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Compulsive CheckingChildren who repeatedly check are often watchful of what’s happening around them. They take care to make sure things are okay, which in itself is fine; but when carefulness develops into something more serious, it’s time to step in.

Responsibility Awareness
Since children with obsessive checking symptoms often believe they are in a position to cause or prevent a dangerous outcome, they do not recognise that responsibility is shared with others. This altered judgement leads to taking on too much concern. Such safekeeping causes children to experience guilt, fear and high distress levels because their attentiveness outstretches them. Consequently, they will manage their broad sense of responsibility with corresponding ideas to find anxiety relief.

Two Examples
Tom, aged 11, avoids leaving the house because in his absence he is afraid a fire will start. However, when he’s home he repeatedly checks the dials on the cooker are at off-switch. Either way, Tom sees responsibility for his feared outcome as exclusively belonging to him, even when that means asking someone else to check.

Hannah, aged 15, believes the thoughts she gets about her mum catching a disease will come true.  To regulate her thoughts, she lines up her books and other belongings perfectly to stop this happening. Because she has the idea of being solely accountable for her mother’s health, she takes on the added task of double checking her things are still aligned in a conscientious effort to cope with her perceived obligation.

Overdeveloped responsibility is often linked to thinking errors such as catastrophising.

Catastrophising – Tom predicts a disaster happening without proof that it will. He frets much of the time and as a result turns a mental event of a fire starting into something massive.

 In catastrophising, the child attaches too much importance to his thoughts.

Solution: Play the Game ‘Try to Stop your Thoughts’
First, engage your child in an activity such as colouring in a picture; for an older child, suggest a wordsearch.  Allow 15-30 minutes for this.

During the activity, ask him to block his thoughts about his feared stimulus (explain this as trying to stop a horrible imagining). After he has finished the activity, give him another fun exercise to do, but this time ask him not to control his thoughts – that is, to acknowledge the thoughts are there but without paying attention to them and to then let them float away.

During the activities, try to normalise the situation. For example, play music, turn on the TV, eat snacks etc.

After he has completed both exercises, ask if he got more thoughts or fewer thoughts while trying to stop them? Ask him how high his anxiety was during the activity on a scale of 0 being no distress and 100 being highly distressed.

Next, ask him the same questions about controlling his thoughts and rate his distress level.

The likelihood is that he will tell you he got more thoughts when trying to block them coupled with higher distress levels than the other way round. Play this game as often as it takes for your child to see how giving more importance to his thoughts puts him out of control; but giving less emphasis to his thoughts keeps in charge. He will grasp that either way, his horrible imagining doesn’t come true. 

A Need for Certainty
Kids with checking “–isms” frequently encounter difficulties coping with two-way situations and therefore find choice-making difficult. Because they overestimate danger they often doubt their competence in decision-making, since for them being safe means proving there is no danger. Unfortunately this cannot be guaranteed. Thus, children become overwhelmed and as a result worry endlessly about making a mistake, which fuels checking.

A need for certainty is often linked to thinking errors such as labeling.

Labelling – Hannah’s need for certainty often resorts to this thinking error, “I’m stupid, I can’t do anything right.” Compensatory rituals to maintain safety and to relieve distress follow more self-criticising thoughts. Hannah adds, “I can’t be certain I lined up my things properly, I need to double check to stop my mum getting ill; if I don’t I’ll be to blame and I can’t live with that.”

 In the need for certainty, the youngster often repeats “what ifs”.

Solution – Play the “what if” game.
(I thought of the “yin and yang” concept for this idea.)

First, cut out two sets of cards (business size) and give one set to your child titled ‘Against Statements’ and one set for you titled ‘For Statements’.

Begin the game by coming up with a ‘for statement’ such as “If you don’t do a checking compulsion, no-one comes to harm.” Write this on your card and show it to your child.

Now it’s your child’s turn to challenge your statement with a “what if”. It might be, “What if that’s not the case.” Make it fun as you consider her “what if” challenges while quietly observing her distress levels.

Your next assertion might be, “The facts say so, and I can see you’re learning to resist the urge to check.”

She might come back with, “What if I’m kidding myself,” to which you write down, “Your experiences are showing you otherwise, and you are coping better.”

Her next challenge might be, “But there’s always the chance that something bad will happen,” to which your response might be, “The risk of something happening is part of how we all live, but in the case of checking to prevent a tragedy, then this would be a coincidence.”

She might follow with, “But how can you be sure it’d be a coincidence?” You might put on your card, “Because there is no evidence to prove this.”

Your child might write down, “Okay, but what if you’re wrong,” to which you write down, “There are no reported cases, this is magical thinking, which is part of the problem linked to repetitive worrying.”

Eventually the game comes to an end when your child’s ‘against statements’ are exhausted. The outcome is that she not only learns to live with risk, she also learns to form and trust healthier beliefs. For positive reinforcement, keep the two sets of cards so that your child can reflect quietly whenever she needs.

Summary
Belief domains that link with thinking errors are what drive a child’s worrying thoughts about causing or preventing harm. Children use compensatory behaviours to counter their fears, such as double checking. Game strategies can help your child manage his or her fears and doubts, which helps to reduce the intensity and frequency of their horrible imaginings.  Youngsters learn that the key to making confident decisions (checking once, but not twice; or deciding not to align/check at all) is to learn to trust their memory, share responsibility, live with uncertainty and to manage anxiety.