Becoming the Dragon Master: OCD and ERP in Adolescence


John Souchak, MFTI

Most of us have experienced childhood fears. Some even anxiety. Often as adults we outgrow these fears, and it can be difficult to identify what is a typical childhood fear and what is not.

For some teens, this type of fear isn’t something that you just “outgrow.” It is a constant pattern which can interfere with sleeping, eating, or hanging out with friends. Thoughts start to rise up, and with it, they become nervous or anxious. It’s like little flames that lick at their heels and won’t leave them alone. The thoughts continue, anxiety increases, and now the flames are all around them. Next the thoughts hold them mercilessly in their grip. It can feel like a monster or a dragon is ready to pounce. The dragon tells them, “if you don’t do my ritual someone will get hurt or die,” “things must be perfect, nothing can be out of order,” or “this world is unsafe, full of germs.”

The more they think these thoughts (obsessions), the worse the thoughts get. The only thing that will make those go away is to count, tap something, or wash their hands excessively. Only then do the thoughts and feelings start to fade. The dragon vanishes. They feel relief for a while, but it’s not over–the dragon isn’t gone, it was only in a cave. And when the dragon creeps out of the cave again, maybe hours later or the next day, it’s even stronger, and the thoughts and feelings are even bigger. So they count, they tap, they do what they can to make the feeling go away. As the pattern is repeated over and over (compulsions), it becomes more entrenched. It feels like they must count, they must take a certain number of steps, they must wash their hands. What started small becomes a flaming terror that rises up, over and over again.

While this can be scary or depressing, teens don’t have to suffer. Through a therapeutic practice known as ERP (exposure response prevention), they can loosen the grip of the dragon. Step by step teens learn to expose themselves to the things that make them anxious and delay the compulsion. After working this way, the symptoms will reduce. Gradually, they learn to face the dragon. This doesn’t mean that the dragon vanishes forever, or they don’t have thoughts and feelings that are big and sometimes scary. Every time they are successful in delaying the compulsion it starves the dragon who eventually becomes smaller and smaller. The need to feed the dragon will pass, and they can become become the Dragon Master. 

Symptoms and Rituals of OCD
Here are some common symptoms for teens struggling with OCD:

  • Fear of touching door knobs 
  • Requesting that all the lights in the house need to be turned on and off 5 times before he/she can go to sleep
  • Counting all of the windows over and over again

Examples of common rituals include:

  • Counting all of the toys in a room, every time he or she comes into their room
  • Saving every scrap of paper, wrapping paper, packing boxes, even trash
  • Washing hands every time they touch a new table, chair, light switch, or door knob
  • Checking to make sure the oven is off repeatedly, each time he or she enters and leaves the kitchen