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.

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 book release

Conversations with Child Psychotherapists

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.

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

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.

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).

Taboo thoughts in teens aren’t signs of danger. They reflect inner conflict during adolescence—when new impulses outpace understanding.

Intrusive thoughts aren’t nonsense—they’re protection. This post helps parents understand the hidden logic behind loops, rituals, and fear.