Hi, everyone, and welcome to the ADHD Kids Can Thrive podcast.

I'm your host, Kate Brownfield.

I'm a certified whole person and ADHD parent coach.

I'm author of How We Roll a Parent's Journey on Raising a Child with ADHD and a parent who's been right where you are.

It is truly my pleasure and my service to bring you a greater understanding of ADHD and all the many aspects to consider.

Every child with ADHD is unique, and so are their individual strengths and struggles.

If you're looking for tools, insights, and real stories to help you and your child thrive, you're in the right place.

You can always find me over at ADHDkidscanthrive.com, and while you're there, you can click to download the first three chapters of my book for free.

And if you're ready for more personal support, you can always schedule a free consultation with me directly on my website.

All right, let's jump into today's conversation.

Welcome to the ADHD Kids Can Thrive podcast.

Today, my guest is Dr.

Chansky.

She is founder of the Children's and Adult Center for OCD and Anxiety in Philadelphia.

She has helped thousands of children overcome fears and gripping mental compulsions.

She is the author of three books, Freeing Your Child from Negative Thinking, Freeing Your Child from Obsessive-Compulsive Disorder and Freeing Yourself from Anxiety.

And today, I think we're going to focus on your book about obsessive-compulsive disorder, because you have a new edition of that book coming out.

Yeah, absolutely.

I'm not sure when this will be aired, but August 5th, 2025, totally revised and updated edition of Freeing Your Child from OCD.

Okay.

And what is, why did you do the update?

Like what can parents find in it to help them?

Okay.

You know, so this was the first book that I wrote 25 years ago, and it's really, I would say my heart has always been with the family, I mean, with all the families that we see, of course.

But when I first started to work with families faced with OCD, there was really nothing that was out there to show them landmarks that there was a way forward, that their kids could get better, have their lives back, their family could have their life back.

And so even though folks were saying, right about anxiety, there are more people, you know, I did that later, I just really felt drawn to sharing what I was learning with the families that I was seeing 25 plus years ago.

And then when the anniversary came around, I saw this, you know, coming up in this year, I just, well, actually, it's a little bit of a funny story because I thought.

Not much has changed in 25 years.

Silly me, right?

And so I thought this will be a very manageable project here for the ADHD podcast, right, of just managing expectations and, you know, organizing your time.

And I thought it was going to be pretty defined to just, I think we'll talk later about strep triggered or, you know, pandas, pandas, kind of medical piece, some updates with medication, things like that.

But what I didn't realize was actually how much I had learned, how much I had changed in 25 years.

Really, you know, the best teachers we have are the families that we work with.

And over the course of these years, I've just refined so much the language of what reaches families, how, you know, how to facilitate conversations between parents and kids.

And so I really, that's why I ended up, and I'm so fortunate that my editor was who, yeah.

You know, to go through and my family willing to put up with me, you know, doing this.

There was just so much refinement that I really wanted to share.

And I feel fortunate to have had the opportunity to put that in writing because, yeah.

When you're when you're lost which is what families experience when their child is going through any difficulty but a mental health challenge which is completely foreign to what you know it's not just kind of more worry than we would expect they're not just really worried about grades or you know will their friends like them those are challenging enough situations for parents but it's these things that just really don't make sense and are frightening to parents and the more frightened that we feel as parents we can't really function yeah and so you know being able to lay out the the kind of landscape for parents and share the language that's going to help reach their child you know we have the first instinct to make things better to you know help people not feel pain that's a good really good instinct and in this realm we have to.

Show you know feel our empathy and connect with our kids but understand we also have to go these places that are strange and be willing to you know understand that it's not our child that's weird They already feel that way.

The more educated that we are, we can say, you know, this is, that is like OCD normal, we'll say.

Because kids will be really frightened of why they're, you know, why would they think that they were going to, you know, hurt their little brother or something like that.

They don't want to do that.

And so when parents are really, you know, kind of up to date with what's the over, you know, what is sort of the pattern to overlay over these strange things, their anxiety comes down.

They can say, this is OCD normal.

We can go in and I, you know, I can help my child.

Label that help separate my child from what ocd is saying and then together we can look at that and decide what we need to do yeah so it's a real kind of you know reorganization if you will of what the conversation looks like because prior to that it might be i have to keep washing my hands no you don't you know they're fine sort of that understandable dynamic or whatever but that's not going to help anybody change a pattern, really.

Okay.

Yeah, so.

Point to the, yeah, point to the, what the pattern is, and that's going to really change the flow from there.

Yeah, so once you recognize, so the reason I wanted to have you on this podcast is because I think ADHD is just, we all think we understand what ADHD is.

It's like this well-known term out there, And I think families tend to think, oh, it's the ADHD.

And if I fix the ADHD, that may fix anxiety and OCD.

And that's kind of not always the case, right?

It's about detecting what is really going on with your child.

And that's where you do the work, right?

So if you have this combo of ADHD and OCD, right?

And maybe the OCD is where the work needs to happen for the child and within the family to make progress, right?

Absolutely.

But I would say certainly with something like ADHD, which is not necessarily focused on certain situations, maybe some situations more than others, but it's more, you know, how a child is walking through the world that it is going to be helpful to do that work, to create that trust, to show that you're on your child's side.

You understand, you know, why the brain is busy, that it's a no-fault thing, you know, how they can focus having that foundation first.

Then you have that trust to go to the next level, which is about, you know, why your child is washing their hands or, you know, lining up their shoes or whatever it may be.

Okay.

And how does emotional regulation play into OCD?

Yeah, I mean, every way.

That's such a great question.

We could just pause there and say, how does no regulation play into this conversation, what we do after this, you know, everything in the world, right?

I always say to kids, I'm like, I think if we all learn to regulate our nervous systems, like we would just, it would be a peaceful world.

It would be, yes.

So yes absolutely that you know it's understandable that say just for the parent if they come upon their child up at one in the morning you know i don't know tucking in their sheets just right because it feels like they can't go to sleep if everything's not right but when they get into bed it moves you know whatever it may be of course we're going to have that.

Up-regulation, if you will.

We're going to have a lot of, you know, reactivity to that, feeling like, uh-oh, something's wrong.

You know, I have to, again, what's the first instinct?

I need to stop that.

You know, that's not right.

And so if we can work on down-regulating our nervous systems.

And it helps.

This is why I write books.

It helps to understand what's going on.

If we understand it, we're willing to downregulate.

If we don't understand it, it wouldn't make sense not to kind of keep escalating to say like, well, what, you know, what is it?

What is it?

So by understanding, okay, right, they're caught in a loop.

It's not that they're, you know, they're not in danger, but they are caught in a loop.

I, my goal is to connect with my child, not correct them, connect, and then point to the problem.

You know, the patterns are really, they're keeping you up or OCDs, you know, really, really rough tonight.

Let's, we got to work together because you need to go to sleep.

So when we can know that part of our job that's going to determine how effective we are in everything else we do is to kind of pause, take a second.

Downregulate, then we're just going to bring our calm to our kids, which is really what they need.

Yeah.

Okay.

All right.

So let's talk about the difference between, like, give us a highlight with your expertise of just what anxiety is.

And maybe like how that looks a little bit different than what OCD is.

Do they often go hand in hand?

They do.

And, you know, ADHD also can overlap, as you know.

Tics, it's just kind of a lot of traffic in the brain.

But what department is it in?

So with anxiety, you know, it's going to be more about worrying ahead about something, feeling like something might be wrong.

Feeling like you need to plan for something, sort of, you know, assuming the worst of a situation and that there's nothing that you can do about it.

These are not choices that we make to have that those, you know, kind of thought paths start.

That's something that is a wiring issue.

Fortunately, when we recognize that that's what's happening, we can start to question that.

Name what's happening.

You know, my worry brain is saying, I, you know, I'm going to fail the test or people are going to laugh at me or something.

Okay, what do I think about that?

Again, making that separation between what worry is saying and what you think.

And then, you know, you start to change that pattern that it might not be that, you know, either you'll nip it in the bud sooner, not listening to worry and the next worry and the next worry, or you, you know, you just really change the pattern that that's not how you're thinking about the world.

There might still be situations that warrant pausing and, you know, being concerned about it, but it's sort of not the default frame of how you're going to walk through the world.

So with anxiety and worry, it's more the what ifs, what could happen, feeling like something could be wrong, planning ahead, that kind of thing.

Yeah.

And so with OCD, it's more of a kind of like superstition on steroids, if you will.

It's, you know, thinking things that don't make sense even to the child.

Either, you know, sort of magical, I need to do something, you know, I need to tap my book four times.

I need to tap everything.

Whoops, it started with the book, but now it's everything in my life because there are four people in my family, and if I don't tap four times, something bad's going to happen to my family.

And it's not, again, it's not that kids are wanting to think that way.

This OCD is, I say, in a positive way, it's a medical problem.

You know, biobehavioral disorder.

This is not your creation.

Fortunately, we're able to make changes with things that come up, but it's not like your child is trying to think this way.

A lot of times, like I said, you know, it doesn't make sense to kids themselves.

They get frustrated with themselves.

That's another kind of landmark for parents to be able to say, this isn't you, that's your OCD.

It is really frustrating.

It feels really personal, but guess what?

There are millions of people around the world having those same thoughts intrude right now.

Just like, you know, they may have a really different life, but this is just how that works.

Fortunately, when you can hear it more as a brain bug, you know, a broken record, then you can downgrade the authority of it.

It's not like the principal telling you that.

It's not, you know, God telling you that.

It's not us telling you that.

It's just, it is this, you know disaster man whatever you know it really helps for the child to name this themselves and that annoying thing that's you know that thing sure then that's how you're going to talk about it it's just that thing it's like a glitch in your brain your wonderful brain and just that one part we're going to teach it when something is important and when it.

Isn't it's not okay

All right.

So tell Tell us now about, in the book, you're updating how pandas may have a play in OCD.

What is pandas and how is it connected to possibly, to maybe OCD?

Yeah, yeah.

So, and I'm so bad with dates.

So forgive me.

Okay, we forgive you.

Checking.

I, yeah, I don't hold on to numbers like that.

But back in the day, what year would have been?

A number of years ago.

Researchers at the National Institute of Mental Health were seeing kids who were coming in with OCD, but the kind of the story, the timeline, and the nature of it were really different from kids who had regular OCD.

Regular OCD might be, you know, develop over years.

Parents come in when the child is eight and they say, you know, since, I don't know, three, four, five, they've always had these things.

And it just like this year, it just got really bad.

That's non-pandas OCD.

Okay.

PANS or PANDAS, and I can explain that in a second, is a type of OCD that is set off by an autoimmune response to an illness, strep, Lyme.

Some kids, you know, with COVID have had like spikes in their symptoms.

So either it can be an exacerbation of OCD, like your child already had it, and then suddenly, like overnight, it's so much worse.

You feel like, do we need to bring them to the hospital?

Like something's wrong.

Just the intensity of it and the suddenness of the onset is completely different from what happens in the typical kind of waxing and waning course of OCD.

So what's really been helpful over the course of this time that I've been working with families with OCD is that there's been more attention that has been brought to pediatric autoimmune neuropsychiatric disorders associated with STRAP.

That was PANDAs.

And Pediatric Acute Neuropsychiatric Syndrome, I believe, is PANs.

A later iteration, you know, the change was to make the bigger umbrella to include not just strep as a trigger, but other illnesses, you know, that could create, you know, set off this sudden disease.

Sudden episode of, you know, where really it's very worrying to parents.

The, you know, really important news is it's very treatable what you have to do.

And it's not necessarily the cognitive behavior therapy that we do for regular OCD may have a role, but it's really going to be medical treatments.

To heal the body, the autoimmune response.

To, you know, address whatever it is that the body is creating the antibodies to.

So if it's Lyme, if it's strep, you know, whatever it may be, and which is causing inflammation that is causing the OCD symptoms.

So, you know, first stop would be to go to your pediatrician.

Hopefully, back in the day, there weren't as many people who were aware of this.

Some people still are like, they don't believe in it.

That's very frustrating.

Find a different doctor.

There are, you know, and I can send you links to organizations that you could share with your listeners.

Oh, that's great.

For a resource list, if you're looking for like a pan.

Exactly.

A pan of, okay.

Viders that, you know, very savvy and they won't say like, huh, well, I'm not, you know, you sure it's not da-da-da-da-da.

No, it's not that.

So many, you know, so many families, sort of part of how I think there's been more awareness is in a school community.

You'll have a family who has this experience and then it's like the school nurse, the guidance, the school counselor, everybody starts to sort of get like, oh, wow, I kind of heard about this, but wow, this is a thing.

Like, they see the child had to be out of school for a few weeks till they were better because it just takes over their system.

There are degrees of severity, but for, you know, for a lot of kids, it really becomes kind of an untenable situation in the acute stage.

Parents feel like, you know, the child's asking a hundred times an hour, you know, the same question over and over.

They are inconsolable.

It becomes, you know, talk about dysregulation, but that is a situation that it makes sense that you would be getting those signals of, we need help.

You know, sometimes families do take their child to an ER, but, you know, the pediatrician would be a great.

The first stop.

So do you see OCD on the rise then?

Well, I'm thinking like Lyme is on the rise.

COVID has exposed pretty much everybody at this point.

You know, and so these are like new diseases, if you will, or new exposures that children are getting.

So does that, have you seen like an increase in OCD-like cases?

That's a really interesting question.

I don't know, you know, what the answer is to that.

I'm going to look into that now that you're bringing that up.

Because there's more illness, you know, is there more, is the frequency of PANS and PANDAS increased?

I don't know.

But certainly with, you know, when you asked before about the difference between anxiety and OCD, that the old, old model of just what causes, if we have, let's say, a genetic predisposition to something, stress is something that, you know, can make the condition such that that predisposition emerges because the system or the body is stressed.

So, you know, during lockdown and everything, and even as we continue to navigate wherever we are in this pandemic, I don't know what you want to call it now, but, you know, that there is stress that certainly that kids experienced extreme stress, you know, actually labeled as a trauma, like a global trauma experience because of being in an unprecedented situation.

But even since then, you know, parents will still talk about what they're, even if researchers aren't looking necessarily at like learning losses, but just social emotional losses or changes that there hasn't been kind of a big reset after that, that kids are kind of doing, you know, we're all doing our best.

But the, you know, the stress continues in different forms.

Yeah.

And that affects everything.

That affects all our mental health, right?

And so, okay.

So are you suggesting, too, if you're prone to it, prone to anxiety, prone to, I guess you're not, I mean, prone to, if you have ADHD, you may exasperate your symptoms with stress, right?

Everything just gets.

Because we don't, yeah, we're, you know, we are built, what is stress?

Excuse me, where we, you know, where we started and talking about anxiety.

Anxiety is the worry part, but our kind of physical makeup is we were built in a time where we needed to mobilize for disaster, you know, emergencies, threats.

So what is stress?

It's our fight or flight system, you know, getting set off.

And so, you know, yeah, we're going to we don't make good decisions in that state.

But we make good decisions if there's actually a threat, right?

Right, like a real-life threat, yeah.

Right, exactly.

I'll say, you know, if there were a tiger here, I would very much thank my nervous system for getting me here faster than I could have ever imagined I could move.

But when it's not a tiger, when it's a picture of a tiger, you know, when it's a test the next day, having that dysregulation doesn't help us study for the test.

That's, you know, that's where really I like to help kids and parents understand how we're built so we can interpret those signals that are coming up for us more accurately.

We're not you know freaking out because freaking out is the response that would be the most adaptive it's our nervous system just you know kind of jumping jumping ahead because that's what it does so we but then we can come in and say like okay i'm nervous about the test but what what's going to be you know like what's sort of the plan that i need for it doing that fact checking Yeah.

Okay.

So if your child does have OCD, there is help and treatment options available for families.

And can you highlight some just like what would be the names of the treatment that parents could explore if they're worried their child has OCD or they know they have OCD, but they haven't done any kind of treatment plan?

Like what are what are those options?

Yeah, absolutely.

So there's the treatment that I talk about in the book is, and it is, you know, first line treatment for children is a kind of cognitive behavior therapy that is exposure and response prevention.

So basically, it seems very counterintuitive that if a child is afraid of touching the floor, you know, and won't, you know, is hopping around the room to prevent that or something or, you know, not touching anything because they don't want their hands to get dirty, it's, then the treatment would be to help them understand the signals that they're getting, help them, you know, have agency to say why even they think those signals aren't exactly right, and then step by step actually doing what we call exposures or courage challenges to, you know.

Whatever they're ready for.

You just need something they can say yes to.

They might say no to a lot, but just the step that they are ready to stretch to challenge and change that pattern of their brain saying, like, you know, if you touch the floor, you know, your hands touch the table that other kids touch, someone in your family is going to die or you're going to get sick or something like that.

So that is the behavior therapy called exposure and response prevention.

So you would look for, and I'll send you the organizations that parents can search by their geographic area to find qualified practitioners who are really experienced with this and will be their child.

So there's that.

There's medication, which is not the first line for kids.

It's, you know, a lot of kids by the time medication kicks in, which might be a couple months, they if they're doing the behavior therapy, they may be at a place where they, you know, they're already improving, they don't need that.

But certainly if, like for teens, if they are at a place that, you know, a lot of depression from, yeah, if they're having a lot of depression from just how OCD is taking over or from some other reason, then medication will absolutely help them to mobilize.

Kind of get their energy together to be able to do the therapy.

So really, those are, yeah, those are the choices.

But I will say.

Parents learning how to respond differently and kind of teach their child what's going on, sometimes, and there's research to support this, that that can be as effective as work, you know, working with a child directly.

Because especially with young, you know, families with young kids, who is receiving all the questions, who is, you know, managing all the towels that thrown in the laundry, you know, over and over.

It's the parents.

So if they can have that language, which again is why I did write this book and share just how to create cooperation and a sense of collaboration in facing what the brain is saying so that you're not the enemy, you know, your child is not the enemy, that you really can see so much change happen.

And that might be enough even to just have parents be really informed about what, you know, what to do and how to respond to OCD situations.

Wow.

And have a huge impact in the whole journey of it.

And As do OCD kids, if you're working on it as a family and perhaps with outside support, does an OCD child who turns into an adult, does that, is that like kind of arc of their development like with a typical child or is it kind of more, takes a little bit more time for them to

I guess my question is.

When I look at, is it like ADHD kids?

I guess if they, you know, where it just takes a little bit longer in their own development of their executive functioning system.

Is that true for OCD kids?

Right.

That's such a, again, I think it's so great to have this conversation together because there are ways that ADHD and OCD kind of have similar impacts and interference in, you know, moments right right but in their ways that it's really different you know we we don't say that we can cure OCD but we do expect and we you know we see and I always tell families like I wouldn't love my work so much if we couldn't make change happen for help kids to make change for themselves that it's more that treatment would be whatever it would be.

Maybe it's, you know, a couple of months or even if it's, you know, a year or something like that, that kids learn in that time how not just to how to respond to the symptoms that they're having or the triggers that they're having.

And in that process neuroplasticity so wonderful change the brain pattern so they don't keep getting those signals you know to wash their hands or whatever if they do they know so much that they're they're able to kind of pivot and override those but they learn that for a lifetime.

Maybe you know i have folks who i will work with for you know intensely for a number of months And then we will do check-ins a couple times a year, but maybe a few years later, now it's a teenager.

They're learning how to drive.

They have new...

You know, kind of intrusive thoughts that are happening.

It's not a long therapy again, usually, but they need a booster.

A tune-on.

Tune-in, tune-up.

This situation, you know, kind of, oh, right, that's OCD again.

What's it saying?

Yeah, what do I do?

So, you know, really the prognosis is good that this is something that is highly treatable and that in, you know, that kids will be able to affect a change, that this isn't how they will be walking through life.

They won't, you know, need to be thinking, you know, they won't need to be kind of working around this all the time.

Yeah.

To manage it, which I think of with ADHD, you know, finding adaptive strategies to manage what the brain's tendencies are, you know, to take you off course or keep you on a course that you need to, you know, kind of switch from that.

I, I think, you know, I think of that, but you can tell me if I'm, if I have a wrong view of that, that that's kind of a longer arc of a managing, you know, your executive functioning.

Yeah.

Okay.

That's good to know.

Okay.

So as we wrap up, what would be kind of your, you said a lot,

What would be, No.

It's been wonderful.

Breaths between, yeah.

You know what?

It's great.

I think like if you're a parent or know somebody that you think OCD is, you know, really affecting their life and you're not sure what to do, this is fantastic.

Very informative.

But if we tied it up, like what would be kind of your parting words of wisdom, which is for sure by the book.

Like if you because there's so much it sounds like you can learn and figure, you know, just learn how your role is as a parent to support your child.

Yeah.

I tell families that often at the end of a first session, kids feel better.

Wow.

One knows what's going on.

It's not like the work is done, but the work can start.

The work can start to change in a new direction of not just how do we get out of the house with these symptoms being so time consuming.

I mean, it's how are we going to, you know, reframe what's happening so that step by step we're reshaping what, you know, those rituals are.

So eventually the child is doing things.

I call it last yearing it.

How did your brain tell you to, you know, handle those situations last year?

Well, I wasn't having that.

Right.

And things were pretty good.

Let's look at, you know, how do we last year it here?

How do we get closer and closer to last yearing it, if that makes sense?

Messages.

Yeah, that even just going to someone who, or, you know, reading the book, you will feel, I think you will know that people have gone here before.

You feel so lost, but everything you're saying has been experienced by, you know, thousands, if not more people, and there are really clear pathways through your child will respond to you once you know how to talk about it and there's you know lots of support and help to you know make that journey whatever parents need really more and more people it's a different time more and more people know how to treat OCD so it won't be like it used to be you know people didn't go to treatment because no one knew how to.

Help them yeah and and the few people who did it was hard to access

Yeah yeah so it's a very hopeful picture also honor the fact of how hard this is because it is can feel really lonely for parents you know because they kind of can't talk to just somebody in the supermarket line about the you know strange and scary things that they're doing but there are you know communities we have online communities to get support.

But I think whether that's reading my book or the other great books that are out there, just like, oh, okay, this is a thing.

These are the steps to take.

Thank goodness we're not stuck here.

Yeah.

Yeah.

This is wonderful.

Thank you for your time today.

Gosh, Kate, it was a pleasure.

Yeah.