Q. My son is 13 he has emotional problems in the past such as anxious attachment disorder, which he is really getting a grip on now, and he has other quirks like he worries a lot about germs and washes his hands quite a lot bordering on the obsessive ,he wont eat anywhere other than home as he worries about germs, none of these things have been of a great worry to me as I feel its fairly normal to worry about these types of things as a child and he is likely to outgrow them, but recently he has become fascinated with girls (which isn't a worry to me) and masturbates, he fantasizes about all kinds of things at inopportune moments, he recently broke down in tears and said he felt horrified with himself, his thoughts and feelings. I told him its all normal and everyone masturbates at some point in there life's and there's nothing he is thinking about that hasn't been thought before, I'm a very open person and have brought both my children up with a very open view of sex and sexuality but I'm a bit at a loss on how to make him feel less horrified with himself, he feels a constant need to confess his feelings to me and although I've told him he doesn't need to tell me everything he says it makes him feel less guilty. I don't know what to say other than what I have been saying to comfort him and its not helping him. any advise will be helpful. I hope my email isn't to long. The reason I have tried to get advise off of the net is that there are such long waiting list for mental health and there might be an easier answer.

  A. I have no easy answer. Any single behavior in an individual is not an illness. The sum total of what you describe, however, suggests a very strong need for psychiatric assessment. Get him to a psychiatrist or psychologist not afraid to refer for medication consult as soon as you can. Nothing horrible is happening, but he is uncomfortable, and this needs to be rectified. On the face of the data you give, it does sound like an obsessive-compulsive spectrum disorder.