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Psychiatry & Psychology--General/Teen age boy with multiple fears

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Hello and thank you for taking the time to read my questions.  My nephew is 15 years old and has some behaviors that concern me.  He has had these behaviors for years and his mother has never been worried about it nor taken him to counseling.
The boy insists on wearing a hat in public places because he thinks that hidden cameras will read his mind if he is bare-headed.  He insists on wearing long sleeves, sweaters, and long pants whenever he goes outside, even if it is 98 degrees out.  He cannot tolerate any curtain or window shade being open - he must keep all windows covered.  He does this wherever he happens to be.  He tapes his bedroom curtains to the walls.  He keeps all of the belongings that in his room covered with sheets and blankets - he told me that he does that because he doesn't want anyone to see his things.  He said that it feels like his things don't belong to him anymore if someone else looks at them.  He is begging me to make a curtain to go across his door so that if anyone opens the door, they can't see inside.  Whenever someone is in the bathroom, he stands guard outside the door to make sure they don't walk down the hallway and into his room.  Every time he walks out of the room, he says, "Don't talk about me, OK?"
I am worried about this boy.  His mother says, "Oh, its just his OCD".  The boy has never been diagnosed with OCD, and has never spoken with any therapist or doctor about these problems.  He also has a history of stealing and of peeking in neighbors' windows.
He has been homeschooled for two years, although not much schooling is going on.
Can you tell me how to help him or what to say to his mom to convince her to get help for him?
Thanks,
Lynn

Answer
Hello Lynn

One extreme possibility is this: Sheltering the lad is the best for him because putting him into the hands of mental health professionals will involve stress, expense, a lot of labeling, and no assurance that they'll do him any good.

The opposite possibility is that it's like a movie plot, in which a delusional mother is virtually abusing her child by keeping him from being diagnosed and treated.

My view: can't tell from here, but in these cases the situation is usually between the extremes.

As to your question, I wouldn't try to help either directly. But you could commend your sister for devoting herself to his needs. Then point out that the younger generation invariably outlives the older, and in the case of her inability to continue, you'd like to further her efforts and look after him. But, of course, you would have to know exactly what you'd be dealing with. (Then try to let her come up with something.)

You want to get the conversation, preferably at her instigation, to this type of resolution. If you managed to get the name of a local specialist in adolescent cognitive disorders (a psychiatrist or clinical psychologist), would she think it a good idea to have him properly assessed?  Maybe if won't make a difference, but who knows? For instance, maybe he has a neurochemical imbalance that medications could normalize, or maybe he could be taught some socialization skills that would let him function outside the home as he gets older.

I hope, for all your sakes, that your concern will lead to some level of improvement. Best of luck with it, and thanks for asking us.

Alan  

Psychiatry & Psychology--General

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Alan Auerbach

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Taught psychology for 30 years, authored four textbooks. Specialize in introductory and industrial/organizational psychology, but will tackle wider range of areas.

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