There is an explanation as to the name of this blog - King Kong's Bitches. It sounds harsh, but it is a way for us to get through CBT:
According to Dr. John March's very helpful book, Talking Back to OCD, it helps a child to better understand that OCD is something outside of his or herself if the child can give OCD a funny name. Then she can use the name when talking about how she feels, "Oh, (silly name) is bothering me again today." Dr. March says sometimes teenagers don't feel comfortable using a funny name and just prefer to call it "OCD." I wasn't sure how Elizabeth would react to this suggestion when I told her about it early on.
However, when I mentioned giving OCD a silly name, she immediately said, "King Kong." No hesitation on her part. I was not too excited about it. I had already come up with a bunch of other ideas, and (of course) felt pretty sure I was more on the right track. "Are you sure? Dr. March said to be careful not to choose a name that makes it seem scary or anything." "Yep, King Kong," she replied. "OK... King Kong it is."
At first, it was very strange referring to OCD as King Kong all the time - I felt downright stupid at times. But that really is the point, I think. After all, the idea is not only to depersonalize OCD, it's also to reduce its power. I thought calling it King Kong would make it seem too big, unbeatable - but it really had the opposite effect, I think. Probably because we felt silly saying it. "Is King Kong bothering you?" is kind of a weird thing to say.
The next steps from Dr. March's book after naming King Kong involved "mapping" her OCD symptoms - identifying exactly what her obsessive thoughts were and the compulsions that those thoughts caused her to do. One easy example - Obsession: My hands are dirty after I touch my belt/use the bathroom/use a keyboard because those surfaces have germs. Compulsion: Wash hands 3 times in a row. More often if at school where soap is suspect. There are several other symptoms that fit in different categories. Elizabeth sort of enjoyed listing them, but it was also a little stressful thinking of them all. She got through it well.
She then assigned each of the symptoms with a number from 1-10... a "fear thermometer." 1-2 is something that isn't as much of a big deal for her, and 8-10 are things that are very hard - very hard to resist doing the compulsion, or cause her a great deal of anxiety. For a couple of weeks, she tried to resist the ones with very low fear temperatures to see how she did, and she did pretty well. Some days were harder than others, and she tried too hard to resist things that had a 5-10 fear temperature, which didn't work very well and sometimes put her into a panic attack. In order to be successful, according to Dr. March, she must work only on things with a fear temperature of 3 or lower. Once she's got that down and she's stronger and motivated by her successes, other obsessive symptoms will get easier to tackle. It's not a good idea to go too fast through the steps, because she will get too discouraged and may be so anxious she can't work on anything. This has happened to her because she thinks she should be able to do it really fast, in a sort of "I should be able to make an A+ at this if I just put my mind to it" kind of way. Hmm... I can understand that thinking, but it's a trap!
Finally, she needed to come up with a visual - a tangible way to see what her "map" was, and how much progress she makes once she began EX/RP in earnest - that is "Exposure/Response Prevention." Her homework each day is to allow herself to be exposed to something uncomfortable related to an obsession (like touching a "dirty" object,) and resisting the compulsion (like only washing her hands one time instead of 3.) Sometimes she has to break these things down into even smaller components of the OCD issue. For example, it's too hard for her to only wash her hands once at school since she doesn't think the soap is good, so she tries to only wash 2 times (in a row.) But she's pretty good at washing only once at home after going to the bathroom, which is still pretty hard but not undo-able.
We went to Joanne's to get some supplies to make a board - kind of like a game board - where she could map her progress. She picked out a white board/corkboard combo and some magnets to move her pieces around. Then, she saw stickers - princess stickers. Lots of them in a big package, on sale! "Mom, do you think I could make OCD things princesses? And they could be trying to get to the castle? What do you think?" I think it sounds awesome.
When we got home, we realized that the princesses actually corresponded very nicely with her various OCD issues - Cinderella is "cleaning," Ariel is "washing," Snow White is "violent images," Belle is "organizing school stuff/checking," and so on. It worked out perfectly! Once she got her path to the castle set up and the princess stickers on the magnets, the princesses were ready to go! Any princess not ready to move toward the castle (because the fear thermometer is too high,) stays behind the line like a game board piece that hasn't gone across the starting line yet.
"Interesting," Elizabeth said, "it's like the princesses are sort of parts of King Kong, like they work for him or something."
"They are just King Kong's bitches," I said. And we laughed and laughed. It is working... now they are truly outside her, and even sillier than before. Any given day, we can laugh at them, get excited at their progress... or just reduce them to the stupid mean girls who are just trying to take Elizabeth down and make her sad so we can fight them.
Dr. John March's book, Talking Back to OCD, available online:
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