When Helping Hurts: A Parent’s Guide to Anxiety and OCD

 

Transcript

ANNOUNCER:  This is Curious Incident, a podcast for special needs families, and your window into the world of special education. Special needs parenting can be challenging, and we want to make it easier by providing you with the resources you need to help your child. Still deep into the world of learning differently with your host, special education attorney Adam Dayan. 

ADAM:  I’m pleased to present my next guest on the Curious Incident podcast, Regine Ashkenazi. Regine is a licensed social worker at Long Island Behavioral Psychology. She received her MSW from Columbia University School of Social Work. Regine’s main focus is cognitive behavioral therapy, specifically for anxiety and OCD. Regine is also trained in dialectical behavioral therapy and studied family systems at Ackermann Institute for the Family. Regine appreciates working with the individual and the family unit to provide comprehensive evidence-based care. She specializes in exposure therapy for children and teens, as well as working with parents of young children to set boundaries and routines. Regine, welcome. 

REGINE:  Thank you. Thanks for having me. 

ADAM:   It’s great to have you here. On this podcast, we’ve talked about anxiety before, but today we’re getting into what actually changes it. Specifically, what parents do in those moments when their child is struggling and how some of the most natural instincts can actually reinforce anxiety. This episode is all about helping kids learn they can handle hard feelings, not avoid them. So let’s jump in. You often start conversations with parents by reframing anxiety as a typical human emotion. Can you walk us through that primer and why it’s so important for families to understand? 

REGINE:  Sure. I often start there because parents walk into my office thinking anxiety is the problem. Like if my child just wasn’t anxious, we would be okay. And what I try teaching is that anxiety is a normal, adaptive, kind of really important human emotion that we all experience and we all feel. Things are internal alarm system and it’s really important for parents to understand that. It’s not the anxiety that’s a problem. It’s what their children are doing because of their anxiety. And that’s where I start my work. 

ADAM:  Before I move on to question number two, is there anything you wanted to add or clarify about what you just said? Anxiety is not the problem. What matters is how children deal with it. 

REGINE:  Anxiety is really uncomfortable. So we try to avoid anxiety. And what we do is we avoid situations that make us anxious. And the more we avoid situations or the more we seek outside reassurance from others, the more anxious those situations become. And what I’m trying to teach parents is that anxiety is not the problem. It’s avoiding and reassuring our children. 

ADAM:  For many parents, it feels counterintuitive to encourage a child to face something that makes them anxious. How do you help parents shift the instinct or mindset from protecting their child to empowering 

REGINE:  them? That’s exactly right. What I’m asking parents to do goes against every parental instinct they have. When our child is in distress, what we want to say is, I want to help you. I’m going to jump up and help you and relieve that distress. And at first, it really works. We can reassure our child. We can tell them everything’s okay. We can take them out of a situation that’s distressing to them and they will feel better. The problem is that the next time they’re faced with that situation, what they’ve learned is I need to avoid the situation. The situation is scary. And the more we do that, the scarier it becomes and the higher their level of anxiety. What I’m telling parents is I want you to help your children face their fears. And in facing their fears, we will teach them that they will eventually feel better. 

ADAM:  Okay. So we’re going to be talking about facing your fears. We’ll be talking about exposure and response prevention therapy. Great. You talk about the balance between validating a child’s fear while still encouraging them to move toward it. What does that look like in practice? We don’t want to minimize what a child is feeling. What does that look like to validate and push them toward the thing that feels difficult? 

REGINE:  My favorite line that I teach parents to use with their children is I know this is hard for you and I know you can do it. And it’s that dichotomy that’s really effective for children. The first part is the validation. I know this is hard for you. I’m watching you struggle. I see it. I might not agree with it. I don’t think you’re in danger, but I see that this is hard for you. The second part of that statement is just as important and that’s the encouragement. It’s I as your parent know that you can do it. And that’s more than just a saying. I’m going to encourage you to do it. I’m going to demand that you do it because I know that you can. And that’s what I want from parents. I’m hoping that they can have the validation, that they can give their children the validation that they really need to feel and be seen while at the same time encouraging them to take those hard steps towards their fears. 

ADAM:  And doesn’t really matter if the thing looks easy to the parent, right? That’s not what’s important here. What matters is the child’s experience. And I think you capture that by saying I know this is difficult for you. 

REGINE:  I love the way that you put it. I know this is difficult for you right now. I don’t think it’s dangerous, right? I need to give my child that confidence in me that I know that you can do this. It’s not dangerous, but at the same time, I see that you’re struggling. I recognize it. It must be so hard for you. 

ADAM:  And what you added right now underscores this moment. The fact that the parent has confidence in the child that they can improve and strengthen that skill. And maybe at some point in the future, it won’t feel so difficult for them. 

REGINE:  That’s exactly the goal. 

ADAM:  Is there anything that the parent can do to notice what is happening inside the child’s body that will help the child to feel validated? 

REGINE:  I often say it’s nice to point out what you see in your child. Sometimes, especially with younger children, they don’t have the words to say, my heart is racing. My breath is short. It’s really scary for me that I feel like I can’t breathe. So allowing them to feel seen is so important. So I can say something like, I know this is hard for you. I see that your heart is beating really quickly. I see that you’re a little bit teary-eyed. And I still know that you can do this. 

ADAM:  For parents who are unsure whether what they’re seeing is typical childhood behavior or something more concerning, what are some early signs that anxiety may be interfering with the child’s daily life? How much anxiety is too much anxiety? 

REGINE:  I always tell parents. It’s not a question if anxiety is present. It’s what is the effect that anxiety is having on my child’s life? And I’ll remind parents, pull up a developmental chart. Look at what experts say is appropriate for your child. For example, at three years old, it’s really typical for children to have a hard time separating from parents, not as much as at eight or nine. And that’s often a good starting point. Is my child within range of their peers? Or does their anxiety feel like it’s taking away from that? The things that I tell parents to look for is my child avoiding the things that they used to do? Is my child asking for reassurance about the same topics over and over again? Is my child’s anxiety getting in the way of his or her daily life? School performance, friends, independence? So it’s not so much a question of how much is too much. It’s more about what is the impact of these worries on my child. 

ADAM:  Do you have an example that comes to mind? 

REGINE:  Sure. We’ll use an easy example. A child who’s scared of dogs, right? Some kids don’t like dogs, and that’s totally fine. But I was driving with my son in the car the other day, and two girls ran in front of my car, two young school-age children ran in front of my car. And I immediately, thankfully, pressed on the brakes. Thankfully I wasn’t looking at my phone or distracted, and I was able to stop really quickly. And I looked at these girls and I said, so what happened? And they said there was a dog, and we were really scared of the dog. So again, is it okay if my child is scared of a dog? For sure. My child doesn’t have to like dogs. But what I looked at these girls and said, it’s really scary when a dog is barking at you or running after you. But it’s way more dangerous to run in front of a car. And that’s kind of what we’re looking for. Is it kind of normative and not really affecting their lives? Or are they going to run in the street and potentially endanger their life to stay away from dogs? 

ADAM:  That’s a great example. 

REGINE:  I love it because it’s concrete and kind of easy. 

ADAM:  Right? Yeah. Do you ever find yourself having to explain to a child what anxiety is? I mean, physically what they may be experiencing in their body so that they can name it as, oh, that’s my anxiety. 

REGINE:  So here’s something that I love doing in the office. I’ll take a huge sheet of paper, one of those rolls, lay a child down and trace their body. And then I’ll have them fill in where they feel their anxiety. Do they feel it in their stomach and will sometimes draw little butterflies? Do they feel their heart racing? And that’s kind of a very concrete way of showing them that this is actually often something we feel physically and that they’re okay. 

ADAM:  So I can see how that helps to locate it. Is there more to that conversation that helps them describe the feeling that’s happening in that part of the body? 

REGINE:  We can talk about what it feels like in their body and for them, it’s really validating but also really freeing to know that this feeling of my heart beating out of my body is okay. And in fact, my therapist knew about it, right? That takes some of the fear of what’s going on away. 

ADAM:  All right. So you covered a lot of components just now avoidance, reassurance, seeking distress. That’s high in intensity, interfering with daily life. I’m just going to go back to reassurance seeking for a minute because I think that’s so important. What would be an example of that and what is the appropriate way for a parent to respond when a child is seeking reassurance? 

REGINE:  We often find that anxious children seek reassurance from their parents. They want to know that they’re okay in whatever they’re anxious about. So for example, they’ll say something like, can I eat this kind of over and over again or I don’t want to go to school. I’m scared to go to school. And often as parents, we just want to say, you’re fine. Go to school. What if I get sick? You won’t get sick. Go to school. And then they keep on asking these questions and the more they ask these questions and the more we answer them and again, sometimes it’s so much easier to say, you’re not sick. Keep moving. You won’t get sick. Keep moving. But what we find with anxious children is that that perpetuates their worries. Every time they think, what if I get sick, they need to check in with their parent. They need to make sure that their parent says that they’re okay. So what I encourage parents to do is leave room for ambiguity. I know you’re scared of being sick. And also, we’re going to go to school. 

ADAM:  I’m going to share this with you. I read a poem recently by a poet who has OCD and writes about her OCD experiences. And she gave the example of a child who is afraid of a monster in the corner of her bedroom at night. And the parent comes in and turns on the light and says, see, there’s no monster there. It was just a jacket hanging over a chair that looked like a monster in the dark. And that sort of thing is not so helpful because the fear was there. The squirrel is afraid of monsters at night and isn’t the switching on the light and saying, see, you’re fine. There’s no monster here exactly the type of reassurance seeking that you’re talking 

REGINE:  about. Exactly what we’re talking about. And sometimes in kids who aren’t anxious, it’s really helpful to turn on the light. And say, you’re okay. But for kids who have such a fear of monsters, when you turn on the light, their brain just goes to it went somewhere else. Or maybe it’s still there. Or next time I think maybe there’s a monster there, I need to check again. And that’s what we want to pull away from. 

ADAM:  What services do you provide? What distinguishes your approach and services from other therapists who deal with anxiety or OCD? 

REGINE:  So my hope is that our approach is really similar to other therapists doing good CBT exposure and response prevention work. We provide services for individuals, skills building, exposure, and for families, for younger children. We provide parenting services for the parents to help their children. And as they get older, we work with kids on developing their skills and helping them engage in exposures. 

ADAM:  So the parenting piece is really what we’re concerned about in this conversation. And you mentioned CBT, exposure and response prevention therapy. How do those apply to the parent? How does a parent consulting with you take principles from those approaches and use them in their home with their child? 

REGINE:  So evidence-based therapy shows that with children younger than eight and even older, and older than eight, what’s most effective is to work with the parents. And what I’m helping the parents become is many little exposure therapists in their own home. They’ll understand the psychotherapy, they’ll understand the principles and the skills, and they will encourage and kind of demand that their children engage in things that are hard for them. 

ADAM:  So let’s focus on the exposure piece. And I know that we refer to it colloquially as exposure therapy. There’s an important part in the middle, which is response prevention therapy, which you’ll talk more about. What does it look like to expose a child to the thing they’re afraid of? And I know it can be in terms of a thought that’s troubling or a behavior that they’re doing compulsively. And how does a parent incorporate that approach into their repertoire to make sure that they are effectively exposing their child to the source of fear? 

REGINE:  So the first thing we’ll talk about is what is your child afraid of? Or what is your child anxious about? And often it’s not the first thing that comes to mind, right? A child will avoid going to school. And you think, oh, they’re scared of doing poorly in school. But really, they’re scared of embarrassing themselves in front of their friends. So we’ll try to get at what actually is the core fear for your child. And then we’ll work on developing small things that that child can do to face their fear. So for example, if they’re scared of making mistakes, the first thing I’m going to do is have a parent show a child their mistakes that they make, right? When you burn dinner being like, oh, wow, I made such a big mistake. I burnt dinner. And also now we’re going to have to order takeout. Starting to model that mistakes are OK. The second thing that we’re going to do is change the way that we speak in the house about mistakes. Taking risks is going to be more encouraged and praised as opposed to praising a child for doing something correctly. So we’re going to change the way that we speak in the home. And then we’re going to start encouraging our child to go to school to make mistakes. I love doing with teenagers my favorite thing ever for kids who are just really scared of saying the wrong thing or being embarrassed. We will call the pet shop all the time in my office and order a pizza. And it’s so hard for some children. They really, really struggle with it. And we’ll do it over and over again. 

ADAM:  So the pet shop is expecting questions about the dogs and cats that they’re selling and they get a phone call about what toppings can I put on my pizza? 

REGINE:  And it’s really great because I can’t control how that sales clerk is going to answer. And that’s exactly the point. 

ADAM:  That’s amazing. I want to get back to identifying the core fear and how a parent does that when the child doesn’t even know what they’re scared of. 

REGINE:  It’s helpful to know the core fear, but it’s more helpful to just get your kid doing that thing that they’re scared of. So I don’t so much mind if you don’t know why your child is going to school as long as you’re making them go to school. And that’s in the parents control. Right? The more a parent says, oh, you look really scared today or you look really sad today. Take a day off. Take another day off. That’s showing the child see my mom knows school is scary. And that makes their fear of school even bigger. So I kind of don’t even mind if a parent doesn’t understand exactly what’s going on as long as they’re pushing their children to do the thing that they’ve been avoiding after school activity going to a friend’s house. And again, I don’t need you to start with something that’s a 10 for your child dropping them at a house that they’ve never been to at a friend that they’re not comfortable with. Right? We can start with you’re going to spend an hour at grandma’s house. You’re going to spend an hour at your cousin’s house and keep moving. You’re really comfortable with the neighbor. We’re going to do that. And from there, move on slowly. 

ADAM:  That makes a lot of sense. Your approach with younger children focuses heavily on coaching parents rather than direct therapy. And you say a little bit more about why that model is so effective. 

REGINE:  Parents are with their children for a large majority of the day. And children take their cues from parents. So this works in a whole bunch of ways. For one, a child is usually not in charge of what they’re doing or not doing. So working with the parent will allow the parent to set the tone for what happens in their home. Secondly, exposure is hard. It’s really hard to approach that thing that’s really scary. And with younger children, it’s really hard to get them motivated to do so. As a teenager, as an adult, you kind of recognize this is taking a toll on my life. Children don’t often have that insight. And they don’t often want to change it. Sometimes they know it feels icky. They want the icky feeling to go away. But they don’t realize the toll that it’s having on their life. So that’s where the parent comes in to kind of set those boundaries. 

ADAM:  We’ve talked a little bit about reducing parental accommodation, which is a key part of treatment. Can you say a little bit more about what that means and why it’s so important in breaking anxiety or OCD patterns? 

REGINE:  Accommodation is anything that we do as parents to relieve our child’s distress. And generally, we’re leaving that child’s distress in the moment. So anything that I do, whether it’s a change of routine, whether I am doing something for this child that I haven’t previously, because they’re anxious, whether it’s answering a child’s question. Sometimes these kids have so many questions and answering the questions over and over and over again. Anything that I do that helps the child feel less distress, I’m going to call a parental accommodation. And what happens is the second I accommodate my child, they feel better. And that’s really hard to pull away from. But what we learn is they feel better in the short term, but kind of really stinky in the long term. When parents come to my office, they already realize that anxiety is kind of taking more and more from their child. They’re seeking reassurance more and more. And so what I tell parents is when we pull back and when we allow children to sit with distress, what we’re teaching them is you can feel anxious and be okay. That’s the learning that I want to happen. 

ADAM:  Are there situations where you are consulting with an anxious parent and you think to yourself, I got to do some different things here because the anxiety is operating on two levels? 

REGINE:  Sure. Anxiety runs in families, right? There’s definitely a genetic component here. And so often we’ll have parents come in and what we notice is that they’re also really anxious about sending their child on play dates. And that’s when we do some values work. What’s important to you, right? Is your child’s independence actually important to you? Or is your anxiety about their safety bigger than that? And when we work through that, parents can really have a sense of what they want for their child and can kind of push them on an exposure level as well. 

ADAM:  That’s great. 

REGINE:  As children get older, you introduce more direct skill building and exposure therapy. 

ADAM:  Can you explain what exposure therapy is and why it’s considered the gold standard for treating anxiety and OCD? 

REGINE:  Exposure therapy is exactly what it sounds like. It is exposing yourself to the thing that makes you nervous. So again, for the dog example, it’s really simple. I have this fear of dogs. It’s interfering with my life. It kind of started with me just not liking dogs. Now every time I see a dog, I have to cross the street. So what exposure therapy does is it allows you to sit with a dog. I’m going to bring a dog into my office. I’m going to keep it far away. And slowly I’m going to bring it closer. And over time, you habituate. That fear that you have kind of feels less intense. It may still be there, but it’s not having the same effect that it once had. And that’s what we do with everything. So same with social anxiety. It’s really hard for some children to socialize. And what we’ll do is encourage them, can you go to that party for five minutes? Can you stay for 10? Can you ask one question? And we go through before and after, like, what do you think is going to happen? And how did it go? And that’s where the learning happens. Not just go, but kind of like, what did you think was going to happen beforehand? Do the exposure? And then how did it go? Did it go as you thought? Was it better? Was it harder? 

ADAM:  I want to linger there for a little bit on social anxiety. I don’t have a specific question, but I think it’s important to talk more about social media is only making that worse. More and more kids are struggling with social anxiety. What chance do parents have of making that better for their children? 

REGINE:  So yes, is there an uptick in social anxiety? Because of social media use, probably. What can parents do? Kids can kind of set boundaries and limits on social media, but also for some parents, I encourage them to say, okay, over the weekend, you need to have one playdate and then enforce that kind of like a house rule. You need to have one social interaction. You get to choose what that is, but it has to happen before Sunday. 

ADAM:  Great. You describe OCD as something that keeps taking and expands over time. Can you help our audience understand why early intervention matters so much? 

REGINE:  OCD often starts with an intrusive thought, like what if I get sick? Or what if I hit someone while I was driving? That thought creates a lot of anxiety and discomfort in our body. We as humans hate the way that anxiety feels and will do anything to make it go away. Often, that’s a compulsion, like washing your hands. We’re like checking to make sure we didn’t hit anybody. Now once we do that, we do temporarily feel better, but the brain learns, as long as I wash my hands, I’m okay. As long as I look behind me, I know I didn’t hit anybody. That was scary. Thankfully, that compulsion I engaged in made me feel better. And we really, in our brains, believe that it’s the hand washing or the checking or the millions of other compulsions that people engage in that help them. And of course, the next time we have that thought, we’re even more anxious and we haven’t even stronger urge to help ourselves. The longer OCD gets to run its course, the stronger it becomes because the more ingrained those thoughts are. The brain gets very comfortable with patterns and the more we do them, the more we believe in them. That’s why I encourage early intervention. I teach parents to catch these problems while they’re still developing. What I want is to form new neurological pathways. I can be anxious not to anything about it and be okay. That’s what I’m looking for. 

ADAM:  New neurological pathway sounds very exciting. Well, that’s the learning model. Exactly. Let’s talk more about intrusive thoughts. Intrusive thoughts can be really distressing, especially for kids and families who don’t understand them. How do you explain intrusive thoughts in a way that helps reduce fear and stigma? How does one distinguish intrusive thoughts that everybody has, including neurotypical people from intrusive thoughts that impede a person’s functioning? 

REGINE:  Let’s start with the definition of intrusive thoughts. Intrusive thoughts are any thoughts or images that I don’t want to be having, that I am having and that I can’t get rid of. That’s what an intrusive thought is. Everybody has them. I have them. You have them. 

ADAM:  I have lots of them. 

REGINE:  Everybody listening to this podcast has them. And they’re often the distressing thoughts that we hold on to. So first and foremost, everybody has intrusive thoughts. And they’re often distressing. And I think that for parents, they very much feel that these intrusive thoughts are indicative of who their child is. All my kid is thinking about is hurting someone. There must be something wrong with them. He must be sociopathic. And what I tell them is sociopaths aren’t really worried about hurting someone. Your child’s worried about hurting someone, the way that intrusive thoughts work is they stick to the thing that you actually care most about. And for these kids, it’s often not hurting anyone. And so that’s why when they get a thought like, maybe I’m going to hurt someone, it’s all they can think of. They have to make sense of it. They have to be sure they’re not hurting someone. And the more they focus on it, the more it comes. So that intrusive thought, what I explained about an anxious brain or an OCD brain, I often call it a sticky brain because we’ll all have the same thought. I’ll be driving in the car and be like, oh my God, imagine I hit that person. But kind of then for me, I think of the next thing, like, what am I having for lunch? For a kid with a sticky brain, it’s imagine I hit somebody. Imagine I hit that person. Oh my God, maybe I hit them. How do I know that I didn’t hit them? Let me check and make sure I didn’t hit them. I’m going to drive around the corner. They never get to the thought of like, what am I having for lunch? Because they’re stuck on that thought. I had the same thought. There’s nothing wrong with the thoughts. And often those thoughts are exactly what a child cares about. I really don’t want to hurt someone. I really want to make sure my family is healthy. And that’s why I connect and obsess about the thought that’s the opposite of what a child cares about, right? 

ADAM:  It’s pretty heartbreaking. It’s the last thing in the world they want to do and yet they can’t stop fearing that they’re actually going to do it. 

REGINE:  Right. What the OCD brain is looking for is 100% certainty. And I spend so much time trying to convince people that we are not certain about anything. 

ADAM:  And so can we make this one more thing we live with uncertainty for? If you have thoughts, questions, comments, or would like to suggest ideas for a future episode, we’d love to hear it. So email your feedback to podcast at dionlofirm.com. 

ADAM:  You’re very clear about the importance of evidence-based treatment and measurable progress. What should families expect from effective therapy and how do they know if it’s working or if it’s time to pivot? 

REGINE:  Anxiety therapy is meant to be short-term therapy, an eight to 16 weeks skills building exposure based model. And I think that effective treatment is specific and measurable. We start with goals and then we work towards those goals. And at different points in therapy, I think you ask, is my child improving? And often, and I want to make that clear, often my child’s behaviors will improve. How far their feelings do? So my kids still may be just as anxious, but they’re not asking as many questions. Or they’ve started engaging in activities that they’ve given up. Even though they would say, I don’t feel better, you’re starting to see improvements in their activities of daily living. And that’s the first goal. 

ADAM:  How do you draw the line between, I don’t want to? Fair, you’re not interested in that. Okay, you know, we don’t have to continue it. And they’re avoiding it because they’re scared. 

REGINE:  Often as parents, we know what’s driving the bus, right? We know if our child just really doesn’t like tennis or if they’re avoiding it for some other reason. And my kid doesn’t need to be a tennis player. They can choose something else, but it’s making sure that if after-school activities are important to you, then they’re engaging in something. 

ADAM:  Eight to 16 weeks may be a course of initial treatment. You’ve mentioned that OCD can ebb and flow throughout a person’s life. Can you talk more about that and how do you help children and families build tools that they can return to over time? 

REGINE:  Our therapy is skills-based. So you’re creating a toolkit. And yes, OCD will show up at different times in your lives, often distressing times or times that you feel life transition times. You may feel an uptick in those OCD symptoms. What we’re teaching is for you to start noticing them early and going back to that exposure model. It doesn’t have to be through therapy. So OCD will come at different points in your life and different transition points or stressful times in your life. You may see yourself going back to some old patterns. And what I am hoping to teach in those eight to 16 weeks is catching those things early and then shifting the way you behave. Because like we said, this cognitive behavioral therapy is a behavioral therapy. It’s all about what you’re doing. So if someone catches themselves starting to wash their hands more, they’re going to notice it and then say, okay, I need to work on getting myself dirty and being okay and sitting with it. And they can go back to that on their own. 

ADAM:  So there are many different types of anxiety. We’ve talked about social anxiety. We’ve talked about OCD. How can families begin to distinguish between them and why does that distinction matter for treatment? 

REGINE:  So from a treatment perspective, what’s driving the bus is really important. I don’t need parents to walk into my office having all of the answers, kind of just some questions or just some things that they’ve noticed. And that often helps me with intake. Art intake procedure is pretty thorough. We start with certain parental measures that we send out to parents and then we do a structured one hour interview with parents and then we do a less structured interview with the child. And often I’ll go back and say, let’s fill out this form. Let’s do this measure together, right? To get a full understanding of what’s going on for a child. I don’t need for a parent to come in kind of with all of those answers of exactly what type of anxiety my child has. 

ADAM:  It’s very encouraging to parents that they don’t have to have it all figured out before coming in to ask for help. 

REGINE:  I mean, if they did, they probably wouldn’t need to come in. Right. 

ADAM:  What makes OCD more prevalent in one community versus another? How does growing up in an insular community where everyone knows everyone’s business affect the person’s willingness to speak up? And what advice would you give in this type of situation? 

REGINE:  So OCD affects all different people and all different kinds of communities. And I think that it’s not so much is there OCD in this community as much as what’s the talk around mental health? What’s the talk around OCD? Do people talk about what they’re experiencing and often in some tight-knit communities that may not be the case? Those communities are often strong communities and people often are willing to help each other. 

ADAM:  There’s also that piece of being afraid to share with people because then everybody’s going to know. And it’s common for kids to keep it to themselves and then sometimes parents are just in the dark about what’s going on. So what advice do you have to parents in those kinds of situations? 

REGINE:  Find someone you trust. And I’ll encourage parents to talk to their pediatrician. That’s a great place to start when you have questions about your child. Reach out to a mental health organization. A lot of these professionals are guided by HIPAA laws and it is super confidential. I mean, for me, everything I do is confidential and nobody knows who my patients are or what I discuss with them. And it’s important to know the people you can trust. 

ADAM:  Mm-hmm. Absolutely. That’s good advice. Is there any other advice you would give to someone trying to learn about and navigate their communities available resources so they can get help? 

REGINE:  There are plenty of mental health referral organizations who do really great work. And you can always reach out to a professional, even if I’m not the right therapist for you, I would try to find you someone who is. So reaching out to professionals who often have proper referrals for you. 

ADAM:  Okay. And that’s a great segue. How can listeners and parents learn more about your work? 

REGINE:  You can check out what we do either through Instagram or on our website. It’s LongIslandBeHajevial.com. I am the director of our Brooklyn office. We have one in Oceanside and one in Brooklyn. And I would love to hear from you. 

ADAM:  And I’ll just ask, are there any books or resources on the subject of anxiety and OCD that you would recommend to parents? 

REGINE:  So many. From a child’s perspective, the director of our organization, Dr. Regine Galanti, has written books for children of all ages. For younger children, it’s when Harley has anxiety. And she has a teen book as well. And these are often a great place to start. You can buy a Harley book and start filling it out with your child and see how it goes. 

ADAM:  Well, Regine, I want to thank you so much for being here for this conversation. I think it’s so important for parents who have kids with anxiety or OCD to understand what they can be doing to help their children. And sometimes the way to help is not a person’s first instinct. So thank you so much for all of your insights. And I look forward to keeping in touch. 

REGINE:  Amazing. Thank you for the opportunity. I’m finally getting comfortable with the podcast. Now we feel like I can go on forever. Do you want to? 

ADAM:  Yeah. Is there anything that we missed? 

REGINE:  I hope it was clear. 

ADAM:  I think you gave lots of great advice and it’s going to be really helpful to parents. 

REGINE:  Amazing. Thank you. 

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