Conversations with Child Psychotherapists

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?

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.

MERP teaches us something Bion knew all along: we must think about thought—not just resist it—if we are to metabolise experience.

Digital compulsions in teens aren’t just screen habits—they’re modern rituals of doubt, fear, and obsessive certainty-seeking. #OCD

Why clinicians must rethink OCD: key insights for psychologists, therapists, and counsellors treating obsessive-compulsive distress in young

Listening to psychic architecture means attuning to deep emotional structures beneath symptoms—containment, presence, warmth, care.

Can we treat OCD without understanding it? A fictional debate between two clinicians explores timing, structure, and symbolic readiness.

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

Not every silence needs decoding. Some states refuse meaning. This lecture teaches how to stay when the symbol won’t come.

Not every interpretation lands. Some come too soon. Learn how to recognise when a symbol isn’t ready—and why that matters in OCD work.

Stop cataloguing rituals. Start listening for what breaks if they don’t happen. Treat the structure, not just the symptom.

When a young person stops symbolising, rituals remain—but meaning drains out. Symbolic collapse is quiet, but devastating. (Lecture 2).

To abandon symbolic work is to leave the child un-met, and the therapist untouched. We must reclaim meaning, or risk becoming procedural.

A guide for clinicians who want to practise symbolically—even within ACT, DBT, and CFT-dominated services. Hold the thread.

OCD rituals aren’t just behaviours — they’re attempts at meaning. Stop listing actions. Start listening for what the act is doing.

When a ritual replaces a symbol, the mind isn’t irrational — it’s grieving. Segal helps us listen to what the act is holding.”

CBT can fail when symbolic resistance blocks meaning. Discover why refusal isn’t laziness—but a defence against unbearable psychic contact.