“He’s So OCD” - When Should Parents Be Concerned? with Dr. Chad Brandt

“He’s So OCD” - When Should Parents Be Concerned?

We use the term OCD incredibly casually.

“My closet is color-coded. I’m so OCD.”

“He has to have everything organized. He’s so OCD.”

“My kid wants his toys lined up perfectly. Is that OCD?”

But obsessive-compulsive disorder is very different from simply liking things a certain way. And when you're a parent, figuring out that difference can be incredibly confusing.

Kids love routines. They repeat things. They can be rigid. They can become very attached to a particular game, bedtime ritual, stuffed animal, or way of doing something.

So when does normal childhood repetitive behavior become something parents should be concerned about?

That's what I wanted to explore with psychologist Dr. Chad Brandt, who specializes in treating severe OCD in children and adolescents.

Our conversation gets at something I think is especially important in parenting and child development: We don't want to pathologize every quirky thing our children do, but we also don't want to dismiss symptoms when a child is genuinely struggling.


What Does OCD Actually Mean?

OCD stands for obsessive-compulsive disorder.

Dr. Brandt broke it down simply.

The obsession is a recurring thought the person doesn't like and wants to get rid of.

The compulsion is what they do to try to make that thought or the distress associated with it go away.

The disorder part means the cycle is interfering with daily functioning.

That last piece is important.

There is a huge difference between preferring your closet organized by color and spending enormous amounts of time trying to make something feel exactly right because you're afraid of what might happen if you don't.

OCD is fear-based.

And according to Dr. Brandt, it can begin consuming minutes, hours, or even enormous portions of a person's day.

That's very different from being organized or particular.


Kids Are Allowed to Like Things a Certain Way

One of the reasons identifying OCD in children can be difficult is that kids naturally have preferences.

Maybe your child wants all of their teddy bears lined up from smallest to biggest before leaving for school.

That alone doesn't necessarily mean anything is wrong.

Maybe they simply like their bears that way.

In my own family, my son loves his Lion King figures and may want to play with them in a very specific way. If I suddenly decide that another character should wander into the game, he might not like my idea.

That's normal.

As parents, we have to be careful not to over-pathologize.

Over-pathologizing means looking at something that could be part of normal behavior, temperament, or development and immediately deciding that it must be a disorder.

One of the reasons I love having experts on parenting podcasts is that we can have these more nuanced conversations. Not every challenging behavior is a diagnosis.

The question is what happens when we gently introduce flexibility.


What Happens When You Change the Routine?

Dr. Brandt suggested that parents who are unsure about a behavior can sometimes gently play with the routine and see how their child responds.

Take the stuffed animal example.

Dr. Brandt's daughter wanted only bunnies on her bed leading up to Easter.

He started sneaking other animals onto the bed.

At first, she didn't particularly like it. But after a few days, they were able to turn it into a game.

Soon she was asking where the new animal was.

That ability to become flexible is important.

A child might say:

“I don't like that.”

“I want to do it my way.”

“Can we do that tomorrow instead?”

They may even become annoyed.

But there's room to move.

With OCD, Dr. Brandt explained, parents may see a much more significant break when the ritual changes.

The child may become genuinely scared.

They may say:

“It doesn't feel right.”

“Something bad will happen.”

“I can't do that.”

The issue isn't simply that the child prefers option A.

It's that changing from option A feels frightening or intolerable.


Preference and Fear Are Different

This distinction came up repeatedly in my conversation with Dr. Chad Brandt.

There's a difference between:

I like it this way.

and:

I'm scared of what will happen if I don't do it this way.

Younger children may not be able to explain exactly what they're afraid of.

They might simply say:

“It feels bad.”

“It makes me worried.”

“Something bad might happen.”

Older children may be able to articulate a more specific fear.

For example, they might worry that something terrible will happen to Mom or Dad if they don't complete a ritual correctly.

That fear component is one of the things parents should pay attention to when trying to distinguish ordinary repetitive behavior from something that warrants further evaluation.


Parents Can Accidentally Become Part of the Ritual

This is where things can become especially difficult for parents.

OCD doesn't necessarily stay contained within the child's behavior.

Parents can get pulled into it.

Imagine your child has a bedtime routine.

Mom says good night three times.

Dad gives two kisses.

One stuffed animal gets kissed.

Then another stuffed animal gets kissed.

At first, it might seem cute.

Lots of kids have bedtime rituals.

But then the ritual starts expanding.

“Mommy, that didn't feel right. Say good night three more times.”

“Daddy, kiss me again.”

“Now kiss the bunny.”

“Now do it again.”

Something that started as a quirky bedtime routine can begin consuming more and more of everyone's time.

Dr. Brandt explained that OCD can consume the child's time first and then begin consuming the parents' time.

That's an important distinction.


When Helping Starts Feeding the Anxiety

As parents, we're wired to respond when our children are scared.

We want to reassure them.

We want to make things better.

If saying good night one more time makes your child feel safe, why wouldn't you do it?

That's exactly what makes this dynamic so difficult.

You may genuinely believe you're helping.

But Dr. Brandt explained that when OCD is driving the request, repeatedly accommodating it can feed the cycle.

Your child says they're scared.

You do the ritual.

Their anxiety comes down.

The OCD learns that the ritual was necessary.

Then the next time the fear appears, the ritual becomes even more important.

This is one of those areas of parenting and child development where the most loving response in the moment may not always be the response that helps a child build skills over time.


Children Need Opportunities to Experience Manageable Distress

A theme that comes up frequently when I talk with other child psychologists is the importance of allowing kids to experience healthy levels of distress.

That doesn't mean abandoning them.

It doesn't mean being cold.

And it doesn't mean leaving a child alone with something they genuinely cannot handle.

It means giving children space to struggle while providing a safety net.

Dr. Brandt described it beautifully as communicating:

“I love you.”

“I trust you.”

“I believe in you.”

“And you can struggle for a little bit.”

That's a very different message from immediately removing every uncomfortable feeling.

Doing hard things successfully is one of the ways children build confidence.

This is also one of the parenting and child development principles that can feel counterintuitive in a culture where parents often receive the message that distress itself is harmful.

Healthy, manageable distress is not the same thing as harm.


What This Can Look Like With an OCD Ritual

Imagine your child believes you have to say good night seven times.

You could acknowledge that they want the ritual while beginning to change your participation in it.

Maybe you say good night six times instead.

You can still be warm.

You can still tell them you love them.

You can still acknowledge that it's difficult.

But you're also communicating that you're not going to do exactly what the fear says must happen.

Your child may become upset.

And that's incredibly hard to watch.

But the goal isn't to guarantee that your child never experiences anxiety.

The goal is to help them learn that they can experience discomfort and move forward.

This is one reason parents who suspect OCD in children can benefit from working with someone who understands OCD specifically. The details of how and when to change accommodations matter, and an expert can help guide that process.


Three Signs Parents Should Pay Attention To

I asked Dr. Chad Brandt for three things that might tell a parent it's time to get an evaluation.

His answers centered around uncertainty, outsized reactions, and what he calls “magical” thinking.

1. Your Child Can't Tolerate Uncertainty

Dr. Brandt described OCD as, in one sense, a “phobia of uncertainty.”

A child without OCD may prefer something a certain way but still be able to experiment with changing it.

A child struggling with OCD may become stuck on:

“But what if something bad happens?”

They don't know what will happen if the routine changes, and that uncertainty feels intolerable.

That can make them insist the ritual must happen exactly as expected.

2. Changing the Behavior Produces an Outsized Anxious Reaction

Imagine a child who likes shooting baskets until they make the final shot.

Lots of kids do things like this.

You tell them dinner is ready.

They want one more shot.

You tell them it's time to come inside.

They might huff.

They might complain.

They may be disappointed.

But they can stop.

Now imagine that stopping produces an enormous reaction.

The child becomes terrified or has a major meltdown.

When you explore what's underneath that reaction, you discover they're afraid that if they don't make the final basket, they'll miss every shot during their game this weekend.

Now we're looking at something different.

The intensity and the fear underneath the repetitive behavior matter.

3. The Fear Becomes “Magical”

This was one of the clearest distinctions Dr. Brandt gave.

Wanting to make your last basketball shot because making baskets feels good makes sense.

Wanting to make it because you have a basketball game this weekend still has a logical connection.

But what if the child believes they have to make the basket so Dad doesn't get into a car accident tomorrow?

Now the action and feared consequence aren't logically connected.

Or maybe the child believes they must perform a ritual so Grandma stays alive.

Dr. Brandt describes that as becoming “magical.”

When you start seeing these kinds of fear-based connections, that's a reason to consider getting an expert evaluation.


An Evaluation Doesn't Automatically Mean Your Child Has OCD

This is important.

Seeing one unusual behavior doesn't allow us to diagnose a child.

Maybe they were having a terrible day.

Maybe something they saw frightened them.

Maybe they're angry because you've never previously enforced a particular limit.

Maybe the behavior passes.

The point of an evaluation isn't to decide in advance that your child has OCD.

It's to have someone with appropriate expertise help differentiate what you're seeing.

Is this normal developmental behavior?

Is this anxiety?

Is this a limit-setting problem?

Could this be OCD?

Those distinctions matter because different problems require different responses.


Look for Someone Who Actually Treats OCD

If you're concerned about OCD in children, Dr. Brandt and I both emphasized the importance of finding a clinician with specific OCD expertise.

Not every therapist who lists OCD on a website necessarily has specialized training in treating it.

Dr. Brandt recommends looking for someone trained in exposure and response prevention, commonly called ERP.

He also mentioned the International OCD Foundation as a resource parents can use to learn more about OCD and search for clinicians.

When you're speaking with a potential therapist, ask what treatment modality they use for OCD.

You don't have to be embarrassed about asking.

You are allowed to understand what kind of treatment your child will receive.


What Is Exposure and Response Prevention?

Dr. Brandt described exposure and response prevention as the gold-standard treatment for OCD.

The concept has two pieces.

First comes exposure.

The child gradually faces something that triggers the uncertainty, fear, or discomfort.

Then comes response prevention.

They practice not performing the compulsion they would normally use to make themselves feel better.

For example, imagine a child who is afraid of germs.

An exposure might involve touching something they consider dirty.

Then, instead of immediately washing their hands, they move on to another activity.

The lesson isn't:

Nothing bad will ever happen.

The lesson is closer to:

I can feel uncomfortable and still move forward.

That is a powerful skill.


Parents May Be a Big Part of Treatment

One of the most encouraging things Dr. Chad Brandt shared is that treatment doesn't always mean putting a young child in a room with a therapist and expecting them to solve the problem alone.

Sometimes his work focuses heavily on the parents.

He may teach parents the language and tools they need to respond differently at home.

In some cases, he may work with parents without meeting the child at all.

That makes sense when we think about how OCD can recruit an entire family into its rituals.

If parents are being asked to provide reassurance, repeat phrases, complete bedtime rituals, or help the child avoid uncertainty, changing the parents' responses can become an important part of changing the cycle.


Effective Treatment Exists

I really want parents to hear this part.

If your child is struggling, there is hope.

In our conversation, Dr. Brandt emphasized that OCD can become increasingly debilitating without treatment, which is why getting an evaluation when you're concerned matters.

But he also emphasized that treatment can be very effective.

I see a similar fear when families receive diagnoses involving anxiety or behavioral disorders. Parents sometimes hear the name of a disorder and immediately imagine that this is simply who their child will be forever.

A diagnosis describes symptoms.

It can also point us toward the treatment that has evidence behind it.

That's why conversations like this belong on parenting podcasts. Parents need more than frightening labels or oversimplified social media advice. We need practical information that helps us understand when something deserves attention and what evidence-based support can look like.


You Don't Have to Diagnose Your Child Yourself

If your child likes their stuffed animals lined up perfectly, you don't need to panic.

If they want the bedtime routine performed in a certain order, that doesn't automatically mean they have OCD.

If they like repeating something, that repetitive behavior by itself doesn't tell us enough.

Instead, get curious.

Can they tolerate flexibility?

What happens if the routine changes?

Is there fear underneath the behavior?

Does your child believe something bad will happen if they don't complete it?

Is the behavior consuming significant amounts of their time?

Is it interfering with school, play, sleep, family life, or other parts of daily functioning?

And are you becoming increasingly involved in completing the ritual for them?

If the answers start making you wonder whether this could be more than a preference or personality quirk, you don't have to figure it out alone.

Talk with someone who specializes in OCD and can help you understand what you're seeing.

That's one of my biggest takeaways from this conversation with Dr. Chad Brandt.

Good parenting and child development information shouldn't make us afraid of every unusual thing our children do. It should help us know what deserves our attention, what questions to ask, and when to bring in someone with the expertise to help.

And that's exactly what I hope conversations like this one add to the world of parenting podcasts.

RESOURCES MENTIONED IN THIS EPISODE: 

International OCD Foundation Website

LET'S CONNECT:

Thriving Child Center

PCIT Experts

Calm and Connected Program

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CONNECT WITH DR. CHAD BRANDT:

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