439. Q&A: What should I do if my child has intrusive thoughts?

Dr. Sarah Bren (00:02):

Ever wonder what psychologists moms talk about when we get together, whether we’re consulting one another about a challenging case or one of our own kids, or just leaning on each other when parenting feels hard, because trust me, even when we do this for a living, it’s still hard. Joining me each week in these special Thursday shows are two of my closest friends, both moms, both psychologists, they’re the people I call when I need a sounding board. These are our unfiltered answers to your parenting questions. We’re letting you in on the conversations the three of us usually have behind closed doors. This is Securely Attached: Beyond the Sessions.

(00:41):

Hello. Welcome back to the Beyond the Sessions segment of the Securely Attached podcast where we answer your listener questions. And I have Dr. Rebecca Hershberg and Dr. Emily Upshur here, and we are going to dig into a good one today. So great to see you guys.

Dr. Emily Upshur (00:58):

Let’s do it. I’m excited.

Dr. Rebecca Hershberg (00:59):

Absolutely. I’m so happy to be here and hear what we’ve got in store.

Dr. Sarah Bren (01:04):

I know. Okay. So this mom wrote in and she wrote, “My son four has pediatric acute onset neuropsychiatric syndrome or PANS. When this all started November of 2025, it was actually an email from you that put all the pieces together. Thank you. That being said, his current recurring intrusive thought is around private areas. He often says, My brain is telling me insert intrusive thought. Thoughts might be about showing his own parts or seeing other people’s. What do I do? He is currently scheduled for CBT, which is cognitive behavioral therapy. So I feel like this is, first of all, I’m just so beyond grateful that something that we put together for parents actually led to her putting the pieces together.

Dr. Rebecca Hershberg (02:01):

It was actually helpful.

Dr. Sarah Bren (02:03):

I know. I’m like, oh wow.

Dr. Rebecca Hershberg (02:05):

Check that out. We don’t just send it into the void.

Dr. Sarah Bren (02:08):

Yeah. Yeah. And…

Dr. Rebecca Hershberg (02:11):

This is a common one though. It is. Sorry, I didn’t mean to interrupt you. It’s a common one. And even if kids don’t have pans, I think that’s important to say the intrusive thoughts can be part of so many different things, including typical development.

Dr. Sarah Bren (02:27):

Right. Especially, I mean, four. So there’s a few things I think we should talk about. One is just talk a little bit, let’s orient people to what pans and pandas and why that’s related to intrusive thoughts. And then talk about maybe intrusive thoughts. How do we think about and handle intrusive thoughts, whether they’re coming from a diagnostic issue like PANS/PANDAs, whether they’re coming from OCD, whether they’re coming from anxiety or whether they’re just completely on track developmentally because we all have them. Because how we deal with them is more or less the same.

Dr. Rebecca Hershberg (02:58):

Exactly. Yep.

Dr. Sarah Bren (03:00):

Who wants to describe PANS/PANDAS? Hot potato, hot potato. Emily’s got it. Emily just did the nat eye finger on her nose. You guys can’t see it.

Dr. Rebecca Hershberg (03:13):

I can give it a shot. I mean, essentially, so pans and pandas are the same, except that PANDAS refers to a specific virus, which is the strepococcalus or strep virus. And PANS refers to sort of any other potential virus. And the idea is that when some kids get inflammation in their bodies because of a virus, it also causes inflammation that results in somewhat extreme emotional or behavioral or psychiatric symptoms. And frequently those manifest as symptoms that are commonly associated with OCD, although that’s not always the case. And typically PANS or PANDAS is treated with a course or several courses, depending on the severity of antibiotics and decreasing the infection related inflammation will also decrease the OCD symptoms. Although a lot of the times it is not like everything else, black and white. And it may be that there’s some residual symptoms because your child has a tendency toward inflammation more naturally. And again, I don’t think in this episode we want to get into the nuances of PANS or PANDAs, but that’s my understanding of generally what this looks like.

Dr. Sarah Bren (04:41):

Yeah. That was a very good subject.

Dr. Emily Upshur (04:42):

It was really helpful.

Dr. Sarah Bren (04:43):

Yeah. Yes. And I can also in the show notes, I’ll link the episode that we did on PANS and PANDAS with Dr. Nancy O’Hara, who is like a pediatric specialist, pediatrician that specializes in this and wrote the book on it too. And I think that synopsis that you gave Rebecca was like exactly what we talked about in that episode.

Dr. Emily Upshur (05:08):

Oh, go ahead, Rebecca. Finish that.

Dr. Rebecca Hershberg (05:10):

I was just going to add two more things that I think I have done various deep dives into PANS and PANDAs because of my own kids as well as patients. There’s two other things that I just want to note. One is that for whatever reason, and doctors and scientists don’t totally understand, there are many more cases now than there were. So our pediatrician, for example, has said that when she was in training, she was told that a PANS or PANDAS case would be something she might see once or twice in her career. And she is now seeing it much more commonly. The other thing is that it is often the case that a child doesn’t meet criteria for PANS or PANDAs per se, but that we still see an increase in some of these symptoms when there is a virus present. And so I will say, at least in my own experience with my son, that there is always a notable increase in a range of symptoms when there is a virus on board.

(06:08):

And unfortunately, there’s not a ton we can do about that other than knowledge is power. And as soon as we see some of these symptoms coming on and the way that we’ve learned they come on, we know there may be a virus coming down the pike. And if we’re unquote lucky, it’s something like strep because then you treat it. Otherwise, it can just be something that we wait out. But I think the syndromes used to be considered this very kind of like you either have it or you don’t. And if you have it, it’s incredibly severe and you can’t function and whatever. And now there’s a lot more nuance to it, as I’m sure Dr. O’Hara goes into.

Dr. Sarah Bren (06:44):

Yeah.

Dr. Emily Upshur (06:46):

And I would like to just add from my own experience too, I had a child who exhibited PANS type behaviors, but in reaction to an asthma medication. So there is medically induced. But I think it’s just important to note that if your child is taking any type of medication that might be out of the norm or is not something that they take regularly and one of the things that can happen if they’re underlying sort of a little bit of that sort of OCD intrusive thought type of thing, it can be kicked in by other things. In addition to viruses, it can also be kicked in by other medications. And that’s just something to note as well if your child has that sensitivity.

Dr. Sarah Bren (07:36):

Yeah. Yeah. So I think this is super helpful because I think it gives people sort of a starting point with some context around what are we talking about? PANS, PANDAs and other types of like medically induced psychiatric symptoms that aren’t just organically coming from without some type of external trigger. But also I think it’s helpful to talk about what these symptoms look like. So typically, OCD is often characterized as an anxiety disorder, but really it’s more of a neurological, neurodevelopmental. It’s in that sort of category. It sort of crosses those two barriers because it has the. And I think which is why when there’s neurological and like brain inflammation, you see these symptoms show up because it’s brain braced. Brain based.

Dr. Rebecca Hershberg (08:37):

Brain based or bain based.

Dr. Sarah Bren (08:40):

Yeah. Oh my God.Because the intrusive thoughts that are present in OCD also kind of look similar to a lot of the tick-like symptoms with Tourette’s or other sort of. It’s almost like these involuntary cognitive ticks, a though that kind of pumps in, in, in, in, in and I can’t dismiss it. It just keeps returning like a loop.

Dr. Rebecca Hershberg (09:14):

Yeah. And I think what Emily said before is important. A lot of times it’s so complicated, but essentially you might have a child who has one of these diagnoses. Specifically you are sort of the triad, right? The OCD, the ADHD and/or the Tourette’s. And then the virus sort of puts them on hyper drive. And so that’s where that acute onset piece comes in is because almost from one day to the next, although not always quite that sudden, but certainly from one week to the next, there’s a tremendous increase in severity. Sometimes it’s out of the blue and your child never had the stuff before, but a lot of times it’s like, oh no, we’ve seen this. We just haven’t seen it at this incredible frequency, intensity, distress and impairment level.

Dr. Sarah Bren (10:06):

Yeah. It’s like the dial all of a sudden gets flipped really, really ratcheted up.

Dr. Emily Upshur (10:11):

Yeah. And I think it’s really important to, I mean, we can talk more about this as well, but I do think it’s really important, Rebecca, I was thinking this when you said this earlier, that often when the strep is treated, the medication is terminated, whatever the sort of underlying virus ameliorates. I say I often see, like what I say to parents is I see about 50% of the symptoms sloughing off quickly. But you still have some behaviors that stick around that do. I’m so glad this parent is doing CBT or sort of knowing that treating it is multifaceted because I do think that some of these things become more ingrained. Some of them just go right away, but some of them are stickier. I call a lot of this kind of stuff sticky thinking. And similarly, they stick around a little. And so it does take some targeted effort to reduce that. And I think that’s a really important…

Dr. Rebecca Hershberg (11:10):

And along those lines, you treat them the same way. So you can start treating the behavioral manifestations of PANS or PANDAs without diagnostic clarity. You can’t treat it medically. You can’t give someone antibiotics, but you can treat from a psychosocial perspective using CBT techniques or whatever else to treat some of these sticky things without yet knowing how much it’s related to a virus or more organic or whatever.

Dr. Sarah Bren (11:46):

And I think that’s the beautiful thing that we can offer in this moment is like, okay, whether or not your kid has a diagnosis of pans pandas, or maybe they have anxiety and OCD and they’re exhibiting intrusive thoughts as a result of that and you have those diagnoses already, the behavioral therapy is still part of that protocol. And if you don’t, let’s say you just have a kid, you haven’t gotten a diagnosis of any of those things, but your kid is coming to you saying, seeking reassurance about a very specific question over and over and over again. My brain is telling me in certain intrusive thoughts. I am having these thoughts about I want to show my private parts to somebody or I’m worried I’m going to, or I don’t know if it’s going to happen or it just keeps looping for me. And your kid is telling you this.

(12:40):

All the strategies that we’re going to talk about for managing and helping kids understand what an intrusive thought is, what they can do to dismiss it and what they can do to tolerate the discomfort that it might bring are all things that you can teach your kid whether or not they have any diagnosis. And they’re just showing you this behavior.

Dr. Rebecca Hershberg (13:02):

Yeah. And this parent who talks about the fact that the child’s private areas, meaning, I mean, I’m just going to call it his penis, I would imagine, and testicles. The fact that that’s the focus of the intrusive thoughts is very common, which is part of the reason I want to just say the word private areas, sure. But also it is frequently around, I can’t stop thinking about my penis. I can’t stop thinking about that. I want to show people my penis. I can’t stop thinking about the fact that I want to ask that person to show me her private vagina.That’s a very common thing and it can be very concerning to parents. Right. Distressing to the kid, distressing to the parent. I mean all kinds. And so if we can do anything today, first and foremost is just to normalize how common that is and how it’s okay.

(13:57):

And there’s ways to deal with it. And no therapist or psychologist is going to say like, “Oh my gosh, what is happening?” It’s like, “Oh, they’re having intrusive thoughts about their penis and vagina. Oh yeah, I see that all the time.”

Dr. Sarah Bren (14:10):

Exactly. There’s two really important things that are embedded in what you just said, Rebecca, which is one, one of the hallmark qualities that defines an intrusive thought is that it is distressing. It isn’t what we would call ego syntonic, meaning I have this though and this though feels comfortable and I don’t notice that it’s like misaligned. It’s actually ego dystonic, which means this doesn’t fit. There’s usually this sort of like, in addition to having the though, there is some sort of like concern about why is this though happening or why can’t I turn this though off? Or this doesn’t feel like my thought. And that’s

Dr. Rebecca Hershberg (14:48):

A very there’s something wrong with me. There’s a lot of shame. There’s something wrong with me. I must be dirty. I must be disgusting. A lot of those words come up when you talk with kids who are having these thoughts. It’s amazing the commonality. The people that do the work, the research on OCD. It’s just interesting. The words that kids use are so common.

Dr. Sarah Bren (15:12):

And they think they’re words like I’m bad. I’m gross. This is shameful, but also things like I’m the only one who thinks this. Exactly. Is a lot of common sort of reactions to having the intrusive thoughts. And then the other thing that I think is important is that there tends to be specific themes that these intrusive thoughts tend to embody. There’s maybe like six or seven kind of common categories of intrusive thoughts. They can be anything, but they tend to be around like sexual in nature or about like aggression or about what are some of the other ones? I forgot.

Dr. Rebecca Hershberg (15:55):

And just to be clear, when you say sexual, I know you know this obviously, but just to be clear for listeners, four and five year olds, you wouldn’t even call it sexual. It’s just about sexual body parts. For older kids, they can be sexual. And even older kids, meaning like nine, 10, if they know about sex, let’s say they can’t stop thinking about sex. But if a child is talking about intrusive thoughts about a private part, it may have nothing to do with anything having to do with sex or sexuality.

Dr. Sarah Bren (16:21):

Totally. The other ones are like contamination, right?

Dr. Rebecca Hershberg (16:24):

I was going to say dirtiness.

Dr. Sarah Bren (16:26):

Yeah. And other things, like things being just right, just in the right place.That’s where you see the kids who are like, this feels out of place. And in addition to intrusive thoughts, you might see compulsive behaviors of like reordering things or touching things a certain number of times or like rearranging stuff or needing things to be just so.

Dr. Rebecca Hershberg (16:46):

Right. Counting things, like rituals come in around these intrusive thoughts.

Dr. Emily Upshur (16:53):

That’s one I think is really sneaky.You’re like, “Oh, you’re making your bed so neatly over and over again.” Or you really, really want to tie your shoes really more than usual. It’s like really like you keep. I think those perseverations are sneaky ones that kind of get in sometimes too, because they start with a normalized behavior that sort of gets out

Dr. Sarah Bren (17:14):

Of control. Right. So we are trying to describe kind of the unique qualities so that you can identify when your kid is having the intrusive thought. They’ll usually be telling you. It’s hard to miss because it’s also usually on repeat and they’ll seek reassurance around it kind of repetitively no matter how much sort of information you give them. I always say like the difference between a reassurance seeking question and an actual information gathering question with anxiety and OCD is if it’s information gathering, when you get the information, it stops. If it’s reassurance seeking, once you get the information, you will find that you continue to see them asking for the same information over and over and over again. And that’s usually a good cue that we’re in intrusive thought and compulsive reassurance seeking behaved territory.

Dr. Emily Upshur (18:03):

But I will say though, Sarah, I will say I think a lot of parents can miss it at first. Because I do think that some of it feels really normal. You like, I keep trying to rationalize with them. And so I say something very similar though. It’s like when all the rational things you’ve said aren’t landing, nothing is getting through and you’re keeping. Because I do think parents are like, “And I’m talking till I’m blue in the face.” They’re really trying to engage in assuaging that kind of like stickiness and loopiness or fear. But sometimes I think it’s sneaky and it sort of like throws parents because they’re like, “Wait, this is again, sometimes these are normative questions, normative reassurance. And sometimes it’s hard to…” And a lot of our kids are really smart and clever and they’ll ask it in a different way. And I just want to really acknowledge those parents out there who are like, “I don’t know. Is this what’s going?” Because it can get a little sneaky.

Dr. Sarah Bren (19:04):

It can get a little confusing.

Dr. Rebecca Hershberg (19:05):

Oh, undoubtedly.

Dr. Sarah Bren (19:07):

But I think once you get a little bit, that’s the whole reason I think we’re trying to kind of pull the curtain back and explain some of the nuances of what is an intrusive thought. So you can start to look for like, are there certain content cues? Are there certain repetition cues? Is there distress around it? Is it feeling like they’re made uncomfortable by the fact that this is happening? Not just the content, but the fact that they can’t turn the thought off. And then if you’re…

Dr. Rebecca Hershberg (19:34):

And. sorry.

Dr. Sarah Bren (19:35):

Oh, go ahead.

Dr. Rebecca Hershberg (19:36):

I was just going to say, I agree with what Emily said, but I think it’s, I mean, just to be clear, if there’s parents who are starting to question, I actually think that’s more rare. I actually think for the most part, if your child is having intrusive thoughts, you know it. They cannot stop asking if we’re going to be late. Or they cannot stop asking like, “But what are we having for dinner again? But what are we having for dinner?” I think it can be insidious, but even when it’s insidious, I think after a day or two, it’s not insidious. Like you’ve gotten a hint as a parent because I just don’t want parents whose kids are really inquisitive and curious to start thinking like, “Well, what if this is that?”. Right. It really does.

Dr. Emily Upshur (20:25):

Yeah. But I also, I know I’m just going to be contrarian today. I’m just going to be a total pain in. But I also think it really depends on the age of your child. I think when you have a child who’s very verbal and grade school age, I think those are harder to miss. But I’ve seen pandas in cases of two year olds and three year olds. And sometimes the developmentally appropriate behaviors of the repetitions and stuff, you’re like, wait, it can get a little confusing. I do think you’re right. Trust your parent gut instinct. Trust your like, this feels off. This feels like too much. Is this like normal three year old behavior? I totally am with you guys on that. I just want to give a little bit of like, there’s such a range because not everybody, there’s still a range in severity in pandas. Oh, for sure.

Dr. Rebecca Hershberg (21:19):

Yeah.

Dr. Emily Upshur (21:20):

Such a diversity of presentations. I just don’t want for you to be like, “You’ll definitely not miss it.” Because I think some families might have a less of your case. I just want to put that out there.

Dr. Rebecca Hershberg (21:37):

I’ll let the point lie.

Dr. Emily Upshur (21:39):

Thank you. Don’t fight me.

Dr. Rebecca Hershberg (21:43):

No one messed with Emily today.

Dr. Sarah Bren (21:45):

Yes. But okay. I want to move to strategies because I think we’ve outlined what pans and pandas is and why it leads to intrusive thoughts. We’re talking a little bit about what is an intrusive thought regardless of where it’s coming from. But why really want to help this mom who’s saying like, “What do I do?” One, we want to normalize it for you parent that this is not an emergency if your kid is telling you, again, sometimes disturbing thoughts that they’re having and that are distressing to them. We want to validate for our kid. That a really hard thought to have. I think it’s really important to help us as parents be able to identify, ah, this is an intrusive thought in the moment to myself. And then I want to help my kid understand that it’s an intrusive thought. Importantly, I don’t think in the moment when they’re looping is the best time to be like, “Let me teach you about intrusive thoughts.” I would look for a time when they’re not so agitated and they’re calm, connected and sort of give them a little bit of info and say like, “Hey, you know how sometimes when your mind kind of has this thought that won’t stop coming and it’s almost like you try to change the channel, but the channel keeps changing back, turning back on. When you’re trying to turn the radio off, the radio keeps popping back on again. Or something that makes sense to your kid.

Dr. Rebecca Hershberg (23:04):

You’re dating yourself.

Dr. Sarah Bren (23:05):

Right?!

Dr. Emily Upshur (23:05):

I was like, what radio are you listening to?

Dr. Rebecca Hershberg (23:08):

I’m like turning the channel. When was the last time we turned the channel?

Dr. Sarah Bren (23:12):

Fine. Okay. So then, when you were talking to a kid about helping them identify this sensation of like a thought that keeps popping in and won’t go away.

Dr. Rebecca Hershberg (23:26):

It’s sticky. It’s sticky. And I have them put post-its on their head.

Dr. Emily Upshur (23:31):

I love that. That’s really cute, Rebecca.

Dr. Rebecca Hershberg (23:33):

It’s a sticky thought.

Dr. Emily Upshur (23:34):

I use this exact same language. I will say working in other populations with OCD, like postpartum OCD, I think the number one intervention, the first step I always say is, “Oh right, that’s the sticky thinking. That’s a sticky thinking thing. You know it’s not you.” I think that egoticonic thing that you brought up, Sarah, which meaning like, does this feel like me or does this feel like something that’s not me that’s happening to me? And saying, “Oh, this isn’t you. And I know that because you’re telling me this feels weird.” And that means that it’s a sticky thought. And I think that is by far the best first stop intervention you can do.

Dr. Sarah Bren (24:16):

Right. But importantly, what you are doing there is helping the kid be able to consciously separate from and observe and name what is happening as distinct from them. So you’re saying, “Ah, that sticky though is happening.” Sometimes we really have to be that explicit to a kid and help them really have a name for what is happening. And then when it is happening in the moment, then you can say, “Oh, there’s that sticky thought we were talking about.”

Dr. Rebecca Hershberg (24:49):

Yeah. I mean, I think we name it for the kid. We’ve been saying like, “Oh, there’s that sticky thought. Mom, I can’t stop thinking about showing my penis on the bus.” It’s like, “Oh, there’s that sticky though again. It won’t go away.” So the first thing you’re doing is separating your kid from the thought. Your kid is good and all the things. And it’s the though that it’s like me and you kid against the thought. And so then it becomes this, how do we build up the kid’s confidence to know that your child is in charge? So it’s like, oh, there’s that sticky though. Let’s see if we can boss it back. Kids love that, love the expecting. It’s from CBT somewhere along the way. But boss back. It’s like we’re so often telling kids not to be bossy or whatever. It’s like they can be as bossy as they want.

(25:37):

Later on in CBT for OCD, they talk about OCD as a bully. Sticky thinking is a. These sticky thoughts, it’s like pretend that a bully is the one who’s giving them to you and really boss it back. No, you can’t do that. I’m in charge of my thoughts. If they say it keeps coming back, it keeps coming back, then you can say sort of like, okay, well show them that it does matter to you. You can ride the bus, you can read a book. You’re not going to let it be in charge. So it’s a lot of that helping a kid feel powerful and agency over their sticky thought. It’s less about the content. So of course you’re going to want to go into, as a parent, I would think if you don’t have all of this education, like, ooh, but we can’t show our penis on the bus.

(26:23):

Your kid knows that. And there’s actually a very low risk of that. That’s sort of what makes OCD so fascinating is that all of the distress that I might do the thing, truly it doesn’t actually happen. And so you would respond to, I can’t stop thinking that I’m going to show my penis on the bus, the same way you would respond to like, I can’t stop thinking that I’m going to eat 10 candy bars. It’s like you’re talking about the process of a sticky thought that you don’t like having and how to boss it back and let it not rule your day.

Dr. Sarah Bren (26:58):

Yeah. One thing I will…

Dr. Emily Upshur (27:00):

And that’s exactly. Ooh, sorry, Sarah. That’s exactly what I would say, Rebecca. I would say you name it. I sometimes will depersonalize it by making it a name or drawing it. Absolutely. And then I say like, okay, so we’re going to create a toolbox to make Joe Blue, bothersome guy go away. And one of my big tactics in my toolbox is boss it back. But I also love, give it a time limit. Okay. I’m not thinking about this for the next five minutes. Or I call that kick the can sometimes. I’ll say like, “Oh, I can think about this after recess. I’m not thinking about it before recess.” Really giving some ways to make it wait, make the thought wait. Again, it’s all in the vein of they’re in charge of this and getting them back in charge. It feels like they’re not in charge when this starts and we want them to feel more empowered to feel in charge. And those are a bunch of the toolbox tools that I like. I’m like, “Carry around with you, put it in your backpack. Let’s do it.”

Dr. Sarah Bren (28:06):

Yes. One thing…

Dr. Rebecca Hershberg (28:08):

And also in keeping with that, sorry, Sarah, we’re just not going to let you talk. So you just hang in there.

Dr. Sarah Bren (28:12):

That’s cool. That’s cool.

Dr. Rebecca Hershberg (28:14):

But is not letting it. These strategies, I think it’s so important to name. The way that Emily and I are using our tones of voice when we talk about them is the way you use your tone of voice. They’re not strategies that you’re like, “Oh gosh, okay. Well, here’s an intrusive thought. Let’s stop everything.” And it’s very much like, “Oh, that’s the intrusive thought. Oh, that’s that thing. So you do the thing we’ve talked about. Oh, okay.” It’s sort of like you’re not going to sort of, if your child runs over to you in distress, necessarily you don’t give them sort of like 10 hugs.

Dr. Sarah Bren (28:49):

You don’t match it.

Dr. Rebecca Hershberg (28:51):

And, right. 10 hugs and let them not do their homework or not take a bath. It’s sort of like because there really is that risk of the secondary gain. It is sort of like, “Oh, this is a sticky though. I know how upsetting it is to you. Of course you validate it, but I see how upsetting it is to you. And also boss it back. But mommy bossing it bag never works. Okay, keep trying. We’ll get there.” It’s that.

Dr. Sarah Bren (29:16):

Very nonchalant, very unruffled.

Dr. Emily Upshur (29:19):

I like to get kids to collaborate on some of the tools too, because I’m like, “Okay, so what do you want? You want to put it in a box? Let’s put it in a box. Let’s step on the box.” I love that we, I think earlier, Rebecca, use a post-it, tear the post-it up. I like collaborating with kids too. And that’s physical.

Dr. Sarah Bren (29:38):

A lot of times if we just say, “What are some of the things that we can do to make this thought a little bit quieter?” Or again, Emily, I really like personifying the sticky brain. I actually will literally, because then I think you can use a lot of visualization strategies that help a kid really conceptualize this in a bear In a much more tangible and less abstract way of like, oh, okay, so that’s like my sticky brain or my OCD brain or my pans brain, whatever, to use language that they know. Should we name it? What’s the name? What do we name your sticky brain? Oh, it’s like you said, Joe Blue. Okay, but a lot of times…

Dr. Emily Upshur (30:26):

I have a kid that named it Bob.

Dr. Sarah Bren (30:29):

It’s so funny when kids give it just random names. I’ve had that happen so many times and they always know what I’m talking about. They’re always like, oh, it’s that name. But I’ve also had kids name it like scary things like venom, like characters that are scary. And when that happens, I’m always really very intentional about saying, okay, now what does Benham look like and what does it look like? And again, it usually matches the name and the fearfulness. And then I’m like, okay, so now how do we make this a little bit goofy? How do we make it a little bit. Can we give it a squeaky voice? Can we make it teeny tiny? We want it to be actively help them make it less intimidating. And I think that’s also part of this sort of like getting to know your and co-create the imagery around your sticky imagery and voice so you can feel more confident in bossing it back and feel more powerful than it.

Dr. Emily Upshur (31:30):

I like it.

Dr. Sarah Bren (31:31):

Okay. I feel like these are just starting points. There’s always lots more that you can do, but no, you don’t have to do this by yourself either. And this mom’s got her child in CBT. I’m sure that this therapist that they’re working with will probably go through some of these strategies as well. And there’s lots of resources. I love the Dawn Huebner workbook.

Dr. Emily Upshur (31:53):

I was going to say, I don’t know if you want to have some link that in the show notes.

Dr. Sarah Bren (31:56):

What Do I Do When My Brain Gets Stuck? Those are great books. They’re like workbooks that are really kid friendly and they’re good for a wide range. And she has ones for slightly older kids too.

Dr. Emily Upshur (32:06):

I really like those.

Dr. Sarah Bren (32:07):

Those are all good starting places.

Dr. Rebecca Hershberg (32:09):

I do too.

Dr. Sarah Bren (32:11):

I think that you guys are on a really good track. You’re addressing it as intensively as you can, and you got this. So thank you so much. Any other thoughts before we say adios?

Dr. Emily Upshur (32:28):

I’m glad we made you wait, Sarah. We just put you in the box.

Dr. Rebecca Hershberg (32:31):

That was an exposure. Right. That was an exposure.

Dr. Sarah Bren (32:35):

Love it. All right. Well, thank you so much. We’ll talk soon.

Dr. Rebecca Hershberg (32:40):

Sounds good. Adios.

Dr. Emily Upshur (32:41):

Bye.

Dr. Sarah Bren (32:43):

Bye.

(32:45):

Thank you so much for listening. As you can hear, parenting is not one size fits all. It’s nuanced and it’s complicated. So I really hope that this series where we’re answering your questions really helps you to cut through some of the noise and find out what works best for you and your unique child. If you have a burning parenting question, something you’re struggling to navigate or a topic you really want us to shed light on or share research about, we want to know, go to drsarahbren.com/question to send in anything that you want, Rebecca, Emily, and me to answer in Securely Attached: Beyond the Sessions. That’s drsarahbren.com/question. And check back for a brand new securely attached next Tuesday. And until then, don’t be a stranger.