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Writing on Adolescent OCD and Emotional Life
Clinical reflections on intrusive thoughts, compulsions and the emotional life of adolescence. These pieces are written for families, young people and professionals who want to understand what symptoms may be communicating, while remaining attentive to established psychological treatment.
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What Metacognitive Exposure and Response Prevention Is Teaching Us (That Bion Already Knew)
MERP teaches us something Bion knew all along: we must think about thought—not just resist it—if we are to metabolise experience.
marcuslewton
Jun 15, 20251 min read
Digital OCD: The Untheorised Ritual
Digital compulsions in teens aren’t just screen habits—they’re modern rituals of doubt, fear, and obsessive certainty-seeking. #OCD
marcuslewton
May 31, 20254 min read
Treating OCD
Why clinicians must rethink OCD: key insights for psychologists, therapists, and counsellors treating obsessive-compulsive distress in young
marcuslewton
May 31, 20253 min read
Listening to Psychic Architecture: A Reflective Practice
Listening to psychic architecture means attuning to deep emotional structures beneath symptoms—containment, presence, warmth, care.
marcuslewton
May 4, 20255 min read
“Do They Really Need to Understand It?”
Can we treat OCD without understanding it? A fictional debate between two clinicians explores timing, structure, and symbolic readiness.
marcuslewton
Apr 21, 20255 min read
The House, the Bunker, and the Panic Room
What if OCD isn’t one condition, but four psychic positions? A new way to understand rituals, retreat, and recovery in young people.
marcuslewton
Apr 18, 20253 min read
Uninterpretable States: How to Stay With What Refuses to Mean
Not every silence needs decoding. Some states refuse meaning. This lecture teaches how to stay when the symbol won’t come.
marcuslewton
Apr 11, 20254 min read
Not Yet: When Interpretation Becomes Intrusion in Adolescent Therapy
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.
marcuslewton
Apr 10, 20252 min read
Stop Focusing on the Compulsion
Stop cataloguing rituals. Start listening for what breaks if they don’t happen. Treat the structure, not just the symptom.
marcuslewton
Apr 8, 20252 min read
Understanding Symbolic Breakdown in Adolescent Obsessionality
When a young person stops symbolising, rituals remain—but meaning drains out. Symbolic collapse is quiet, but devastating. (Lecture 2).
marcuslewton
Apr 8, 20255 min read
The Institutional Defence Against Meaning: Why Clinics Abandon Symbolic Work
To abandon symbolic work is to leave the child un-met, and the therapist untouched. We must reclaim meaning, or risk becoming procedural.
marcuslewton
Apr 8, 20253 min read
Beyond the Skills: A Symbolic Clinician’s Guide to Working Psychodynamically in a Manualised World
A guide for clinicians who want to practise symbolically—even within ACT, DBT, and CFT-dominated services. Hold the thread.
marcuslewton
Apr 7, 20253 min read
Don’t Tell Me What They’re Doing — Tell Me What It’s For
OCD rituals aren’t just behaviours — they’re attempts at meaning. Stop listing actions. Start listening for what the act is doing.
marcuslewton
Apr 6, 20252 min read
When the CBT Workbook Stays Closed
CBT can fail when symbolic resistance blocks meaning. Discover why refusal isn’t laziness—but a defence against unbearable psychic contact.
marcuslewton
Apr 3, 20253 min read
Broken Links, Repeated Acts: Attacks on Linking and the Architecture of OCD
Some OCD rituals aren’t about fear — they’re about broken psychic links. This post explores obsessionality through Bion’s theory of linking
marcuslewton
Apr 3, 20253 min read
When the Drive Repeats: OCD as Repetition Compulsion, Not Just Anxiety
Not all OCD is driven by fear. This post explores how some rituals repeat unconscious guilt, desire, or helplessness — not just avoid anxiet
marcuslewton
Apr 2, 20253 min read
When Kindness Feels Contaminated: Envy, Projective Identification, and the Adolescent Who Can’t Let the Good In
Envy and intrusive thoughts- not what it seems.
marcuslewton
Apr 2, 20254 min read
More Than a Symptom: Understanding Obsessive Structure, Intrusive Thoughts, and OCD
Understanding obsessive structure means seeing beyond symptoms—into how a young person thinks, defends, and survives through loops and contr
marcuslewton
Apr 2, 20254 min read
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