Intrusive Thoughts in Children and Teens

In this episode, Lindsay dives into the world of intrusive thoughts in children and teens, drawing on her extensive experience treating OCD and anxiety. She explains that intrusive thoughts are sudden, unwanted thoughts, images, or urges that can be upsetting or shocking, but importantly, do not reflect a child’s desires or character. These thoughts are common in kids with OCD and anxiety and often cause guilt, shame, and fear. Lindsay differentiates intrusive thoughts from regular anxiety, noting that anxiety typically relates to real-life situations and future concerns, whereas intrusive thoughts are ego-dystonic—they conflict with a child’s values and identity. Using relatable analogies like scary movies, pop-up ads, and junk mail, she illustrates how intrusive thoughts are essentially "brain noise" that lose power when approached calmly. The episode offers three practical strategies for parents: Normalize without over-reassuring – acknowledge the thought is scary but avoid giving repeated reassurance, which reinforces it. Separate the child from the thought – help children externalize the thought and recognize it as random brain noise. Allow the thought to exist without panic – teach children to notice the thought, label it, and continue with life, reducing its power over time. Lindsay also highlights when professional support is helpful, emphasizing the importance of therapists trained in OCD and exposure-response prevention (ERP). The key takeaway: intrusive thoughts are normal, manageable, and do not define a child. With calm, compassionate guidance, parents can help their children build resilience and respond to thoughts with understanding rather than fear, just like watching a scary movie multiple times until it’s no longer frightening.