Intrusive Thoughts and Compulsions in Adolescent OCD

This comprehensive and clinically-focused volume offers a therapeutic framework for understanding and treating intrusive thoughts and compulsions in adolescents with OCD. By bridging theory and practice, it provides clinicians with the tools to explore the emotional and symbolic dimensions of OCD, fostering deeper therapeutic engagement. Grounded in post-Kleinian and Bionian theory, the book offers a structural reading of obsessive-compulsive symptoms, shifting focus from surface content to the psychic architecture beneath. Through vivid clinical vignettes, annotated transcripts and practical interventions, Marcus Lewton equips clinicians with the skills to recognise and address the unique emotional stances adolescents take toward their OCD symptoms. The book integrates psychoanalytic insights with structured cross-modal approaches such as Exposure Response Prevention and Cognitive Behavioural Therapy, emphasising patience, attunement and the symbolic meaning behind compulsions. Alongside detailed clinical material, the book provides guidance on tracking emotional and relational movement in therapy, communicating with parents and working thoughtfully with complex dynamics in adolescent treatment. This book is ideal for clinicians across disciplines - from psychologists and psychiatrists to social workers and educators - working with adolescents experiencing OCD. It is a valuable resource for advanced students and researchers in child and adolescent mental health, offering a nuanced perspective that combines psychoanalytic depth with evidence-based practices.

Marcus Lewton is a child and adolescent clinical psychologist based in the UK. His work in independent practice and public services focuses on a wide range of adolescent mental health issues, with a specialist interest in intrusive thoughts and OCD.

Table of Contents Dedication Disclaimer Foreword Note for Clinicians A Note on Language Chapter One The Heart of It Chapter Two Beyond the Label: Differentiating OCD in Practice Chapter Three From Infancy to Intrusions: Early Mechanisms in Adolescent OCD Chapter Four From Childhood Shadows to Adolescent Storms Chapter Five Before the Thought, the Feeling Chapter Six What We Know Works Chapter Seven The Threshold Chapter Eight The Claustrum Position in OCD Chapter Nine The Psychic Retreat Chapter Ten The Paranoid-Schizoid Position Chapter Eleven The Depressive Position Chapter Twelve Measuring the Invisible - Integrating Reflection and Evidence Chapter Thirteen Closing Reflections References Index