The Invisible Scars: Growing Up with a Parent with OCD and the Lingering Echo of Abandonment

As mental health professionals, we strive to understand the intricate web of experiences that shape an individual's well-being. We recognize the profound impact of mental health conditions not just on the individual, but on their entire family system. Yet, there's a vital piece of this puzzle that often remains in the shadows: the emotional world of children growing up with a parent battling Obsessive-Compulsive Disorder (OCD).

In my own clinical practice, a consistent and heartbreaking pattern has emerged. I've witnessed firsthand how children of parents with OCD often grow up feeling neglected, carrying the heavy burden of anxiety and depression, and, perhaps most profoundly, a persistent and chronic sense of abandonment that takes root at a very young age. This holds true even for individuals whose parents received treatment much later in life, long after the foundational years of childhood had passed.

Consider the recent case of a 22-year-old patient. Diagnosed with Borderline Personality Disorder and recurrent depression, she spoke eloquently about her difficult upbringing with a mother consumed by OCD, a mother who, crucially, had absent insight into her condition. Much of this young woman's presenting symptoms, particularly her chronic sense of abandonment, could be directly attributed to the emotional landscape of her childhood. Her mother's preoccupation with rituals, fears, and compulsions inadvertently created a profound emotional distance, leaving a child feeling unseen, unheard, and emotionally isolated.

Why does this happen?

OCD, especially when severe and without insight, can be an all-consuming force. The parent's mind is often held captive by intrusive thoughts and the desperate need to perform compulsions to alleviate intense anxiety.¹ This leaves little emotional bandwidth for attuned parenting. For a child, this can translate into:

• Emotional Neglect: Not a conscious act of malice, but a byproduct of the parent's severe distress. The child's emotional needs for comfort, validation, and playful interaction may go unmet as the parent is consumed by their own internal struggles.

• Role Reversal: Children may inadvertently take on a caregiver role, trying to soothe the parent, participate in rituals, or avoid anything that might trigger their parent's anxieties. This robs them of their own childhood and places an unbearable weight of responsibility on their young shoulders.

• A "Ghost in the Room": Even if physically present, the parent might be emotionally absent, leading to a feeling that the child is not truly seen or prioritized. This is where the profound sense of abandonment takes root – a child experiencing the presence of a parent, yet simultaneously feeling their absence emotionally.

• Unspoken Rules and Anxiety: The household environment often becomes dictated by the parent's compulsions, creating an atmosphere of tension, uncertainty, and "walking on eggshells." Children learn to adapt to these unspoken rules, often suppressing their own needs and emotions to maintain a fragile peace.

  
  
  

The Lingering Echo: Long-Term Consequences

As these children grow into adulthood, the unaddressed emotional wounds can manifest in various ways:

• Chronic Anxiety and Depression: A heightened sense of worry and persistent low mood are common.²

• Relationship Difficulties: Challenges with trust, intimacy, and a fear of abandonment can significantly impact adult relationships, sometimes mirroring the very dynamics experienced in childhood.

• Self-Esteem Issues: Feelings of not being "enough" or being unlovable can stem from the childhood experience of emotional neglect.³

• Emotional Dysregulation: Difficulty managing intense emotions, sometimes seen in conditions like Borderline Personality Disorder, where abandonment fears are central.⁴

A Call to Action: Integrating the Child's Experience into Therapy

It is clear that merely treating the parent's OCD, while vital, is often not enough. We must broaden our therapeutic lens to include the significant, often silent, suffering of their children.

• Early Intervention is Key: Recognizing the risk factors and offering support to children of parents with OCD, even when the parent is in treatment, can be transformative. This might involve individual therapy for the child, family therapy, or psychoeducation for both parents and children.

• Addressing the "Echo of Abandonment": For adult children, acknowledging and processing these long-held feelings of neglect and abandonment is crucial for healing. This involves validating their experiences, helping them grieve what they missed, and building healthier emotional coping strategies.

• A Family Systems Approach: Therapy should ideally consider the entire family dynamic, helping all members understand OCD's impact and fostering healthier communication and interaction patterns.

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Our patients' stories are a powerful reminder that mental illness casts a wide net. By listening intently to the narratives of adult children of parents with OCD, we can not only validate their past experiences but also equip them with the tools to build a future free from the invisible, lingering scars of abandonment. It's time to shine a light on these often-overlooked concerns and ensure that no child's emotional needs are forgotten.

Dr Zoheb Raj, MD