A teacher watches her student, Nimashi rub out a whole line and write it out again. She takes another critical look at her work and decides to tear the page and start afresh. Nimashi’s handwriting is beautiful and her work is always neatly presented but she is never satisfied. It’s an obsession with her. Most cultures do value neatness and drive in children. Parents encourage them to persevere until they’ve finished a task. Teachers reward them for turning in neat papers and getting every answer right on a quiz. Most children gain a sense of mastery from putting together a jigsaw puzzle, painting a picture or writing an essay. There are some children for whom orderliness is not enough.

Their rooms are never quite tidy enough to suit them. They may put off doing their homework until the last minute, then rush through it, claiming they could do better if only they had had more time. These overly compulsive children usually need some professional help to break the cycle.

"It’s a problem when neatness, not the completion of a task, becomes the objective," says psychologist. "They lack the spontaneity and playfulness that we associate with being a child. They’re worried about the future like a stockbroker worries about the next crash."

Instead of feeling masterful, these children feel increasingly anxious. Nimashi’s mother, in a confidential confrontation, confessed that she often feels frustrated and alienated. Psychologists agree that compulsive behaviour tends to run in families. Ask yourself if you insist on having dinner at a particular time or on wearing perfectly ironed clothes. Many of the adults who are obsessive and compulsive tell me —at their parents were so proud of how they insisted on so much cleanliness and orderliness as children. "Because parents expect and value a certain amount of compulsiveness in a child, it is often difficult for parents to realise when things have gone too far. It is normal, for example, for toddlers to insist on drinking out of a special cup or to become upset if they do not hear the same story or song at bedtime. Their demands tell their parents that they realise that they can influence the world rather than passively accept it.

Preschoolers and children in early elementary school will often develop complex rules for the games they play; indeed, some first graders may spend as much time negotiating the rules for a new game as they do playing it. Trying to account for all the possibilities helps them feel powerful and in control but when the need for order becomes too strong, they feel powerless and out of control.

Highly compulsive children may become upset if they find a speck of dirt on their clothes, or they may spend hours each day counting objects or taking showers. The key factor is whether the children’s compulsiveness interferes with their schoolwork or play. A child may procrastinate and never finish his homework because all his energy is going into largely irrelevant details, like whether he has the right number of pencils.

Parents may interpret this as a deliberate avoidance of school work instead of the child being so caught up in making everything perfect. Parents should try and control their anger and frustration. This is more easily said than done, of course. "Yelling at your child about the problem will simply raise his anxieties. Instead, tell your child that you can see how uncomfortable he is and that you want to help out."

A psychologist describes a 11-year-old boy, who had been treated by him. Ahamed was constantly drawing maps. If you asked him about his vacation, he would draw a map of where they had been, where they had parked, the hotel and so forth. Each map took about half an hour to draw and involved many erasures and corrections until it satisfied the boy. He would spend several hours a day drawing such maps. It interfered with his friendships since other children did not find him fun to be around. "The map was a strong metaphor of his need to find his way in life," says the psychologist "When he did this, he wasn’t anxious. He could control his fears."

Such extreme cases affect about one per cent of children, child psychiatrists say, although many more have milder problems with rituals and neatness. Boys are slightly more likely to have these problems in junior school. Older compulsive children are equally likely to be of either sex. Trying to help these children is an onerous task for parents and teachers alike. With these children simply telling them that their homework looks good, doesn’t help.

Parents of such children should read a book titled The Boy Who Couldn’t Stop Washing by Dr. Judith L. Rapoport. It tells parents to remain tuned in to their child’s needs and give encouragement to keep him from becoming sure that he is not doing well enough and increases his compulsive behaviour.

The transition from being appropriately organised to overly compulsive is almost always gradual, making it difficult for parents to realise when their children first had problems. In the rare instances when change in behaviour occurs suddenly and dramatically, it may be a sign of a bacterial infection in the brain or other physical illness. The vast majority of anxious and compulsive children quickly respond to treatments that are much less dramatic, behaviour therapy and if their anxieties are too overwhelming, a short course of medication may help them feel back in control.
by Geetha Munasinghe