Understanding Intrusive Thoughts and Compulsions in Adolescents Release on June 25th

As many readers are likely aware, for the past few years, alongside ordinary clinic work, I have been writing a book about adolescent OCD.

I didn’t actually set out to write a book. It started because the same conversations kept happening in my room.

Parents would sit down and say some version of,

“We’ve read about OCD but this doesn’t look like what they describe.”

And they were right.

Most information about OCD focuses on visible rituals. Handwashing, checking locks, counting behaviours. Those certainly exist. But many teenagers I meet are not primarily washing or checking. They are thinking.

• They are reviewing memories for hours trying to make sure they didn’t hurt someone.

• They are asking questions they don’t really want answered.

• They are confessing things repeatedly.

• They are frightened by thoughts that feel as if they must mean something about who they are.

Often they understand on one level that the fear makes no sense. At the same time it still feels completely real.

This leaves families in a confusing position. Reasoning doesn’t help. Reassurance helps briefly and then makes it worse. Arguing escalates distress. Ignoring it feels abandoning. Parents end up walking a narrow line between comforting their child and accidentally feeding the problem.

Again and again I found myself explaining the same ideas in slightly different words depending on the family in front of me. Eventually I realised I was, in effect, already writing the book out loud.

So I began putting it down properly.

The aim of the book is simple. It explains what intrusive thoughts are, why they feel convincing, why compulsions temporarily calm anxiety but strengthen the cycle, and what treatment actually involves. It is written for clinicians, but also for parents who want to understand what is happening inside their child rather than just what to do next.

One thing I felt strongly about was tone. OCD is frightening for young people. Many are deeply ashamed of their thoughts and hide them for a long time. I wanted the book to be accurate but also recognisable. Families should be able to read a page and think, “that is my child”, not “that is a textbook patient”.

The book is called Intrusive Thoughts and Compulsions in Adolescent OCD: A Psychoanalytic Framework for Treatment and it will be published later this year.

If you are a parent currently living with OCD in your home, I hope it gives you something very specific: understanding. Not quick reassurance, not blame, and not a list of rules to rigidly follow, but a clearer sense of what your child is experiencing and why they behave in ways that can look so puzzling from the outside.

The most consistent thing I have learned from young people with OCD is this. They are not trying to be difficult. They are trying to become certain enough to feel safe again.

Once you see that, many of their behaviours begin to make emotional sense.

A brief note for parents

Although this book is primarily written for clinicians, a number of parents have already asked whether it would still be useful to them. Many do find it helpful, particularly if they want a deeper understanding of what may be happening inside their child’s mind rather than a quick summary of strategies.

That said, it is still a clinical text and parts of it are inevitably more detailed than most families need day to day.

For that reason I am also working on a separate book written specifically for parents and carers. The intention is to keep the same ideas but explain them in a more direct and practical way, focusing on what helps at home, how to respond to reassurance seeking, and how to support recovery without becoming caught in the OCD cycle yourselves.

I hope to share more about that in the near future.

https://www.amazon.co.uk/dp/1041219199