Psychodynamic Perspectives on OCD

Abstract

A psychodynamic perspective attempts to understand the symptoms of obsessive-compulsive disorder (OCD) and obsessive-compulsive personality disorder (OCPD) in terms of excessive, maladaptive efforts to cope with perceived dangers posed by aggressive or sexual impulses and in terms of distorted information processing and rigid cognitive styles that are intolerant of ambiguity. The psychodynamic perspective also sees OC phenomena against the backdrop of normal childhood development and the vicissitudes of conscience formation, as well as culturally defined notions of ordered boundaries/transgressions and cleanliness/pollution. This perspective provides valuable insights into the subjective experience of patients with these disorders. Similarly, although psychodynamic therapy in its classic form appears to be ineffective for the core symptoms of obsessions and compulsions, the psychodynamic approach can be very helpful in understanding what patients make of their symptoms and in forming a therapeutic alliance that facilitates more evidence-based approaches.