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OCD shows up in kids more often than most parents think, and it usually doesn’t look like what you see in the movies. You might notice them asking the same question over and over,checking things constantly, or getting stuck in bedtime routinesthat seem harmless—at first.
The good news? There are real tools that can help calm the brain, break the cycle, and give your child a sense of safety—without leaning on constant reassurance or rituals.
How Does Obsessive Compulsive Disorder (OCD) Show Up in Children?
OCD isone of the most treatment-resistant mental health disordersin kids and teens because it builds strong habits that trap the brain in a loop of obsessions and compulsions.
These repeated behaviors get stuck in the brain’s groove, making the cycle feel nearly impossible to break.
Some ways how OCD can show up include:
- Bedtime rituals—checking under the bed or inside the closet again and again.
- Asking the same questionsover and over, looking for reassurance.
- Other repetitive actionsthat might seem like harmless quirks but are actually coping moves for an overactive, dysregulated nervous system.
OCD isn’t just a phase or a personality quirk—it’s a real mental health condition that rewires how the brain handles anxiety.
Compulsions might bring momentary relief, but they also fuel those obsessive thoughts, making the loop even stronger.
Catching these signs early gives you a chance to help your child find a calmer, clearer path toward healing.
What are OCD intrusive thoughts?
Intrusive thoughts, or obsessions, are unwanted, uncontrollable worries, images, or urges that kids with OCDcan’t shake—even when they know these thoughts aren’t real.
These persistent thoughtsdisrupt daily life, making it hard to focus, connect, or feel calm.
Parents might think these thoughts are random or meaningless, but they often come out of nowhere and can be about anything—usually without any real basis. For your child, these thoughts don’t just come and go; their brain gets stuck on repeat.
I get how overwhelming this feels for the whole family. These thoughts don’t just block healing—they build a wall just as solid as OCDitself.
Learning how this brain gets rewired helps break the heavy cycle of shame and fear.
You might hear your child say things like:
- “What if I touched something gross and got sick?”
- “What if I accidentally hurt someone?”
- “What if I’m a bad person for having these thoughts?”
- “What if I offended God and get punished?”
These confusing thoughts feel so real, trapping kids in anxiety and mental checking. They might try to undo, confess, or avoid triggers just to find relief.
Why Are These Thoughts So Distressing for Kids?
Kids with OCD don’t want to act on these thoughts—in fact, they’re often terrified by them.
That fear twists into shame, and suddenly silence feels like the safest place. Many kids suffer alone, worried that having “bad” thoughts means they’re bad people but the truth is they’re not.
Those intrusive thoughts? They’re ego-dystonic.It means these thoughts don’t match who your child really is or what they actually want deep down. That’s a big red flag showing OCD’s got a hold.
What makes OCD so stubborn? Its neurological grip. The brain latches onto upsetting thoughts and refuses to let go. This mental loop sparks an urgent needto cancel or neutralize those thoughts through compulsions or mental rituals.
When parents don’t fully grasp what’s going on, they might unintentionally feed the cycle—offering reassurance, avoiding triggers, or brushing off worries—all of which can strengthen the OCD loop instead of breaking it.
Can you have intrusive thoughts without OCD?
Seif and Winston (2019) estimate around 6 million people in the U.S. wrestle with intrusive thoughts. These pop up not just with OCD but also withanxiety,stress, or even hormone shifts during teen years and adulthood. In PTSD, they often link back to trauma—like a car crash or a violent event.
Intrusive thoughts aren’t always harmful—if someone can brush them off. But when these thoughts start changing how a person thinks or acts, which happens a lot with kids battling OCD, that’s a clear sign it’s time for professional help.
What are OCD compulsions?
Compulsions are compulsive rituals that children and young adults with OCD feel they must keep repeating to make their anxiety disappear.
They feel better for a moment after doing the compulsions, but it just keeps the cycle going. The thoughts don’t make sense, and the rituals don’t solve the real problem.
What are the 4 Types of OCD?
OCD can look different from child to child, which makes it hard to recognize and diagnose.
If your child shows signs of OCD, it’s important to get help from a mental health professional.
You can also check with The International OCD Foundation for helpful resources and a “find help” tool to connect you with trained OCD therapists and get the right treatment.
1. Contamination OCD
Children and teens experiencing contamination OCD often demonstrate compulsive behavior aimed at decontaminating themselvesin response to their fears of contamination like excessive hand-washing or long showers that can cause physical pain.
During the COVID-19 pandemic, symptoms worsened for many, with a study by Jalal et al. (2020) showingincreasedobsessions and compulsionsduring lockdown.
I recently worked with a teen boy whose OCD made him believe his parents spit in his food, leading to extreme food restriction and significant weight loss.
Using PEMF, exposure and response therapy, and nutritional support through supplements, we calmed his brain and helped his parents stop accommodating the OCD.
Common Obsessions
- Fear of contamination and contaminating others
- Fear of getting in contact with anything thought of as unclean
- Fear of germs
- Fear of being around sick people
- Fear of getting poisoned
Common Compulsions
- Excessive hand washing
- Repeated disinfection
- Frequent clothing changes
- Rigid cleaning and scrubbing
- Avoiding dirty areas or persons
2. Orderliness or Symmetry OCD
A study by Jacobsen and Smith (2017) found that symmetry OCD is one of the most common types in young people, involving a need for perfect order or sameness.
These urges can feel uncontrollable, often triggering anxiety and fears that something bad will happen unless rituals are performed.
Common Obsessions
- Overly concerned that something will happen if something is not in the proper order
- Feels anxious when things are asymmetrical
- Has an imperative need to achieve balance
Common Compulsions
- Lining up things
- Compulsive counting
- Positioning items in perfect order
- Ordering or arranging items by size or color
- Repetitive behaviors related to visual checks
- Rewriting things
- Straightening up things
- Counting
3. Checking OCD
This may be mistaken for perfectionism, as the individual feels compelled to avoid mistakes. According to Van den Hout and Kindt (2003), this can lead to memory distrust.
This over-conscientiousness feeds the OCD, making them more irrational and prone to the very errors they fear.
I once worked with a young woman who had to check septic and sewer caps because she feared she would fall in them. She knew it was completely irrational yet she could not leave her house because of her checking behaviors.
Common Obsessions
- Fear of starting a fire
- Fear of hitting people while driving
- Fear of inducing harm due to carelessness
- Fear of sending messages or emails with wrong content or inappropriate materials
- Fear of losing things
- Fear of leaving home unlocked
Common Compulsions
- Repeatedly checking that all home appliances are off
- Constantly ensuring that all window and door locks are working
- Always inspect things closely
- Never-ending seeking of reassurance about their concerns
- Engage in mental rituals to go over things that they did and didn’t do
- Repeatedly saying certain words or phrases
4. Harm OCD
Those with this OCD subtype have unwanted intrusive thoughts about being aggressive or doing a violent act and have certain compulsions to get rid of those violent thoughts.
Children with Harm OCD often need reassurancethat they won’t act on their intrusive thoughts, yet they’re frequently misdiagnosed as suicidal due to a misunderstanding of their fears.
Harm OCD treatment typically involves therapy and sometimes medication, but many kids are hospitalized because their OCD is not properly recognized.
Common Obsessions
- Getting violent mental thoughts and images and then worrying that they will act on them
- Thinks about inadvertently causing harm and never realizing it
- Terrified of hurting themselves or others on impulse
- Constant worrying about losing control and becoming a vicious person
Common Compulsions
- Locking away sharp and pointed objects
- Reviewing one’s every action to check if they caused harm
- Avoiding violent movies, TV shows, or news
- Excessive research of crimes online
- Compulsive praying and belief in spiritual items
- Always asking if they are capable of hurting themselves or others
What are the Common Types of OCD Intrusive Thoughts?
1. Violent Intrusive Thoughts:
Some kids withOCDget stuck on scary mental images or fears of hurting themselves or others—even though they have zero desire to do so.
What might this look like?
- Fear of stabbing someone with a kitchen knife
- Worry they’ll blurt out something violent
- Thoughts of harming a pet or sibling
These kids might try to:
- Avoid sharp objects altogether
- Mentally “cancel” the thought
- Repeat phrases or count silently to prevent something bad
It’s not about intent. It’s a faulty brain alarm misfiring over and over again.
2. Religious Intrusive Thoughts:
Some children with OCD have upsetting religious thoughts, like being scared they’ve sinned or done something wrong in the eyes of their faith. This is called scrupulosity. To feel better, they might pray over and over even if they don’t wantto—these thoughts are often driven by anxiety, not real beliefs.
McIngvale et al. (2017) found that children with these kinds of thoughts often have more severe OCD symptomsand more trouble in daily life. Siev et al. (2011) also found that they’re less likely to get help, since the behaviors can look like normal religious habits.
3. Sexual Intrusive Thoughts:
Some kids with OCD have upsetting sexual thoughts, like fears about their sexual orientation or worries about being touched.
It’s important to rule out any history of abuse, but if the thoughts are part of OCD, ERP therapyis the recommended treatment.
4. Magical Thinking Intrusive Thoughts:
These thoughts often start small but grow over time. Kids may believe certain actions—like touching something a certain way—can prevent something bad from happening. They might even think something bad happened becausethey didn’t do things “just right.”
How Can Parents Reframe OCD Intrusive Thoughts?
Reframing is about shifting how your child views the thoughts—not eliminating them. That part comes later with therapy.
But in the beginning, it’s all about removing fear and shame, and helping your child understand that thoughts are not facts. Here’s how:
1. Normalize the Experience
Let your child know that everyone has weird or unwanted thoughts. It’s part of being human. But kids with OCD have brains that “get stuck” on those thoughts.
Try saying: “That sounds like an OCD thought. Your brain’s just sending out an alarm that isn’t real.”
2. Name the OCD
You can call it “the worry monster,” “sticky brain,” or just “OCD.” Giving it a name helps your child separate their identity from their thoughts.
“Oh, that sounds like Mr. Worry again.”
3. Avoid Reassurance Traps
When your child asks for reassurance repeatedly, try not to feed the OCD cycle. Instead of saying, “You’re fine,” try:
“I hear you’re really uncomfortable, and that’s okay. You don’t need to solve this thought right now.”
4. Teach Brain Science in Kid Terms
Help your child understand that their brain is sending false alarms. The threat feels real, but it isn’t.
“Your brain is kind of like a smoke detector going off even when there’s no fire.”
5. Model Calm and Acceptance
If you panic, they panic. If you stay calm and matter-of-fact, it teaches them that the thought isn’t dangerous.
Calm the brain first… and everything else falls into place.
What Happens When You Don’t Reframe?
When intrusive thoughts are misunderstood—or worse, ignored—kids may:
- Avoid school, people, or everyday tasks
- Become highly anxious or irritable
- Engage in compulsions that take up hours of their day
- Start to believe the thoughts must mean something about who they are
That’s why early recognition, understanding, and support are key. You can’t logic OCD away—but you canteach your child to respond to thoughts differently.
What are Natural Solutions and Treatments for OCD Symptoms and OCD Intrusive Thoughts in Kids and Teens?
Helping a child manage OCD and intrusive thoughts isn’t easy—it takes time, patience, and consistent support.But with the right tools, kids can learn how to calm their minds and take charge of those scary thoughts.
1. Exposure and Response Prevention Therapy(ERP):
It is one of the best and effective OCD treatment options which exposes OCD patients to trigger their feelings of discomfort until they can regain control and eventually ignore them entirely.
ERP therapy, led by trained therapists, may initially increase anxiety but helps address OCD, with parents learning to manage emotions and support their child. Other treatments can also improve OCD symptoms:
- Neurofeedback
- Deep brain stimulation
- Cognitive behavioral therapy
2. Psychoeducation:
This plays a crucial role in OCD treatment to effectively overcome the behavioral habituation that affects the entire family. A comprehensive understanding is important to help parents grasp howOCDimpacts a child’s brain and behaviors, ensuring a more effective therapy process.
3. Natural Solutions:
Usingmind-altering drugs may not be the most effective treatment for kidsand research-backed natural treatments are often more effective for addressing OCD symptoms. That’s why I’ve been advocating for natural solutions to support children’s health and well-being.
If you’re seeking natural ways to support your child, I’ve created a therapist-tested Natural OCD Thought Tamer Parent Kitthat is packed with helpful tips, recommended supplements for OCD, calm brain tools, and other strategies to help you manage OCD at home.
Regular use of natural solutions can improve your child’s OCD symptoms, but it’s essential to first get an accurate diagnosis from a qualified mental health professional, such as a clinical psychologist. With the right treatment planin place, you’re setting your child up for success and lasting improvements!
Parent Action Steps
FAQs
How do I know if my child’s intrusive thoughts are OCD and not just normal worries?
All kids worry from time to time, but OCD intrusive thoughts are repetitive, distressing, and often come with rituals or behaviors meant to “neutralize” the thought. If your child is stuck in loops—like needing constant reassurance or repeating actions to “undo” a bad thought—it’s time to talk to a qualified mental health professional.
What should I do when my child tells me about a disturbing or scary thought?
The best thing you can do is stay calm and nonjudgmental. Avoid reacting with fear or labeling the thought as “bad.” Let your child know that intrusive thoughts are common in OCD and that having a scary thought doesn’t mean they want to act on it.
Reassure them that help is available and that they’re not alone.
What is Exposure and Response Prevention (ERP), and How Does it Work?
ERP is a therapy designed to help kids face their fears without performing compulsions. Over time, this reduces anxiety and retrains the brain. It’s done gradually, with support from a trained therapist.
ERP may feel uncomfortable at first, but it’s one of the most effective treatments for OCD.
Citations
Berman, N. C. (2018).“Should I Be Scared?” Examining Parents’ Interpretations of Children’s Unwanted Intrusive Thoughts. OCD in Kids. Retrieved from https://kids.iocdf.org/from-the-experts/should-i-be-scared/
McIngvale, E., Rufino, K., Ehlers, M., & Hart, J. (2017). An In-Depth Look at the Scrupulosity Dimension of Obsessive-Compulsive Disorder. Journal of Spirituality in Mental Health, 19(4), 295–305. https://doi.org/10.1080/19349637.2017.1288075
Seif, M., & Winston, S. (2019).Unwanted Intrusive Thoughts. Adaa.org. Retrieved from https://adaa.org/learn-from-us/from-the-experts/blog-posts/consumer/unwanted-intrusive-thoughts
Siev, J., Baer, L., & Minichiello, W. E. (2011).Obsessive-compulsive disorder with predominantly scrupulous symptoms: clinical and religious characteristics. Journal of Clinical Psychology, 67(12), 1188–1196. https://doi.org/10.1002/jclp.20843
Dr. Roseannis a mental health expert in Neurodivergence who is frequently in the media:
- Business Insider How to practice ‘autonomy-supported parenting’ to boost your family’s wellbeing
- HealthlineGet Stuff Done: A Realistic Guide to Working From Home with Kids
- Love Shack LiveHow To Navigate The Parenting Journey As A Couple
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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