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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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The Imagined Sin
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.

marcuslewton
Jul 175 min read


The Question That Cannot Be Checked
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.

marcuslewton
Jul 125 min read


Why so painful now?
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.

marcuslewton
Jul 126 min read


Empowering Parents
“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.

marcuslewton
Jul 71 min read


The Illusion of Efficacy
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?

marcuslewton
Jun 19, 20252 min read


Perverse Thoughts in Adolescents: A Clinical Note on Intrusion
Not all dark thoughts in adolescence are perverse. Some are collapse. Know the difference—and listen for structure, not content.

marcuslewton
Jun 16, 20254 min read


Many in Government Think a Child’s Mind Is a Datapoint
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.

marcuslewton
Jun 16, 20251 min read


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

marcuslewton
Jun 15, 20252 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


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


Why Is My Child Doing This?
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.

marcuslewton
Apr 5, 20252 min read


How Can I Help If I’m Not Supposed to Reassure?
Reassurance feels kind—but can keep OCD stuck. Learn how to support your child without feeding the fear, and what to say…

marcuslewton
Apr 4, 20252 min read


“What Should I Say?” When Reassurance Doesn’t Work
When reassurance doesn’t work, it’s not because you’re doing it wrong. Sometimes, it’s not about answers—it’s about staying close.

marcuslewton
Mar 29, 20251 min read


The House with a Locked Door: A Parent’s First Glimpse into OCD
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.

marcuslewton
Mar 29, 20252 min read
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