Ever notice your child doing the same thing over and over, like checking the locks, washing their hands endlessly, or counting steps on the way to school? As harmless as they seem, these habits could be OCD rituals, a way for your child to cope with intrusive thoughts that make their world feel out of control.
Behind these repetitive actions is a brain stuck in overdrive, trying to calm overwhelming fears through rituals. From years of working with OCD kids, time and again I’ve learned that while these rituals offer relief, the relief is only temporary and will only keep the cycle going.
Obsessive Compulsive Disorder (OCD) found a mysterious partner-in-crime in rituals. OCD obsessions and compulsions, commonly referred to as OCD rituals, are mental acts that individuals with OCD experience. These are not just compulsions, but they are pressured as they feel compelled to perform in response to obsessive thoughts. Such persistent thoughts and rituals are aimed at reducing anxiety or preventing a feared event (Foa et al., 2012).
Compounding the problem is a lack of properly trained mental health experts who can help diagnose and treat this increasingly common disorder.
What are compulsions?
Understanding what OCD rituals look like is the first step in understanding obsessive compulsive disorder.
I remember working with Sarah, an 11-year-old who couldn’t leave the house without checking her school bag at least ten times. She was consumed by the obsessive thought, “What if I forget something important and get in trouble or fail at school?” This fear played on a loop in her mind, convincing her that she had to double-check everything to avoid disaster.
She worried endlessly about forgetting something crucial, like her homework or lunch, and would repeatedly unpack and repack her bag until she felt “sure.” These rituals provided temporary relief from her anxiety but kept her stuck in a cycle that made mornings a daily struggle. This is an example of true OCD, where both key features- obsessions and compulsions are present.
Common Examples of OCD Rituals
There are many OCD rituals children and teens may engage in as they navigate the challenges posed by their intrusive thinking. Here are compulsive behaviour examples:
Handwashing OCD Rituals
- This is probably the most common compulsion associated with OCD. Handwashing rituals are a form of excessive cleaning driven by contamination fears or illness.
- Insisting on a precise sequence while washing hands, like scrubbing each finger a certain number of times.
- Often driven by a fear of germs or the belief that cleanliness will prevent harm.
Checking Behaviors and Rituals
- Repeatedly checking doors, appliances, or windows to ensure they are secure, even when running late.
- Reviewing homework or emails multiple times to ensure there are no mistakes or nothing was forgotten.
- Rooted in the fear of making a mistake or being responsible for something going wrong.
Counting OCD Rituals
- Counting objects like steps, tiles, or pencils in a specific order or pattern to feel “safe.”
- Repeating actions, such as blinking or tapping, several times to prevent a feared outcome.
- Stems from magical thinking that specific numbers or patterns can ward off bad events or bring a sense of control.
Tapping or Touching Rituals
- Tapping furniture, walls, or objects a specific number of times
- Touching body parts or objects in a mirrored pattern to maintain balance or symmetry.
- Often arises from a need to relieve discomfort or ensure a sense of balance and control.
Ordering and Arranging Rituals
- Some children would have strict rules when it comes to their possessions. Compulsions can show as aligning toys, books, or furniture in perfect rows or patterns, sometimes spending hours rearranging.
- Insisting on particular orders or exact angles for items on desks or shelves
- Driven by a belief that disorder will cause anxiety or lead to negative consequences.
Mental Rituals
- Silently repeating specific words or phrases to neutralize unwanted thoughts.
- Engaging in mental counting or prayers to “fix” bad thoughts or prevent imagined dangers.
- These mental rituals can be their way to counteract or “erase” distressing thoughts that feel overwhelming or threatening.
Symmetry and Precision Rituals
- Adjusting objects or positions repeatedly until they are perfectly symmetrical.
- Repeating movements or actions in a precise manner to feel a sense of balance.
- Arises from the belief that imbalance or disorder could lead to unease or catastrophic outcomes.
Reassurance-Seeking Rituals
- Younger children would often constantly ask parents or teachers if what they are doing is “right.”
- Seeking reassurance and validation about decisions or actions, even when unnecessary.
- This need for constant reassurance is rooted in a fear of uncertainty and the need for external confirmation to alleviate anxiety.
Avoidance Rituals
- People with OCD would often avoid certain people, places, or activities that trigger obsessive thoughts.
- Steering clear of situations that might provoke distress, such as being in crowded spaces.
- Often driven by the desire to avoid anxiety, even if it disrupts daily functioning or routines.
Magical Thinking Rituals
- Wearing “lucky” clothing or repeating a specific word to avoid harm or illness.
- Performing superstitious actions, like avoiding cracks on the sidewalk, to prevent imagined disasters.
- Rooted in the false belief that unrelated actions or objects can control or influence real-world events.
Intrusive Thoughts: The Root of Compulsions
You might ask yourself, Why is my child compelled to do these rituals? The answer lies in a dysregulated brain. Obsessive compulsive symptoms are significant in relation to neurological factors, as research indicates abnormalities in brain structures and neural pathways may contribute to their manifestation.
When the brain is stuck in overdrive, it misinterprets intrusive thoughts as threats, triggering a cascade of anxiety and fear. These feelings don’t just go away on their own, so the brain tries to find relief through rituals or compulsions—like the examples of OCD rituals mentioned above—to feel a sense of control.
Obsession vs Compulsion
Think of it this way: obsessions are the bossy thoughts that won’t stop yelling in your kid’s brain—“Germs are everywhere!” or “What if I hurt someone?”
Meanwhile, compulsions are the things they feel they have to do to shut those thoughts up, like scrubbing their hands raw or triple-checking the locks. Obsessions are the “why,” and compulsions are the “what” keeping the OCD cycle going. Understanding OCD compulsions involves recognizing these intrusive thoughts and compulsive behaviors and how they affect daily life by causing significant distress and challenges in resisting them.
Breaking Free from OCD Rituals
OCD rituals may feel like a way for your child to cope with the anxiety triggered by obsessive thoughts, but they only provide temporary relief while reinforcing the OCD cycle. Over time, these behaviors complicate life, making it harder for your child to feel in control. The good news? There are effective treatments to help break this cycle and empower your child.
Treatment Options to Manage OCD Symptoms
The most effective treatment for OCD combines Cognitive Behavioral Therapy (CBT) and Exposure and Response Prevention (ERP) to manage OCD symptoms. These science-backed approaches help children challenge obsessive thoughts, resist compulsions, and regain control over their mental space.
Cognitive Behavioral Therapy (CBT): Helps reframe obsessive thoughts and reduce their impact on mood and behavior.
Exposure and Response Prevention (ERP): A core technique in CBT, ERP involves facing fears directly in a safe, controlled way. I once worked with Jake, a 9-year-old who was consumed by a fear of germs. He couldn’t touch a classroom desk or a doorknob without immediately scrubbing his hands raw. During exposure therapy, we started small. I asked Jake to place his hand on a surface he thought was “dirty” and then sit with the discomfort, resisting the urge to rush to the sink.
At first, he was visibly anxious, asking repeatedly if he was going to get sick. But with reassurance and practice, Jake began to realize that nothing bad happened when he didn’t wash his hands. Over time, his brain learned to tolerate the discomfort, and those once overwhelming compulsions began to fade.
Natural Solutions That Support the Healing Process
In my Ridgefield, CT clinic, our signature program, BrainBehaviorReset™ Program blends natural, science-backed methods with therapy to regulate the brain and nervous system. This program includes:
- Neurofeedback and PEMF Therapy to help calm the brain and address dysregulation in the nervous system, paving the way for healing.
- Magnesium Supplements to support brain health and reduce anxiety naturally.
- CBT and ERP Therapy to tackle both obsessions and compulsions, helping children manage their symptoms effectively.
OCD is not a reflection of who your child is—it’s just one part of their mental health journey. The key to breaking free is the right support and tools. With natural approaches and expert care, there’s often no need for medications like Selective Serotonin Reuptake Inhibitors (SSRIs).
Remember, your child is so much more than their OCD. They are brave, capable, and deserving of a life filled with joy and adventure. With the proper guidance, your child can conquer their challenges and step into a life where they feel confident and empowered.
You’re not alone in this journey—there’s a whole community of parents and professionals cheering you and your child on. Keep fighting the good fight because the future is bright for your amazing kid!
Parent Action Steps
☐ Learn more about OCD by listening to my It’s Gonna Be OK! Podcast and the OCD series.
☐ Listen to your child with empathy. Hear every bad thought that crosses their mind.
☐ Don't try to be a therapist yourself. Seek the help of an OCD specialist for the sake of all family members.
☐ Encourage your child and celebrate their courage in facing the bad things they feel due to OCD.
☐ Take this OCD Quiz to get the right OCD treatment plan for your child.
☐ Use the Solutions Matcher to work 1on1 with Dr. Roseann.
What is the meaning of OCD?
OCD, or Obsessive-Compulsive Disorder, is a mental health condition characterized by persistent, intrusive thoughts (obsessions) and repetitive behaviors (compulsions) performed to reduce anxiety.
What is compulsive behavior, and is it normal in children?
Compulsions are repetitive behaviours or mental acts performed in response to an intrusive thought to reduce anxiety or prevent a feared outcome. These repetitive behaviours can occur in everyday life, such as typical childhood practices, but it's important to understand when they may signal a disorder like OCD rather than normal developmental phases.
Is OCD the same as anxiety?
No, OCD and anxiety are not the same, although they are closely related. Anxiety is a broader emotional response to stress or fear, often without compulsive actions. While anxiety is a key component of OCD, the two conditions differ in their symptoms and treatment approaches. Comparing the behaviors of OCD patients to those with Generalized Anxiety Disorder (GAD) highlights the unique compulsions experienced by OCD patients.
What is pure OCD?
Pure O OCD, short for “Purely Obsessional OCD,” is a subtype of Obsessive-Compulsive Disorder where individuals experience intrusive, distressing thoughts (obsessions) without engaging in visible, outward compulsions. Unlike traditional OCD, where compulsive behaviors like handwashing or checking are noticeable, those with Pure O engage in mental rituals or internal compulsions to cope with their obsessive thoughts.
Citations
Abramowitz, J. S. (1996). Variants of exposure and response prevention in the treatment of obsessive-compulsive disorder: A meta-analysis. Behavior Therapy, 27(4), 583–600. https://doi.org/10.1016/s0005-7894(96)80045-1
Foa, E. B., Yadin, E., & Lichner, T. K. (2012). Exposure and response (ritual) prevention for obsessive compulsive disorder : therapist guide. Oxford University Press.
Dr. Roseann is an OCD mental health expert who frequently is in the media:
- Insider: What is OCD?
- Single Care Controlling the uncontrollable: Living with OCD during a pandemic
- Holistic Counseling Podcast: Effective Treatments for OCD
- Epidemic Answers: Neurofeedback for ADHD, anxiety, OCD and mood
- BCIA: Calming the OCD Brain with Neurofeedback and ERP Therapy
- Integrative Practitioner: Integrative Approaches to Treating OCD
- HappiHuman: Is it an Eating Disorder or OCD
Always remember… “Calm Brain, Happy Family™”
Disclaimer: This article is not intended to give health advice and it is recommended to consult with a physician before beginning any new wellness regime. *The effectiveness of diagnosis and treatment vary by patient and condition. Dr. Roseann Capanna-Hodge, LLC does not guarantee certain results.
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Dr. Roseann is a Children’s Mental Health Expert and Licensed Therapist who has been featured in/on hundreds of media outlets including The Mel Robbins Show, CBS, NBC, PIX11 NYC, Today, FORBES, CNN, The New York Times, The Washington Post, Business Insider, Women’s Day, Healthline, CNET, Parade Magazine and PARENTS. FORBES called her, “A thought leader in children’s mental health.”
She coined the terms, “Re-entry panic syndrome” and “eco-anxiety” and is a frequent contributor to media on mental health.
Dr. Roseann Capanna-Hodge has three decades of experience in working with children, teens and their families with attention-deficit hyperactivity disorder (ADHD), autism, concussion, dyslexia and learning disability, anxiety, Obsessive Compulsive Disorder (OCD), depression and mood disorder, Lyme Disease, and PANS/PANDAS using science-backed natural mental health solutions such as supplements, magnesium, nutrition, QEEG Brain maps, neurofeedback, PEMF, psychotherapy and other non-medication approaches.
She is the author of three bestselling books, It’s Gonna Be OK!: Proven Ways to Improve Your Child's Mental Health, The Teletherapy Toolkit, and Brain Under Attack. Dr. Roseann is known for offering a message of hope through science-endorsed methods that promote a calm brain.
Her trademarked BrainBehaviorResetⓇ Program and It’s Gonna be OK!Ⓡ Podcast has been a cornerstone for thousands of parents facing mental health, behavioral or neurodevelopmental challenges.
She is the founder and director of The Global Institute of Children’s Mental Health, Neurotastic™Brain Formulas and Dr. Roseann Capanna-Hodge, LLC. Dr. Roseann is a Board Certified Neurofeedback (BCN) Practitioner, a Board Member of the Northeast Region Biofeedback Society (NRBS), Certified Integrative Mental Health Professional (CIMHP) and an Amen Clinic Certified Brain Health Coach. She is also a member of The International Lyme Disease and Associated Disease Society (ILADS), The American Psychological Association (APA), Anxiety and Depression Association of America (ADAA) National Association of School Psychologists (NASP), International OCD Foundation (IOCDF).
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