The theoretical concept of the interpretation of symptoms of obsessive-compulsive disorder (OCD)

Abstract

Obsessive-compulsive disorder (OCD) is a common mental disorder (prevalence 2-3 %) with a highly stressful and variable symptomatology which expresses itself in the form of repetitive and intrusive thoughts (obsessions) and ritual actions (compulsions) (World Health Organization, 2003). Patients with OCD respond well to treatment with serotonergic antidepressants; the first choice of treatment being a combination of selective inhibitors for reuptake of serotonin and cognitive behavioural psychotherapy with the method of exposure and prevention of response (Olatunji etc., 2013). Even though the psychoanalytic treatment of OCD in clinical practice has proven itself as highly effective, the psychoanalytic treatment of OCD is poorly researched and subsequently known only to a handful of experts that face OCD on a daily basis. This paper will present a psychiatric and psychoanalytic formulation of OCD and its pathogenesis with an emphasis on psychoanalytic theory. The second part of the paper focuses on the theoretical concept behind the psychoanalytic treatment of OCD by introducing the conceptual metaphor theory which is my suggested basis for developing a model for the interpretation of obsessive-compulsive symptomatology. Recognition and understanding of the abstract meanings of an individual’s conceptual system can serve as a tool that, especially during psychoanalytic therapy, makes an important contribution towards a more oriented and consistent interpretation of the symbolic meaning of OCD symptoms. The paper also highlights the basis for further research into the diagnosis and treatment of OCD and into the symptomatology that is linked with OCD.