This article presents a new model that elucidates the etiology and adult manifestation of obsessive-compulsive disorder (OCD). The author links transactional analytic and psychoanalytic concepts of symbiosis together with the latest neurobiological research and evidence. This is related to Winnicott's (1949/2004b) concept of overactive mental functioning and to illustrations from clinical work.
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References
1.
AllenJ. R. (2000). Biology and transactional analysis II: A status report on neurodevelopment. Transactional Analysis Journal, 30, 260–269.
2.
American Psychiatric Association. (2000). Diagnostic and statistical manual of mental disorders (4th ed. rev.). Washington, DC: Author.
3.
AntonyM. M., DownieF., & SwinsonP. (1998). Diagnostic issues and epidemiology in obsessive-compulsive disorder. AntonyM. M., RachmanS., & RichterM. A. (Eds.), Obsessive-compulsive disorder: Theory, research and treatment (pp. 3–32). New York: Guilford Press.
4.
BerneE. (1961). Transactional analysis in psychotherapy: A systematic individual and social psychiatry. New York: Grove Press.
5.
BilletA. A., RichterM. A., & KennedyJ. L. (1998). Genetics of obsessive-compulsive disorder. AntonyM. M., RachmanS., & RichterM. A. (Eds.), Obsessive-compulsive disorder: Theory, research and treatment (pp. 181–206). New York: Guilord Press.
6.
BollasC. (1987). The shadow of the object: Psychoanalysis of the unthought known. New York: Columbia University Press.
7.
BrazeltonT. B., & CramerB. G. (1991). The earliest relationship: Parents, infants, and the drama of early attachment. London: Karnac Books.
8.
BrombergP. M. (1999). Shadow and substance: A relational perspective on clinical process & AronL. (Eds.), Relational psychoanalysis: The emergence of a tradition (pp. 379–404). Hillsdale, NJ: The Analytic Press.
9.
ClarkD. A. (2004). Cognitive behavioural therapy for OCD. London: Guilford Press.
10.
CottrauxJ., & GerardD. (1998). Neuroimaging and neuroanatomical issues in obsessive-compulsive disorder. Toward an integrative model: Perceived impulsivity. AntonyM. M., RachmanS., & RichterM. A. (Eds.), Obsessive-compulsive disorder: Theory, research and treatment (pp. 154–180). New York: Guilford Press.
11.
FairbairnW. R. D. (2003a). Endopsychic structure considered in terms of object-relationships. In FairbairnW. R. D., Psychoanalytic studies of the personality (pp. 82–132). Hove, England: Brunner-Routledge. (Original work published 1944)
12.
FairbairnW. R. D. (2003b). The repression and the return of bad objects. In FairbairnW. R. D., Psychoanalytic studies of the personality (pp. 59–81). Hove, England: Brunner-Routledge. (Original work published 1943)
13.
FairbairnW. R. D. (2003c). Schizoid factors in the personality. In FairbairnW. R. D., Psychoanalytic studies of the personality (p. 3–27). Hove, England: Brunner-Routledge. (Original work published 1940)
14.
FonagyP., GergelyG., JuristL., & TargetM. (2004). Affect regulation, mentalization, and the development of the self. London: Karnac Books.
15.
FramptonI. (2003). Neuropsychological models of obsessive-compulsive disorder. In MenziesR. G. & de SilvaP., Obsessive-compulsive disorder: Theory, research and treatment (pp. 39–58). Chichester, England: Wiley.
HoferM. A. (1991). Early symbiotic processes: Hard evidence from a soft place & BoneS. (Eds.), Pleasure beyond the pleasure principle (pp. 55–78). New Haven, CT: Yale University Press.
18.
KohutH. (2001). The analysis of the self: A systematic approach to the psychoanalytic treatment of narcissistic personality disorders. Madison, CT: International Universities Press. (Original work published 1971)
19.
LittleR. (2006). Ego state relational units and resistance to change. Transactional Analysis Journal, 36, 7–19.
20.
LoewaldH. (1980). Papers on psychoanalysis. New Haven, CT: Yale University Press.
21.
MahlerM. S., PineF., & BergmanA. (2002). The psychological birth of the human infant: Symbiosis and individuation. London: Karnac Books. (Original work published 1975)
22.
MayR. (1996). The meaning of anxiety. New York: Norton. (Original work published 1950)
23.
NolanK. (2004). CTA case study theory question. Unpublished manuscript.
24.
RycroftC. (1995). A critical dictionary of psychoanalysis (2nd ed.). London: Penguin. (Original work published 1968)
25.
SchiffA. W., & SchiffJ. L. (1971). Passivity. Transactional Analysis Journal, 1 (1), 71–78.
26.
SchoreA. N. (1994). Affect regulation and the origin of the self: The neurobiology of emotional development. New Jersey: Lawrence Erlbaum Associates.
27.
SpelkeE. S., PhillipsA., & WoodwardA. L. (1995). Infants' knowledge of object motion and human action. PremackD., & PremackA. J. (Eds.), Causal cognition: A multidisciplinary debate. Symposia of the Fyssen foundation (pp. 44–78). New York: Clarendon Press.
28.
SteketeeG., & PruynN. A. (1998). Families of individuals with obsessive-compulsive disorder. AntonyM. M., RachmanS., & RichterM. A. (Eds.), Obsessive-compulsive disorder: Theory, research and treatment (pp. 120–140). New York: Guilford Press.
29.
SternD. N. (1985). The interpersonal world of the infant: A view from psychoanalysis and developmental psychology. New York: Basic Books.
30.
StewartI., & JoinesV. (2002). TA today: A new introduction to transactional analysis. Nottingham, England, and Chapel Hill, NC: Lifespace Publishing. (Original work published 1987)
31.
SullivanH. S. (1997). The interpersonal theory of psychiatry. London: Norton. (Original work published 1953)
32.
SummerfeldtL. J., HutaV., & SwinsonR. P. (1998). Personality and obsessive-compulsive disorder. AntonyM. M., RachmanS., & RichterM. A. (Eds.), Obsessive-compulsive disorder: Theory, research and treatment (pp. 78–119). New York: Guilford Press.
33.
WinnicottD. W. (2004a). Aggression in relation to emotional development. In WinnicottD. W., Through paediatrics to psychoanalysis: Collected papers (pp. 204–218). London: Karnac Books. (Original work published 1950)
34.
WinnicottD. W. (2004b). Mind and its relation to the psyche-soma. In WinnicottD. W., Through paediatrics to psycho-analysis: Collected papers (pp. 243–254). London: Karnac Books. (Original work published 1949)
35.
WinnicottD. W. (2004c). Transitional objects and transitional phenomena. In WinnicottD. W., Through paediatrics to psycho-analysis: Collected papers (pp. 229–242). London: Karnac Books. (Original work published 1951)
36.
WinnicottD. W. (2005). Psychiatric disorder in terms of infantile maturational processes. In WinnicottD. W., The maturational processes and the facilitating environment: Studies in the theory of emotional development (pp. 230–241). New York: International Universities Press. (Original published 1963)