At the outset of this article I would like to thank the hundreds of kids whom I have seen professionally in my more than twenty five years of clinical practice. They were as much my teachers as my patients, in that they opened my eyes to numerous insights, some of which are outlined here. Many were indulgent enough to describe their experience with OCD and related problems in such exquisite detail that they shaped my thinking--and re-thinking--of what I thought I knew about OCD, Tourette Syndrome (TS) and the multitude of clinical features that often presented within the same young packages. Some just had OCD in its familiar forms, and others just tics. But many had a hodge-podge of clinical features--OCD and TS and ADHD (attention deficit hyperactivity disorder) and LD's (learning disorders) and ODD (oppositional defiant disorder) and … you name it. I had innumerable opportunities to learn about their first-hand experiences so near to the genesis of their own disorders. As a result, a picture began to emerge that was consistent with their descriptions but often at odds with orthodox views. Here I will briefly outline several perspectives that derive from a re-examination of the relationship between OCD and TS based on that picture.