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An eleven-year-old pausing in a dim hallway with a hand on the light switch, checking it again before bed

The Rituals Nobody Talks About

Childhood OCD is rarely about tidiness. It is about a frightening thought and the desperate act that makes it go away.

Written by Sian Trombley · BEd, MACP, CCC

Clinically reviewedLast reviewed 31 July 2026
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It starts as something small enough to explain away. A child who needs the bedroom door at an exact angle. A goodnight that has to be said in the right words or repeated until it is. A hand that goes back to the light switch one more time, then one more time again.

Obsessive-compulsive disorder in childhood is often invisible for years, partly because of how it is portrayed. It is not fussiness about tidiness. It is a loop between an intrusive thought that feels catastrophic and a behaviour that briefly makes the fear subside.

What it actually looks like

  • Checking: doors, switches, plugs, schoolbags, homework — repeatedly
  • Repeating: re-reading, re-writing, walking through doorways again
  • Asking: the same reassurance question, needing the exact same answer
  • Ordering: objects, routines, sequences that must be 'right'
  • Contamination fears: hand-washing, avoiding certain surfaces or foods
  • Mental rituals: silent counting, praying, undoing a 'bad' thought with a good one

Why families end up inside the ritual

Almost every parent of a child with OCD accommodates. You answer the question again. You check the door for them. You buy the specific soap, avoid the specific street, adjust bedtime by twenty minutes. Every one of these is an act of love, and every one of them teaches the brain that the danger was real and the ritual is what prevented it.

How exposure work feels in practice

  1. 01
    Build a ladder

    Rank the rituals from easiest to hardest to resist. Start near the bottom, not the top.

  2. 02
    Delay before you deny

    Ask for a five-minute wait before the compulsion. Waiting proves the anxiety falls on its own.

  3. 03
    Stay for the wave

    Distress rises, peaks and drops. The child has to be present for the drop — that is where the learning lives.

  4. 04
    Celebrate the resisted urge

    Praise the act of not doing it, not the absence of anxiety. Anxiety is expected.

When to seek professional support

Seek an assessment if rituals take more than an hour a day, cause distress, or interfere with school, sleep or friendships. Ask specifically for ERP-trained clinicians. Sudden, dramatic onset in a young child following illness warrants medical review as well.

Children do not need a perfect parent. They need a predictable one who returns after hard moments.

Sian Trombley, Canadian Certified Counsellor

What you can try this week

Step 01

Map the rituals

For one week, note what is checked, repeated, avoided or asked. Patterns are easier to treat than impressions.

Step 02

Name it as separate

Give the OCD a name your child chooses. 'What is the Bully asking for tonight?' externalises the disorder and protects their self-worth.

Step 03

Withdraw one accommodation

Pick the smallest one — the extra goodnight, the repeated answer. Warn them in advance, do it kindly, and hold it.

Key takeaways
  • OCD is an obsession (a frightening thought) plus a compulsion (the act that neutralises it).
  • Children often hide compulsions out of shame.
  • Family accommodation is well-intentioned and strengthens the disorder.
  • ERP is the treatment with the strongest evidence.
  • Fighting the thought is not the goal — refusing the ritual is.
Reflection
  1. Which parts of our routine now exist because of the OCD?

  2. What does my child believe will happen if the ritual is not completed?

  3. Am I reducing their distress today at the cost of their recovery?

Printable resources

Recommended Thrive courses

Sian Trombley, BEd, MACP, CCC
Written by

Sian Trombley

Canadian Certified Counsellor · Founder of Thrive Family Co.

About Sian

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