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?

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

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

MERP teaches us something Bion knew all along: we must think about thought—not just resist it—if we are to metabolise experience.

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

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

Can we treat OCD without understanding it? A fictional debate between two clinicians explores timing, structure, and symbolic readiness.

If your child won’t talk about their thoughts, don’t panic. Silence isn’t failure—it’s a signal. Here’s what to do instead.

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.

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).

To abandon symbolic work is to leave the child un-met, and the therapist untouched. We must reclaim meaning, or risk becoming procedural.