Understanding Intrusive Thoughts Service (UITS)

When OCD first enters family life, it rarely arrives as a diagnosis. It appears as delay, tension, repetition and disruption. The morning routine buckles, rooms are avoided, questions are repeated, and ordinary life starts reorganising itself around something nobody has yet properly named. Adolescent OCD needs more than one language because it is not only a set of symptoms. It is often a relationship.

In Chapter 13, Closing Reflections, of Intrusive Thoughts and Compulsions in Adolescent OCD, I argued that what mattered most clinically was not the content of an adolescent’s obsessions or compulsions, but the relationship they had with them. Since finishing the book, one question has stayed with me: could this framework apply more broadly? The more I reflect on it, the more cautious I have become

Whenever I find myself working with an adolescent and their family where OCD has begun to take hold, there is a point in the work that arrives with a certain predictability. A parent, often after a period of careful listening and reflection, will ask what they should actually do. By then they usually understand the reassurance seeking cycle. They can see how they’ve been drawn into it, how their responses, given with care, have also been maintaining something that no one real

My experience of health and illness anxiety in adolescents has gradually moved me away from thinking of it as a primarily cognitive problem. This was not where I started. My clinical training pointed clearly in a different direction, and for good reason. The cognitive model of health anxiety is a genuinely compelling one. The account offered in texts like the Oxford Guide to Cognitive Behavioural Therapy, and in the broader clinical literature, makes a strong case: that what

Anxiety has become a word that seems to explain everything and, in doing so, risks explaining very little. In clinical practice, we may be too quick to name it and then move to reduce it, without asking what it is doing or how the mind is using it.

Adavanced training in OCD. For those clinicians who need a fresh perspectove beyond CBT\ERP I am offering something for 2027. An additional lens for thinking about OCD. Practical. Hand-on training.

It describes what works. But not when it becomes possible. In the clinic, ERP rarely fails because of effort. It fails when the thought is too close. For some, there is enough distance to approach it. For others, there isn’t. The issue is not motivation. It is whether there is space in the mind for the work to begin.

New book release

Some obsessions protect. Others protest. OCD isn’t always about fear—it’s sometimes the mind trying to break free.

Even after 8–10 years of ERP, most don’t recover. The data is clear. So why are we still treating OCD like a procedural problem?

When neurodivergent children show OCD-like distress, services often step back. But not all repetition is the same.

Not all dark thoughts in adolescence are perverse. Some are collapse. Know the difference—and listen for structure, not content.

To many in government, a child’s mind is a datapoint. But some suffering isn’t measurable—it’s symbolic, not yet sayable, still surviving.

Why are my daughter’s intrusive thoughts so much darker than mine? A blog for the parent who quietly wonders—and wants to understand.

Repetitive thoughts aren’t always questions—they’re often cries. Listen beyond logic. It’s not about the answer. It’s about the feeling.

Reassurance won’t help if the fear can’t be digested. Sometimes, your presence—not your answer—is the real container.

If your child won’t talk about their thoughts, don’t panic. Silence isn’t failure—it’s a signal. Here’s what to do instead.

When OCD rituals don’t respond to logic, it’s not defiance—it’s emotional code. Learn how to listen for what’s really being said.

What if OCD isn’t one condition, but four psychic positions? A new way to understand rituals, retreat, and recovery in young people.

Intrusive thoughts often strike hardest at night. Here’s why bedtime makes the mind vulnerable—and how to support your child through it.