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chocolate-chip chooky

OCD - what do you think of this advice? UPDATED

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My 12yr old has OCD. It waxes and wanes, but it's always there.

She has a range of Os and Cs, but handwashing is a big C.

Her counsellor has suggested we invest in an expensive organic handsoap. I think the idea is that she'll feel the need to restrict her usage of it, because of the cost and 'specialness' of it.

I'm a tad concerned that she'll just add soap-using guilt to her list of worries, but maybe it's worth a try?

Any thoughts or experiences? I'm open to all suggestions.

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That really depends on her personality. My kids never ever felt bad about the cost of things. So it wouldn’t add guilt but it also wouldn’t have caused them to want to restrict.  Plus- I am not an expert but the compulsiveness of hand washing doesn’t seem like something that can be reasoned away by an expensive special product. 

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5 minutes ago, Jean in Newcastle said:

That really depends on her personality. My kids never ever felt bad about the cost of things. So it wouldn’t add guilt but it also wouldn’t have caused them to want to restrict.  Plus- I am not an expert but the compulsiveness of hand washing doesn’t seem like something that can be reasoned away by an expensive special product. 

Thanks for your reply, Jean.

My daughter's first response to me was related to the cost. She *really* thinks about these things. I guess the fact that she would care about the cost is what could make it work? Or make it a dismal failure too 😕 

To the bold - my thoughts exactly. But I'm not an expert either.

Edited by chocolate-chip chooky
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Imagine how much worse she'll feel if she can't restrict and uses the expensive soap!

Money guilt on top of hand washing shame.

No, I wouldn't do that.

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I have a child who spent nine weeks in partial hospitalization for OCD, undergoing extensive ERP therapy.  I’m no expert, though I feel like my experiences and our family’s time there at least gave me an undergrad degree in OCD and ERP. 😝 I am pretty sure that the advice we’d have been given would not involve or include some other complication to a compulsion.  We did take intermediate steps (& my child’s compulsions never settled on hand washing anway), but even then it was by way of “undoing” a ritual mostly, not adding another complication.  I don’t know.  Maybe other ocd veterans have other ideas, too. 

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I have OCD and I feel strongly that that would not work and may add guilt on top of the handwashing. OCD is so insidious because it can not be reasoned away. There is no logic involved. OCD involves compulsions that you can not control. If it was as simple as coming up with a good reason not to do something, you wouldn't even need to mess with new soap because there are already so many good reasons to stop doing this. I've managed mine for the most part with medication.

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I have a couple of friends and relatives with OCD.  The only things I am aware of working are inositol ideally  plus therapy along cBt lines, or prescription meds ideally plus therapy...

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I'm surprised this was even suggested. It makes me wonder if this person really understands OCD. I would focus on retraining her brain. Have you read "Brain Lock," by Jeffrey Schwartz? I found his 4-step method to be incredibly helpful for managing OCD. Here's a summary of the method: https://www.harleytherapy.co.uk/counselling/managing-obsessive-compulsive-disorder-ocd.htm. The phrase, "It's not me, it's my OCD," is a really helpful mantra and helped me to retrain my brain. 

Taking NAC also helps. I didn't realized the grip OCD had on my brain until I started taking this. NAC makes it so the obsessions just don't stick in my brain like they use to. NAC combined with the 4-step method has been a powerful combination. I take Source Natural N-Acetyl Cysteine 600 mg 2 times a day, but my daughter takes it 3 times a day. (My daughter's psychiatrist is the one who recommended it.)

Meditating also helps. There are so many different ways to meditate, but a good place to start is the Calm app. You can get it for free as a homeschooler. https://www.calm.com/schools#teacher-form Also, eating well, exercising, and getting outside all help. Yoga is good too. I also take inositol if I'm having a hard day and need something that works fast. It calms down my brain.

I would look for a therapist who better understands OCD and who can help your daughter retrain her brain.

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This does not sound to me like the advice of a therapist who is experienced in treating OCD.

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2 minutes ago, maize said:

This does not sound to me like the advice of a therapist who is experienced in treating OCD.

 

Agreed.

For OCD I would seek out a child and adolescent psychiatrist as a first step (GP can refer).

 

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Specialized exposure response prevention treatment was vital for us.  Check out the Peace of Mind Foundation as well as the IOCDF for resources.Dr Elizabeth McIngvale of the Peace of Mind Foundation has ocd herself and shares many videos on FB discussing it.  

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1 hour ago, StellaM said:

Imagine how much worse she'll feel if she can't restrict and uses the expensive soap!

Money guilt on top of hand washing shame.

No, I wouldn't do that.

Thank you. 

My mama intuition is telling me the same thing. 

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1 hour ago, Jean in Newcastle said:

Is she being treated for anxiety?

Yes, this is partly what the counsellor is for. Her GP has not wanted to start her on medication at this age, so just therapy for now.

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1 hour ago, hopeistheword said:

I have a child who spent nine weeks in partial hospitalization for OCD, undergoing extensive ERP therapy.  I’m no expert, though I feel like my experiences and our family’s time there at least gave me an undergrad degree in OCD and ERP. 😝 I am pretty sure that the advice we’d have been given would not involve or include some other complication to a compulsion.  We did take intermediate steps (& my child’s compulsions never settled on hand washing anway), but even then it was by way of “undoing” a ritual mostly, not adding another complication.  I don’t know.  Maybe other ocd veterans have other ideas, too. 

Thank you.

Yes, I am aiming for 'undoing' as well - Trying to wash for a bit less time each time, or less pumps of soap each time, or less time between washes etc.

I absolutely agree that this seems like a new complication. 

I'm glad that my gut feelings are being validated.

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1 hour ago, KidsHappen said:

I have OCD and I feel strongly that that would not work and may add guilt on top of the handwashing. OCD is so insidious because it can not be reasoned away. There is no logic involved. OCD involves compulsions that you can not control. If it was as simple as coming up with a good reason not to do something, you wouldn't even need to mess with new soap because there are already so many good reasons to stop doing this. I've managed mine for the most part with medication.

I 100% agree with all of this.

This is a very intelligent child and if reason and logic were enough, we wouldn't have this issue.

Thank you 🌻

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32 minutes ago, 6wildhorses said:

I'm surprised this was even suggested. It makes me wonder if this person really understands OCD. I would focus on retraining her brain. Have you read "Brain Lock," by Jeffrey Schwartz? I found his 4-step method to be incredibly helpful for managing OCD. Here's a summary of the method: https://www.harleytherapy.co.uk/counselling/managing-obsessive-compulsive-disorder-ocd.htm. The phrase, "It's not me, it's my OCD," is a really helpful mantra and helped me to retrain my brain. 

Taking NAC also helps. I didn't realized the grip OCD had on my brain until I started taking this. NAC makes it so the obsessions just don't stick in my brain like they use to. NAC combined with the 4-step method has been a powerful combination. I take Source Natural N-Acetyl Cysteine 600 mg 2 times a day, but my daughter takes it 3 times a day. (My daughter's psychiatrist is the one who recommended it.)

Meditating also helps. There are so many different ways to meditate, but a good place to start is the Calm app. You can get it for free as a homeschooler. https://www.calm.com/schools#teacher-form Also, eating well, exercising, and getting outside all help. Yoga is good too. I also take inositol if I'm having a hard day and need something that works fast. It calms down my brain.

I would look for a therapist who better understands OCD and who can help your daughter retrain her brain.

Thank you for the book recommendation. I've read a lot, but not that one. I'm off to look it up.

Oh yes, 'name it to tame it'. That has definitely helped in the past and my daughter is getting better and better at using it. 

I'll also look up NAC. Thank you!

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23 minutes ago, maize said:

This does not sound to me like the advice of a therapist who is experienced in treating OCD.

I think you could be right.

To be fair, this counsellor has been fabulous for my daughter, whose issues go well beyond just OCD. We have an interesting mix of needs, which have been really very well managed overall. We just have this OCD flare-up right now and this seemingly odd advice that has left me feeling a bit befuddled.

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22 minutes ago, StellaM said:

 

Agreed.

For OCD I would seek out a child and adolescent psychiatrist as a first step (GP can refer).

 

The GP has said this would be the next step if needed. He seemed hesitant to refer just yet, because it would likely mean medication. His words were that that 'he's loathe to head to medication at her age', which gave me pause.

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I absolutely agree that the last thing you want to do is introduce another element of guilt and shame. Those of us with OCD already have more than enough of that!

Do you have the book What to Do When Your Brain Gets Stuck by Dawn Huebner? There are three of us with OCD in our house and that book has been hugely helpful, even for older kids and adults.

I also second the recommendation for Brain Lock, which was instrumental for me in learning to wrangle my OCD and keep it under control.

I have never taken medication for my OCD - just my personal preference.

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Thank you folks. 🌻

My gut feelings have been validated, which I'm grateful for. I didn't want to just dismiss the advice immediately, even though my mama heart is yelling 'don't do it!'

 

What I think is happening is that my daughter is in a growth spurt. She's always hungry and she's needing more sleep right now. Her chemical balance is out of whack and I think this leads to an upswing in her OCD and anxiety. I think we'll likely ride this wave and then see where we land. If need be, we'll go back to the GP and take it to the next step.

To be clear, this counsellor has been very helpful for my daughter overall, with her big ol' mix of issues. 

I just have to be okay with letting this bit of advice wash over me and let it go.

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3 minutes ago, Selkie said:

I absolutely agree that the last thing you want to do is introduce another element of guilt and shame. Those of us with OCD already have more than enough of that!

Do you have the book What to Do When Your Brain Gets Stuck by Dawn Huebner? There are three of us with OCD in our house and that book has been hugely helpful, even for older kids and adults.

I also second the recommendation for Brain Lock, which was instrumental for me in learning to wrangle my OCD and keep it under control.

I have never taken medication for my OCD - just my personal preference.

Thank you for your input. The Huebner book hasn't been a style that suits. Not the message, just the style. I'll definitely look into Brain Lock. 

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13 minutes ago, chocolate-chip chooky said:

The GP has said this would be the next step if needed. He seemed hesitant to refer just yet, because it would likely mean medication. His words were that that 'he's loathe to head to medication at her age', which gave me pause.

 

Honestly, I would just ask for the referral. 

My experience of child and adolescent psychiatrists is that they are quite careful around meds for children; having said that, meds can sometimes be what enables a child or teen to be able to engage with therapies effectively.

Is she seeing a psychologist or counsellor ?

That's another step, I guess...if she's not currently seeing a psychologist, you could make that switch.  You can get a mental health plan through the GP which will cover 10 psychology sessions in one year (six, then review, then four).

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10 minutes ago, chocolate-chip chooky said:

Thank you folks. 🌻

My gut feelings have been validated, which I'm grateful for. I didn't want to just dismiss the advice immediately, even though my mama heart is yelling 'don't do it!'

 

What I think is happening is that my daughter is in a growth spurt. She's always hungry and she's needing more sleep right now. Her chemical balance is out of whack and I think this leads to an upswing in her OCD and anxiety. I think we'll likely ride this wave and then see where we land. If need be, we'll go back to the GP and take it to the next step.

To be clear, this counsellor has been very helpful for my daughter overall, with her big ol' mix of issues. 

I just have to be okay with letting this bit of advice wash over me and let it go.

My kids with OCD go through cycles, and I do think that flare ups often correspond with growth spurts. Also with illness.

OCD is really kind of a specialised field of practice and doesn't respond well to techniques that work for other symptoms.

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2 minutes ago, StellaM said:

 

Honestly, I would just ask for the referral. 

My experience of child and adolescent psychiatrists is that they are quite careful around meds for children; having said that, meds can sometimes be what enables a child or teen to be able to engage with therapies effectively.

Is she seeing a psychologist or counsellor ?

That's another step, I guess...if she's not currently seeing a psychologist, you could make that switch.  You can get a mental health plan through the GP which will cover 10 psychology sessions in one year (six, then review, then four).

Her counsellor is not a psychologist. This option has been considered as well and has been discussed with the GP.

The big picture with my daughter led us to this specialised counsellor. Like I said upthread, overall this has been a very good move and the improvements in the 12 months with this counsellor have been phenomenal. It's this one bit of advice that hasn't sat right.

Thank you for your advice. I really do value it.

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17 minutes ago, chocolate-chip chooky said:

Thank you folks. 🌻

My gut feelings have been validated, which I'm grateful for. I didn't want to just dismiss the advice immediately, even though my mama heart is yelling 'don't do it!'

 

What I think is happening is that my daughter is in a growth spurt. She's always hungry and she's needing more sleep right now. Her chemical balance is out of whack and I think this leads to an upswing in her OCD and anxiety. I think we'll likely ride this wave and then see where we land. If need be, we'll go back to the GP and take it to the next step.

To be clear, this counsellor has been very helpful for my daughter overall, with her big ol' mix of issues. 

I just have to be okay with letting this bit of advice wash over me and let it go.

 

I wonder if looking into inositol and if in growth spurt other B vitamins

or / and NAC as mentioned by someone else could help take some edge off symptoms 

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Just now, Pen said:

 

I wonder if looking into inositol and if in growth spurt other B vitamins

or / and NAC as mentioned by someone else could help take some edge off symptoms 

I don't know anything about either of these and I'm all ears. I'm assuming they are OTC?

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I really can't thank you all enough. The support and advice I get on this board is so very much appreciated.

I've ordered Brain Lock (unfortunately our library didn't have it) and I'm looking into inositol and NAC.

I'll go with my heart (and all of your unanimous - so far - advice) and skip the soap for now.

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Just now, chocolate-chip chooky said:

I don't know anything about either of these and I'm all ears. I'm assuming they are OTC?

 

Yes.  OTC.

 Inositol is classed as a B Vitamin.  It comes as a powder and is sweet.  I use it in place of sugar (though it isn’t that sweet on yoghurt, or in cocoa... not too hot to not ruin its effectiveness).  B vitamins in general can get depleted during growth and stress and can relate to anxiety symptoms.  Inositol is usually or often included in B complex vitamins, but not in anywhere near high enough amounts to help anxiety or OCD to my knowledge. There have been studies showing inositol useful for anxiety and ocd, not just anecdotal.  

NAC is N-acetyl- cysteine and is in the amino acid category afaik, but I’m not the one who suggested it, so cannot speak to it for OCD.  

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Correction, just learned Inositol is no longer classed as a Bvitamin...apparently because it was found body is capable of making it...so it got de - Vitamin status.  Nonetheless seems very important to brain function, and likely that not all bodies can make enough.  

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I have OCD, and I agree that advice is just bad.

Be careful if you try NAC. I tried it and while it worked well for my OCD, it also landed me in the ER with heart issues. It isn't a common side effect, but it can happen and it's something to be aware of.

Edited by Mergath
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2 minutes ago, Mergath said:

I have OCD, and I agree that advice is just bad.

Be careful if you try NAC. I tried it and while it worked well for my OCD, it also landed me in the ER with heart issues. It isn't a common side effect, but it can happen and it's something to be aware of.

Have you tried inositol?

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In case relevant, the specific inositol used in my home has been NOW brand myo-inositol.  

 

You might start a thread on inositol itself since there may be people here who have used it, but won’t notice discussion in an ocd thread

also if you look it up on amazon or somewhere you might see if people have reported bad reactions there

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My DS has OCD and that sounds like terrible advice. If people could be reasoned out of OCD it would be a whole lot easier to deal with, but the whole point is that it is unreasonable. 

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I have severe OCD and have had it most of my life. Hell no to the expensive hand soap.

I'll come back later to write more.

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You might want to see if you can find a holistic psychiatrist. They can be terribly expensive, but I have been able to find some great providers who take insurance. A holisitic psychiatrist can better recommend supplements for your daughter's specific issues. I was so resistant to going to a psychiatrist because I thought it meant meds, but my psychiatrist and my daughter's psychiatrist changed our lives with supplements.

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1 minute ago, 6wildhorses said:

You might want to see if you can find a holistic psychiatrist. They can be terribly expensive, but I have been able to find some great providers who take insurance. A holisitic psychiatrist can better recommend supplements for your daughter's specific issues. I was so resistant to going to a psychiatrist because I thought it meant meds, but my psychiatrist and my daughter's psychiatrist changed our lives with supplements.

How did you go about finding your holistic psychiatrist?  We have a hard enough time even finding psychiatrists and therapists who are knowledgeable about and trained in OCD treatment, much less one who utilizes primarily supplements.  We did try both Inositol and NAC early in my dd's treatment but ultimately had to utilize regular psychiatric meds (after genetic testing) in order to get her to the place she was able to tolerate the ERP therapy.  We loved her psych in the hospital but haven't found another one like her.  She is triple board certified and used to direct a residential OCD program.  She knows her stuff!

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Okay! Back again. Yes to Jeffrey Schwartz's approach. He has an excellent understanding of OCD and how to treat it. Highly recommended.

I tried inositol and it didn't seem to do much for me. B vitamins are helpful. Sleep is helpful. Viruses are detrimental (although we obviously can't totally avoid them). Some chemical food ingredients worsen my symptoms, especially food dyes and preservatives. 

Medication was life-changing for me. I honestly never expected such a huge improvement in my symptoms. My doctor (who has a son with OCD himself) told me that he very much regrets not starting his own child on medication sooner, because every year his son was untreated, harmful brain pathways were being laid down. He believes earlier is actually better, and I tend to agree, if other methods of coping aren't effective. I take fluvoxamine, which is approved for both adult and pediatric treatment of OCD. 

Edited by MercyA
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22 minutes ago, hopeistheword said:

How did you go about finding your holistic psychiatrist? 

 

I did a lot of research online to find providers. It took quite a while to sort through providers to find ones who were holistically minded, accepted insurance, and who were accepting new patients. My psychiatrist doesn't treat children, so I had to start over when my daughter needed a provider.

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Agreeing with everyone else, but also, did the counselor specifically *say* the reasoning was to use the expensive soap as a deterrent? Because my initial though before I read that sentence was "Oh, so it's gentler on her hands since she is washing them all the time...." 

Which is something I'd do (switch to a very gentle soap), but wouldn't have to be organic. And not as a deterrent, obviously, but as a way of keeping her hands from chafing or drying out or anything from being washed so much.   

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2 hours ago, Pen said:

 Inositol is usually or often included in B complex vitamins, but not in anywhere near high enough amounts to help anxiety or OCD to my knowledge.

So what are the doses you need for kids and teens for anxiety and is it involved in the methylation cycle?

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For the op, I missed the age of the dc, but it seems like there could be more on the table than just prescription medications. It's becoming more common now to run genetics and look for things feeding the anxiety and OCD. There are docs who specialize in that or you can do it yourself. 

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3 hours ago, chocolate-chip chooky said:

Have you tried inositol?

 

Yes, a couple years ago. From what I remember, it didn't do much. Paxil was the absolute best thing, but I had to go off it when I was pregnant and haven't restarted it again because I'm still breastfeeding.

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1 hour ago, PeterPan said:

So what are the doses you need for kids and teens for anxiety and is it involved in the methylation cycle?

 

I don’t know that there’s a one size fits all answer, and certainly can’t give medical advice.  

  I personally tend to start things very low whether for myself or dc, like what is in a standard child’s vitamin formula and work up gradually if it seems tolerated and warranted based on research or medical supervision or personal response or whatever seems appropriate under the circumstances.   Here’s someone who wrote about using it with a child: 

https://www.nutritioncare.net/childhood-anxiety-natural-nutritional-solutions/

Methylation cycle?  I don’t know. Very probably is in some way.  If you do research on that and find anything I hope you’ll share about it. 

It’s connected to neurotransmitter transport, I believe, so if whoever might take it is also taking things like 5-htp, or other supplements that affect nerurotransmitters, Id look up interactions of those and for that matter interactions with regard to whatever all the person is already taking. 

Looking up interactions is pretty common sense for anything , I think.  

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It would likely be much more helpful to ask her to call to you when she is feeling a compulsion so that you can help her calm down. Has the counselor taught her relaxation techniques yet?

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Jeffrey Schwartz’s 4-step method goes something like this:

1. When you recognize an OCD event is occurring, label it. Labeling helps to manage the fear and stress response.

2. Say to yourself: “This is a faulty brain circuit. It is not me.” This separates you from the OCD event.

3. Focus on a pleasant image or activity. This creates a new brain circuit that will replace the old one.

4. Revalue and discard the faulty OCD message.

 

An article about Schwartz’s method which has a pretty good success rate even for more difficult cases. Doesn’t work for everyone, though, but it is not too difficult to do.

http://discovermagazine.com/2013/nov/14-defense-free-will

 

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17 hours ago, TheReader said:

Agreeing with everyone else, but also, did the counselor specifically *say* the reasoning was to use the expensive soap as a deterrent? Because my initial though before I read that sentence was "Oh, so it's gentler on her hands since she is washing them all the time...." 

Which is something I'd do (switch to a very gentle soap), but wouldn't have to be organic. And not as a deterrent, obviously, but as a way of keeping her hands from chafing or drying out or anything from being washed so much.   

This is a very good point and it's one my daughter and I have mulled over together several times. My daughter saw the counsellor alone first and then we chatted together for a little while too. My impression was definitely as a deterrent ie if it's so expensive and special, then she'll feel like she should use less.

My daughter has clarified that she was told two things about the soap idea -

1. That just a change in soap could be helpful,  just to break the cycle, and to jolt the routine a bit.

2. If it's expensive and special, she'll use less of it at a time, to make it last.

 

I should ponder #1. That sounds quite reasonable. Thoughts folks?

We use the soap we do now because it is gentle and my daughter tolerates the scent. (And it's readily available and reasonably priced.)

 

Also to clarify, the counsellor even gave us the name of a specific brand that you order online only. She was very specific in her recommendation and really seemed to emphasise that it was 'special'.

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