I had 10 minutes to speak about how to support parents at the PANS PANDAS UK Conference in October. In reality I could have spoken for hours on this subject. I think supporting parents is such a big part of the work so they can support their children, feel safe and navigate this complex illness.

In this talk, I follow a fictional family through three stages: before, during and after diagnosis. I look at what parents actually need.

I cover:

• Why parents are the frontline historians of their child’s illness, and why believing them is clinical information
• The “inversion,” where a parent’s response to illness becomes the explanation for it, and how this can escalate to FII allegations
• Lessons from medicine’s history of mother-blame
• “Holding the frame,” which means keeping biology, psychology and family circumstances in mind together

• Why referrals need to be joined up, and how therapy, including ERP, needs adapting

Because you can’t CBT your way out of inflammation! We need to work together, as while we debate diagnosis, a childhood is slipping away - for both child and parent.

I am Lucy McDonald, a child and adolescent psychotherapist. I have a special interest in PANS PANDAS, and support families and children with the illness. I have an online course for parents sharing what I know.

More information on lucy-mcdonald.com

** NOTE - IN THIS EPISODE I say that inference-based CBT is not evidence-based. This is wrong. I meant it is not evidence-based in children yet (although that work is underway) but it is evidence-informed in children. It is approved by the IOCDF for adult populations and is a rigorous treatment that I like as an alternative to ERP**

Meet the brilliant Barb Shephard who advocates passionately for PANS in New York.

She is an empathic therapist with a deep understanding of OCD. Here she talks about Exposure and Response Prevention for OCD, working with PANS, and how her own experiences have shaped her as a therapist.

She says: "I often meet parents and they say, we don't see them doing any rituals. Their room is untidy...It's such a dangerous idea that we have of what OCD is. When you work with OCD and you see the mental compulsions and the emotional toll that that can take on people who have no idea that it's OCD."

She is also on the team with me at MIND Global Council - an international coalition of therapists working to improve psychotherapy outcomes in PP.

PS If you live near Niagra, and visit on PP Day - you will see it lit up green - that is Barb's work!

PANS/PANDAS Stories was co-created by Jo Joyner and Lucy McDonald. It is hosted by Lucy, a child and adolescent psychotherapist with a special interest in PANS/PANDAS. She sees children, teens and families in Harley Street, Kew and online.

Take her online PANS PANDAS course for parents. More info https://lucy-mcdonald.com.

This podcast does not replace medical advice.

OCD and PANS PANDAS specialist Angela Henry talks about treating OCD using I-CBT. This is a different approach that focuses on doubt – particularly how OCD can make us distrust what we know through our senses and experience.

Rather than starting with “How do I tolerate the anxiety this thought creates?”, I-CBT looks at an earlier step: “How did I come to doubt this in the first place?”

It helps people recognise when OCD is pulling them away from what’s actually happening in the here and now and into imagined possibilities - the endless “what ifs” that can make something feel possible even when there’s no real evidence for it.

She talks about suicidal OCD. This specific subtype involves unwanted and distressing intrusive thoughts or fears about self-harm, rather than a genuine desire to hurt oneself.

Professional help is needed to understand what is happening and ensure the child or young person gets the right treatment. It can be so alarming for parents when their child experiences intrusive thoughts like this. Angela explains them as egodystonic – which means they are against a person's values or wishes. A key marker of OCD thoughts. She is so kind, clear and reassuring. A must-listen.

Angela talks about I-CBT, an emerging treatment for OCD which works by targeting reasoning and distinguishing reality.
I was fascinated to learn more, particularly as it is a good evidence-informed alternative to ERP, which does not always work for neuroimmune children.

PANS/PANDAS Stories was co-created by Jo Joyner and Lucy McDonald. It is hosted by Lucy, a child and adolescent psychotherapist with a special interest in PANS/PANDAS. She sees children, teens and families in Harley Street, Kew and online.

Take her online PANS PANDAS course for parents. More info https://lucy-mcdonald.com.

This podcast does not replace medical advice.