Outcomes of psychoanalytic work with metaphors in obssesive-compulsive disorder

Abstract

Obsessive-compulsive disorder (OCD) is a highly prevalent mental disorder that can significantly compromise the quality of life. Because many cases do not respond to standard pharmacological and cognitive-behavioural treatment methods, research and validation of a wider range of treatment approaches is important. This article shows the course and outcome of eight cases of psychoanalytic psychotherapy for OCD, whose approach is justified by the theoretical framework of conceptual systems in cognitive science. In this context, OCD symptoms are understood as metaphorical mappings of the patient’s intangible inner experiences onto tangible and experientially accessible OCD symptomatology. Interpretation through the discovery of metaphorical mappings in the presented treatments is related to the processing of traumatic content, which is reflected in the reduction of the intensity of OCD symptoms. The results of the selected treatment approach are presented with the quantification and monitoring of cumulative intensity of symptoms. Eight cases of treatment of patients with a psychiatric diagnosis of OCD without associated disorders are described and analyzed with conventional content analysis. For each case, a set of OCD symptoms is extracted and classified on the timeline of the psychotherapeutic process, and then the intensity of the symptoms is assessed at regular time points by two observers. The collected data is processed using the trend analysis method to present the dynamics and treatment outcomes, which show a consistent decline in symptoms during psychoanalytic treatment utilizing working with metaphors. Based on these results, we confirm the selected approach as a suitable choice for the treatment of OCD.