A child with OCD always has intrusive thoughts, impulses, and images they cannot control. Typical intrusive thoughts include fears of contamination or someone getting hurt, becoming ill, or dying. They fear something bad will happen. These intrusive thoughts are illogical, and kids with OCD have difficulty stopping them or the rituals they have developed around them to control these intrusive thoughts.

Intrusive thoughts may seem random to parents because they have no connection to their children’s activities or life. Thoughts like these can come from anywhere and can be about anything. Often, they aren’t grounded in reality and can be dark and scary.

Intrusive thoughts make kids anxious, uncomfortable, disgusted, afraid, or uncertain. They can be embarrassing, and kids don’t understand why they can’t stop them. Because intrusive thoughts run constantly, these children will have difficulty concentrating, interacting socially, and completing their daily chores.

Some can even get wholly incapacitated and be shut down at home. It isn’t unusual for someone with long-term OCD to have trouble getting to school or work. Furthermore, school refusal is typical amongst kids with OCD and PANS/PANDAS.

A parent needs to address their child’s intrusive thoughts before the OCD behaviors become more entrenched. Because of a negative reinforcement cycle, obsessions and compulsions can easily get habituated and worsen. Helping your child or teen manage intrusive thoughts is possible with the right wording and tools.

Managing Intrusive Thoughts

Sometimes, stopping intrusive thoughts feels impossible. The goal should be to manage them by supporting your child’s coping skills and not accommodating the behavior. Giving your child the words to talk back to the OCD and tolerate the accompanying uncomfortableness should be the focus.

Parents must help their children cope with their fears and anxiousness and show them that they are in total control of their thoughts and not the other way around. That means they can’t avoid the fear, nor can a parent provide too much reassurance because both feed the obsessions and compulsions.

Here are some helpful tips to support your child in managing their intrusive thoughts:

8 Ways to Help Children Manage Intrusive Thoughts

1. Don’t suppress intrusive thoughts

Many parents teach their kids to try to forget intrusive thoughts as soon as they have them. However, the results they get are the exact opposite. Doing this only makes it more likely that the intrusive thoughts will continue. 

Consciously suppressing thoughts won’t help. Every time you avoid or suppress a fearful, intrusive thought, you get a little relief that makes it more likely the brain will fall into the same habit.  This negative reinforcement cycle reinforces that fearful behavior and worsens the OCD over time.  

2. Know why the thought disturbs your child

The things your child holds dear may become the focus of intrusive thoughts and disturb their nervous system. Their thoughts could be about their family, pets, school, or friends… almost anything. While many unwanted thoughts run through their minds, those going against their core values make them feel most fearful, disgusted or alarmed.

They can involve religion, violence, or sex. These dark thoughts scare them because they pop into their brain, and they can’t turn them off.

As a parent, any adverse reaction towards your child about these thoughts will only amplify them. A good first step is understanding your child’s core values and comparing them with unwanted thoughts. Ask them, “Is that your brain or your OCD brain?”  This will help them distinguish and not be so overwhelmed.

You will then know why they feel afraid or stressed. Doing this also makes it easier for you as a parent to explain to your child why they should let go of their intrusive thoughts and refuse to be affected.

3. Determine the triggers

Sometimes, your child’s thoughts are not random. Their daily interactions may influence them. You’ll better understand your child’s intrusive thoughts if you identify their triggers. List out their intrusive thoughts. Creating a hierarchy list of triggers is often an eye-opener for parents because OCD is a disorder that often can’t be seen.

Find a pattern in your notes and see how triggers may or may not be related. This will become important in the exposure process when working with an OCD therapist who uses exposure and response prevention (ERP) therapy.

Perhaps their thoughts occur after being alone for long periods, after watching too much TV, or when you leave for work. Track the patterns to pinpoint what is driving the behaviors. Your notes will also greatly help a therapist.

4. Practice visualization and mindfulness

Visualization and mindfulness techniques allow your child to feel more in control of their thoughts. Various mindfulness techniques exist, such as paying attention to body sensations when you are and aren’t activated. This can be very helpful when distinguishing between one’s “own brain and OCD brain.”

Simple breathwork can also help to calm the busy OCD mind. Some children may be resistant, which is okay if you use another technique daily to calm the brain.

These techniques calm down the nervous system. It can reduce stimulating brain waves while increasing calming brain waves. There are techniques more applicable to a child and where they are in their OCD journey, which can help them focus better, make them feel less anxious and stressed, be more creative, and have improved memory.

5. Implement positive changes into your child’s daily routine

Make your child’s day more positive so they don’t have room for negative thoughts. Integrate lifestyle changes proven to make your child feel good and develop productive habits. For example, give them healthy, nutrient-dense meals so they’ll have more energy throughout the day. 

Some activities they can do regularly are yoga and nature walks. Ensure your child starts their day healthy so they can shift their mindset early. Even sitting in front of a window in the morning and doing breathwork for a few moments can help them shift the negative to the positive. A day started right can help them cope better with their intrusive thoughts and can help lessen school anxiety and school refusal.

6. Don’t Allow Avoidance

Kids with OCD learn to avoid uncomfortableness and that avoidance only feeds the OCD. Every time they avoid the fear or icky sensations, it gives the brain a bit of relief, which makes it more likely they will repeat the behavior. The more the behavior happens, the more the OCD grows.

Parents should focus on teaching their child or teen coping skills and serve as a coach to provide positive reinforcement to learn how to tolerate being uncomfortable..

7. Don’t Accommodate the OCD Behaviors

This is probably the single biggest OCD trap that parents fall into. They accidentally provide reassurance for OCD behaviors to relieve their child’s stress and worry. As parents, we don’t want to see our kids suffer, and their intrusive thoughts and rituals are painful for everyone.

Switching from reassurance to reinforcement of coping skills is what we teach in our BrainBehaviorReset™ Program. Parents need tools, and OCD can make parents feel like a failure when it is just that they need professional help with talking back to the OCD.

8. Seek professional help

As stated earlier, avoiding intrusive thoughts could cause more anxiety, causing the child to ruminate. It can also lead to depression due to the feeling that things are so out of control. Consult a therapist if your child has intrusive thoughts because it will negatively affect your child’s health and well-being.

Cognitive-behavioral therapy, or CBT, can help you understand the intricate links between thoughts, behaviors, and feelings. Exposure and Response Prevention, or ERP, combines CBT and exposure therapy. It can help expose your child to their fears until they no longer feel afraid. Then they learn to address the cognitive distortions with CBT techniques.

The therapist may suggest behavioral changes and then ask you to observe how these changes influenced your child’s perception or understanding of the situation. Furthermore, they can help reframe negative thoughts into positive ones.

Children with severe intrusive thoughts may have OCD and comorbid mental conditions like anxiety disorder. depression, or PANS/PANDAS. In such cases, don’t postpone seeking professional help, especially if they can no longer do their daily tasks because of these intrusive thoughts.

Combining therapy with a holistic approach that doesn’t require medication is essential for healing and wellness. The best way to deal with these issues is to find a personalized treatment that works for you and your child.

Dr. Roseann is a Children’s Mental Health Expert and Therapist who has been featured in/on hundreds of  media outlets including, CBS, NBC, FOX News, PIX11 NYC, The New York Times, The Washington Post,, Business Insider, USA Today, CNET, Marth Stewart, and PARENTS. FORBES called her, “A thought leader in children’s mental health.”

She is the founder and director of The Global Institute of Children’s Mental Health and Dr. Roseann Capanna-Hodge. 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) International Society for Neurofeedback and Research (ISNR) and The Association of Applied Psychophysiology and Biofeedback (AAPB).

© Roseann-Capanna-Hodge, LLC 2023

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