Obsessive position: the new psychoanalytic approach of obsessive-compulsive disorder.

Abstract

Obsessive-compulsive disorder (OCD) is considered one of the most difficult disorders to treat due to the diversity of its symptomatology, the difficulties of establishing and maintaining a relationship with patients and their rather rigid functioning. Freud made basic findings that described the nature of the disease, however in psychoanalysis there has been no truly novel theoretic approach to OCD ever since Freud’s seminal work. In this present theoretically study, I am examining OCD-symptoms primarily through object relations theory focusing on one group of certain key theoreticians and their followers. My summary of psychoanalytic literature on OCD is based on the works of Freud, Ferenczi and Klein. As a second step, from an object relational point of view, beside paranoid-schizoid and depressive, I am postulating a third position under the name obsessive position, what we can assume as a specific constellations of object relations with anxieties, defence mechanism and patterns of thinking. The specific characteristics of this position are discussed in the study. I am making a clear distinction between the obsessive ego-state and the realistic ego-state and discuss the differences between the two states. Through the introduction of the obsessive ego-state I am suggesting the definition of OCD as a disorder of personality organization and ego-organization. In the study, I therefore, argue for the application of a modified psychoanalytic methodology in the case of OCD-patients. I am offering a glimpse into this technique through a segment from a session of psychoanalytic therapy with an OCD-patient.