Writing on Adolescent OCD and Emotional Life

An intrusive thought is not a moral offence, but OCD can make it feel as though it is. For some adolescents, a frightening image or unwanted thought becomes an imagined sin, followed by a private demand for payment: confess, check, avoid, seek reassurance, give something up. This essay considers why the punishment can seem to match the fear, and what may help loosen that cruel logic.

What if compulsive checking is not simply an attempt to remove doubt, but a retreat from a question that cannot be answered? Drawing on Donald Meltzer’s idea of aesthetic conflict, this piece considers how adolescent OCD may convert the uncertainty of bodies, parents and other minds into rituals with rules. The compulsion offers a procedure where emotional life offers none.

“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.

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

New book release

Conversations with Child Psychotherapists

Not all dark thoughts in adolescence are perverse. Some are collapse. Know the difference—and listen for structure, not content.

Repetitive thoughts aren’t always questions—they’re often cries. Listen beyond logic. It’s not about the answer. It’s about the feeling.

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.

Intrusive thoughts often strike hardest at night. Here’s why bedtime makes the mind vulnerable—and how to support your child through it.

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.

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.

Sometimes a ritual isn’t just a habit — it’s a child’s way of saying, “I’m sorry,” or “I love you,” when words feel impossible.

Reassurance feels kind—but can keep OCD stuck. Learn how to support your child without feeding the fear, and what to say…

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

A parent’s first glimpse of OCD isn’t always a diagnosis—it’s the sense that their child is there, but behind a door they can’t yet open.