Month: March 2026

There is a particular kind of exhaustion that comes with parenting a child with Obsessive-Compulsive Disorder (OCD). You have tried reasoning with them. You have tried reassuring them. You have answered the same question seventeen times in one afternoon, walked through the same bedtime routine for the fourth night in a row, and watched your child fall apart over something that, from the outside, seems entirely manageable. You are not doing anything wrong…but you may be doing something that is accidentally keeping OCD alive.

That is not a criticism. It is one of the most important things to understand about OCD.

What childhood OCD actually looks like:

OCD in children does not always look the way people imagine. It shows up as repetitive questions, rigid routines, inability to move forward until something feels “just right,” and emotional outbursts that seem wildly out of proportion to the situation. A child with contamination OCD might wash their hands until the skin breaks, clearly not because they enjoy it, but because they cannot make themselves stop until something feels “just right.”) A child with scrupulosity OCD might confess endlessly after getting in trouble at school, seeking a specific response that temporarily quiets the doubt that they are a “bad kid”. When they don’t get the exact response OCD is looking for, they may completely unravel.

What parents often notice first is the rigidity and the “stuckness.” The sense that their child is being oppositional or dramatic, when actually their nervous system is in a state of constant threat response. The irritability and emotional dysregulation that come with OCD are not behavioral problems. They are what it looks like when a child is white-knuckling their way through life with a brain that will not stop generating alarm signals.

How parents get pulled into the cycle:

Here is the part that is hardest to hear: if you are the parent of a child with OCD, your behavior should be part of the treatment. Not because you caused this (you did not), but because OCD expands to include whoever is closest to the child.

The most common way parents get pulled in is through excessive reassurance-giving. When your child asks “I’m a good person, right?”, saying yes feels like the kind thing to do because, normally, it is the kind thing to do. In the context of OCD it functions as a compulsion because it provides the (illusion of) certainty OCD is demanding, temporarily quiets the anxiety, and teaches your child’s brain that the only way through the distress is to get an answer. The relief lasts maybe twenty minutes. Then the question comes back, and it needs a more specific answer this time.

Parents can get caught enabling OCD by helping their child avoid in life-limiting ways. Opening doors so a child doesn’t have to touch the handle. Avoiding certain foods, TV shows, or places that trigger distress. Sometimes parents can get involved in elaborate, multi-step rituals at bedtime just to get everyone to sleep. These feel like reasonable adaptations. Over time, they become the architecture of a smaller and smaller life for your child, and often for your whole family.

The children who are struggling most are often the ones whose families have quietly restructured everything around the OCD. And the families doing that restructuring are, almost universally, doing it out of love and care. It just doesn’t work, unfortunately.

So, what can you do instead? 

The goal in treatment is not to eliminate your child’s anxiety. It is to help your child learn that they can continue to live their life even when the anxiety is present. To help them learn that they do not have to give into OCD’s commands to be okay. That requires a shift in how the whole family responds and it is genuinely hard work.

One of the most effective tools is externalization: helping your child learn to separate themselves from the OCD. Giving it a name. Saying “that sounds like it might be your OCD talking” rather than engaging with the content of the fear. This is not dismissive. It is one of the most validating things you can do, because it tells your child that the thought is not who they are.

Tolerating uncertainty, rather than resolving it, becomes the family’s shared practice. That means moving toward “maybe” and “I don’t know, but I think we can handle it” instead of “you’re going to be fine” and “that won’t happen.” It means letting your child feel upset (maybe sometimes even really upset) without rushing in to fix it right away. This requires understanding that the ultimate goal is not for your child to feel calm, but again to help them learn that they can act, connect, and move through their life even when they don’t feel calm.

Exposure and Response Prevention (ERP) is an active treatment and parental involvement in it is essential. ERP asks your child to do difficult things deliberately, and it asks you to support that process without accommodating the OCD in the meantime. Therapists working with children will almost always work with parents directly, helping families develop specific language, set compassionate limits on reassurance and compulsions, and build tolerance for the hard moments that come when OCD pushes back.

Special note* 

When families begin pulling away from accommodation, OCD often escalates before it gets better. Sometimes tantrums get bigger, confessions get longer or more elaborate, and the emotional intensity often spikes. This is not a sign that treatment isn’t working. It is OCD doing exactly what it does when the certainty it has been relying on starts to disappear.

What parents most need to know:

You are not failing your child by setting a limit on how many reassurance questions you will answer today. You are not being cruel by letting them sit in uncertainty. You are not making things worse by refusing to open the door for them, check the stove one more time, or confirm again that they are a good kid or that they are safe.

You are doing something much harder than reassuring them. You are teaching them that discomfort is survivable, uncertainty is livable, and that they do not need certainty to move forward.

You have an opportunity to help them do all this in loving, supportive, and (at times) firm ways.

That is the foundation of recovery from OCD, and you get to be a part of building it!

If you think your child may have OCD, or if you recognize your family in any of this, working with a specialist makes a significant difference. At Dallas CBT, we specialize in OCD and anxiety treatment for children, adolescents, and adults. You don’t have to white knuckle through life and neither does your child. We are here to help.

To hear more from our child and adolescent anxiety and OCD specialists, listen to our most recent podcast episode of Exposing Anxiety: Parenting a Child with OCD– When Love and Logic Aren’t Enough. Available on both Spotify and Apple Podcasts.

Link: https://open.spotify.com/episode/3ZNfCzvvNrJbCE8s0bnq8N?si=0b129e6fd73246d9

Perfectionism, Health Anxiety, and the Slippery Slope Toward OCD

In recent years, “health optimization” has become mainstream. We’re encouraged to minimize toxins, track every metric with our smart devices, perfect our routines, and do everything possible to protect our health and longevity.

For many people, this focus on health is neutral or even beneficial. But for others, especially those prone to anxiety, perfectionism, or a need for control, these same behaviors can quietly shift from self-care into control, and from flexibility into rigidity.

Traditional health anxiety often centers on fears of illness, disease, or death, with repeated checking, reassurance-seeking, or avoidance aimed at reducing that fear. However, what we are calling “health optimization anxiety” seems to be slightly sneakier, and can look more socially normative. This form of health anxiety can include strict rules about food, exercise, supplements or sleep, excessive research about “toxins” or health risks, rigid health routines and non-negotiables, anxiety when these routines are disrupted, and a sense that if you just do this perfectly, you’ll be safe.

This form of anxiety often goes unnoticed or even praised, because it aligns with wellness culture. But internally, it can feel all-consuming.

The Role of Perfectionism and Rigidity

One of the clearest ways to tell whether a health pursuit is helpful or harmful isn’t what you’re doing, it’s how you’re doing it. Perfectionism and rigidity are powerful signals.

Ask yourself:

• Does this behavior allow flexibility when life changes?
• Can I bend the rule without intense anxiety or guilt?
• Do I feel calmer long-term, or only briefly relieved?
• Is this expanding my life, or shrinking it?

True health and wellness allow flexibility. Health and wellness anxiety demand perfection. When the nervous system starts to believe that being perfect is the only way to be safe, we move closer to the psychological formula that underlies OCD.  It creates an endless loop of control and safety seeking, which deepens our engagement with triggers and new variables to control or perfect

It’s important to note that not everyone who is anxious about their health has OCD, and not everyone with a rigid health routine will develop OCD. But, if you are a rigid or perfectionistic thinker and begin to focus on optimizing your health, you may at least have the “flavors” to develop OCD at some point along your health journey.

OCD isn’t defined by the topic of your obsessive thoughts, but by your relationship to uncertainty and control. Health optimization anxiety often shares this same structure.

When Wellness Backfires

To test the adaptability or helpfulness of your health goals, engage in this cost-benefit analysis as a check

If a health behavior:

• Increases anxiety
• Pulls you out of the present moment
• Creates fear around normal experiences
• Interrupts relationships or meaningful time
• Requires constant mental monitoring

…it may be doing the opposite of what you intend.

This doesn’t mean you’re “doing health wrong.”It means control may be replacing self-care.

For example, if you are wanting to make holiday cookies with your child as a way to better connect with family over the holidays, but find yourself obsessing over the ingredients, dyes, and sugars…it’s worth pausing and asking yourself what you are really trying to protect.

A powerful reframe we often use in therapy is this:

Zoom out. What is the real goal underneath the rule?

Longevity?
Energy?
Being there for the people you love?

Then ask:

• Is this behavior truly moving me toward that?
• Or is it narrowing my life in the name of safety?

Sometimes the path you’re on isn’t the only path forward.

The OCD Control Loop

At its core, OCD, and OCD-adjacent patterns, are about control. The mind demands certainty now, often around questions that don’t have absolute answers. Perfectionism feeds this loop:If I do everything right, nothing bad will happen.

But actual health doesn’t work that way. There are many variables we cannot control, no matter how optimized our routines are. When perfectionism promises certainty, it sets an impossible standard, and ultimately keeps anxiety alive.

So, how do you move toward flexibility?

Treatment doesn’t mean abandoning health goals. It means changing your relationship with them.

Using principles from Exposure and Response Prevention (ERP) and Acceptance and Commitment Therapy (ACT), we can practice flexibility instead of rigidity, resist compulsive “fixing” or reassurance behaviors, build tolerance for uncertainty, reconnect with values like presence, connection, and vitality, and choose behaviors based on who we want to be, not what fear demands.

Healing isn’t about fearlessness,  it’s about willingness. If your goal is health, but the process is shrinking your life, it’s worth asking yourself what you’re really trying to protect. You don’t need to be perfect to be healthy, and you don’t need certainty to live fully.

If this resonates, we explore these themes more deeply, including practical tools for loosening rigidity and responding differently to anxiety, in Episode 4 of our podcast Exposing Anxiety. Available on Apple Podcasts and Spotify.

Why Social Media Triggers Obsessive-Compulsive Disorder

Social platforms show us a constant stream of provocative, worry-inducing, or ambiguous content. For someone with OCD, particularly if themes like health, contamination, harm, or uncertainty are present, this can feel exceptionally activating.  The OCD brain already fixates on scary uncertainties; social media gives it a lot more fuel to work with.

A typical pattern looks like this:

1. A triggering post, headline appears, or story appears on your feed
2. Anxiety spikes.
3. The OCD brain insists on control (usually through reassurance-seeking, avoidance, or checking)
4. You engage with OCD (go down the rabbit hole, go through the comment section, Google or chat GPT your questions) or avoid (scroll past, mute, block).
5. Relief is temporary, and the cycle repeats

Both avoidance and reassurance behaviors are common safety behaviors in anxiety and OCD: they feel protective in the short term but actually reinforce fear in the long term. This is consistent with how OCD operates: compulsions and avoidance maintain and strengthen the cycle because they teach the nervous system that fear equals actual danger and must be controlled

Your Algorithm Doesn’t Cause OCD, But It Can Feed It

Much like OCD, our social media algorithms are designed to keep us engaged. They learn from what you click, watch longer, or interact with, including content that spikes anxiety. If you linger on anxiety-provoking posts or spiral into comment threads or related videos, the algorithm delivers more of the same.

For someone with OCD, this feels like evidence that the content matters, that the threat is real, and that something must be done. However, this interpretation isn’t necessarily a reflection of truth, it’s the result of how OCD and algorithms interact.

 

Responding to Triggers (Don’t React)

The good news is that responding differently to these digital triggers with Exposure and Response Prevention (ERP), which is the gold-standard treatment for OCD, teaches the nervous system a new message: I can tolerate uncertainty, and fear doesn’t always equal danger.

Typically, our OCD wants us to respond in one of two ways: avoid the triggering content or become the expert on the topic at hand. Here are practical strategies that can be applied when these urges to gain control appear on your feed:

1. If you are an “avoider”: sit with the trigger 

If you typically scroll past anxiety-inducing posts, try pausing and allowing yourself to read the content without immediately turning away. This may feel uncomfortable, and that’s part of the therapeutic process.

Then, resist “fixing” the fear. Allow the fear to come and run it’s course without compulsion.

It’s common to want to “cancel out” the anxiety with reassuring content. Examples include clicking related articles, googling symptoms, or consuming “success stories” to prove nothing bad will happen.

Avoiding or muting everything that feels threatening teaches the brain that those things must be avoided to stay safe. Learning to tolerate content that makes you uneasy, without reacting, is the core of exposure work.

Instead:

• Notice the urge to research, and try not to obey it.
• Resist checking for reassurance or certainty.

These patterns are classic compulsions that keep OCD strong.

2. If you are a “detective”: resist the urge to find out more

If you compulsively dive into internet research to control your fears, skip the comment section.

The comments section often pulsl you into deeper engagement, rumination, and uncertainty, all of which feel good in the moment but reinforce the fear network.

Avoid scanning your body.

If content makes you worry about sensations (e.g., health anxiety), avoid checking or scanning your body. This is another form of compulsion that short-circuits progress.

Daily Practice: Responding with Values, Not Fear

An everyday way to practice this is simple: After encountering content that spikes anxiety, pause. Notice the urge to avoid or fix, then choose not to follow it. Instead, bring your attention back to what matters most to you: relationships, goals, or meaningful activities, daily tasks. Over time, this trains your nervous system to tolerate uncertainty without letting it dictate your behavior.

How Therapy Supports This Work

Exposure and Response Prevention (ERP), often integrated with Acceptance and Commitment Therapy (ACT), helps people systematically and compassionately build tolerance for uncertainty and reduce compulsive responses, whether online or offline. Our goal is to notice and allow thoughts without acting on them, which eventually weakens the compulsion cycle.

Therapy doesn’t mean avoiding triggers perfectly. It means learning to face them with intention and values, not fear.

If your OCD feels amplified by social media or digital environments, remember this:

• The platform isn’t the enemy.
• Your brain is responding to uncertainty,  which is a human experience.
• With practice and support, your relationship with uncertainty can shift.

Your nervous system can learn new ways of responding, not by erasing fear, but by learning it doesn’t have to control the way you live.