Writing on Adolescent OCD and Emotional Life

By the time a young person reaches CAMHS, their OCD has usually been described many times. The clinician may know the rituals, the risk concerns and the reassurance being sought at home, yet know very little about the young person. Meltzer helps us think about what enters the room with them: the institution, the pressure for certainty and the fear that an intrusive thought will be treated as a confession. The task is to create an encounter in which thought remains possible.

“I can’t reassure them anymore.” “I feel like I’m failing.” Parents of teenagers with OCD say some version of this to me constantly, and none of them are failing. In this post, Marcus Lewton introduces his new book, When Your Teenager’s Mind Gets Loud, and makes the case that NICE guidance on adolescent OCD, unchanged since 2005, leaves parents carrying more than anyone tells them to expect.

New book release

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

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.

You don’t need to be perfect. You need to stay in the room. What to say when you’re scared to say the wrong thing to your child.

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

Is your child expressing something—or just repeating it? Learn how to tell if a ritual is symbolising, or if it’s stuck in survival mode.

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