Understanding Intrusive Thoughts Service (UITS)

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.

I stay mindful of a young person’s emotional world before naming thinking biases like Thought Action Fusion. Moving too fast risks missing the intensity of what they live with. I do not teach them developmental theory, but I might describe how fused their inner and outer world feels. This lets me validate their experience before shifting toward cognitive work.

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 OCD treatments appear every decade, but the core clinical patterns have been recognised for over a century.

New book release

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.