OCD type rituals

Hi,

My teenage son have been struggling of late with his anxiety, he has always from a young age done rituals when doing certain things, these aren't stimming but a sequence that he feels he has to do. They mainly occur when he is getting dressed, and at bedtimes, but can occur at other times depending on how he is feeling. He kind of has a period where his anxiety levels are at a plateau and relatively low, but over a period just tend to go up before he has a period of time with quite high anxiety before a big blow out and then tends to come back down again.

When he is on an upward spiral of anixety the rituals that he does become more regular and prolonged. For instance when getting dressed he may have 2 or 3 things he normally does, like lining up a seam with something else or he holds his hands in a certain position. When he is more stressed this can then increase to 4 or 5 things he does and so on.

The same with bed time he will line his pillow up with the wall, then adjust the position of were he is in the bed, then he may have to touch something in a certain way etc

We have tried to speak to him to try and see if there is a way we can help him to maybe break the cycle or to bring his tension down to reduce the number of things he does.

It just seems to be a cycle that gets him more stressed and continuing to add for things is just more things to get stressed about. He feels that he needs to do these 'rituals' before he can then just carry on life as normal.

Any ideas or suggestions on things to try would be great.