natural and logical consequences haven’t worked with Blake,” he reminded us. “We can’t try the same old thing.”
The hubby wasn’t convinced, but he was willing to give it a try. I was intrigued and kind of confused, but I understood that Blake had been unmoved by the natural consequences that had been coming to him, or any consequences that the hubby and I had employed that were logically connected to his behavior. The therapist wrote the plan down. All that was left was to inform Blake of the plan.
Blake was infuriated by this new plan. He didn’t even make it to dinner that night. He went upstairs to his room. He slammed his door and his shutters, and he threw things everywhere. Then he came back downstairs like nothing had happened.
The hubby and I carried out the consequence as directed. We didn’t make a big deal out of it to Blake. We simply quietly wiped a tissue on both our dogs’ fur, then cut it apart into several pieces. Then I went upstairs and placed those pieces on his floor. Blake responded by pouring Nature’s Miracle all over his carpet.
The next night, he showed up to dinner on time. And the next. And the next. And our dinners were actually pleasant. The hubby was still confused about the plan and wrote to our therapist.
“Why again are we using Blake’s OCD as part of getting him to come to dinner? It just doesn’t make sense to me.”
“Remember, Blake hasn’t been functioning and he hasn’t responded to regular consequences. We are trying to prevent you from having a 35-year-old who hasn’t launched.”
The rest of the week continued without incident. We felt just the littlest bit hopeful. It was a baby step. It wasn’t the big goal we wanted. We could only hope Blake would respond well to what came next.