The world is full of rules: rules that are imposed from without and those that are established from within. For most children, rules are anchors in a chaotic world. From the moment the child can walk, he or she begins to challenge those rules. As the maxim goes, the adults set the rules, the children break them, and the adults re-assert them. This process becomes a dialogue of sorts. Before long, the adult demonstrates some flexibility within the rules and the child begins to integrate them with an understanding that rules and rituals are necessary guidelines that function best in context. For children with obsessive-compulsive disorder (OCD), it would appear that rule making and rule adherence are the central organizing features of their personality. In fact, for these children, the strictures of daily life imposed from within are crushing, oppressive, fruitless measures to ward off an overwhelming anxiety stemming from intrusive, horrifying thoughts. These unrelenting thoughts, often quite frightening, can only be stopped by creating a set of intractable rituals and rules. In short order, the rules themselves become an organic force with a mind of their own. For the child with OCD, disobedience or defiance of the rules will bring on certain destruction to his or her loved ones or the entire universe.