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.

Why can an old memory suddenly become unbearable in adolescence? Freud’s idea of afterwardsness helps us think about how the past acquires new meaning as the young person develops. In adolescent OCD, an ordinary childhood event may return as moral evidence, inviting review, confession and reassurance. The facts may be unchanged, yet the mind meeting them is different. Therapy can help the young person live with uncertainty without forcing the past into a final verdict.

“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.

Conversations with Child Psychotherapists

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?

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.

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).