How obsessive doubts about the past differ from ordinary ones.

Abstract

Obsessive-compulsive disorder (OCD) still presents several enigmatic aspects, especially when viewed only from a third-person perspective. Instead, things become more comprehensible if we try to reconstruct the patient's first-person point of view. In this paper, an analysis of obsessive doubts about the past, illustrated by clinical examples, allows us to show that obsessive doubts, unlike ordinary ones, do not arise from insufficient knowledge of what happened. Instead, they seem to arise from the fact that OCD patients perceive all the mental images in which a feared event occurs as a sort of window open to a possible world. So that the authentic drama of an OCD subject is that he/she will face every time an array of possible worlds without knowing which of them is the real one. Furthermore, a comparison is made between the hypothesis presented in this paper and one of the best-known models in the literature: the hypothesis of 'inferential confusion'. Finally, some implications for psychotherapy of OCD are discussed.