Obsessive Compulsive Reaction (Disorder)

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In this reaction the anxiety is associated with the presence in consciousness of unpleasant and morbid thoughts or repetitive impulses to perform apparently meaningless and realistic acts.  Although the patient may regard his ideas and behaviour as unreasonable, he is unable to control them. Either the obsessive thought or the compulsive ceremonial may arise singly or both may appear in sequence.   The patient regularly repudiates the distressing thoughts, which are often highly repugnant and concerned with violent aggressive or sexually perverse impulses.  However, the more he struggles to dispel his thoughts, the more insistently do they intrude.  Great fear may be associated with such ruminations, and a ritualistic act frequently serves as an attempt at mastery of the fear. 

The personality of obsessive-compulsive patients is characterized by inflexibility, constant doubt, vacillation and adherence to excessive standards of morality.   They tend to be over conscientious and inhibited in the expression of pleasure and in the capacity for relaxation.  A tendency toward checking and rechecking of the simplest acts contributes toward lack of productivity and the consumption of much energy in unprofitable and wasteful labour. 

The  Danger of Defence  Action

Although defence is undertaken in the service of self preservation, reason, mental equilibrium and social adaptation, such major interference with the natural forces in the human mind cannot fail to have serious consequences for the individual’s health and happiness.  The effort of maintaining a constant defence system is in itself a strain on the ego and may deplete it on energies needed for other constructive purposes.

Turning aggression against the self socializes the individual but simultaneously weakens his efficiency and creates a self destructive masochistic  attitude to life.   Regression may promise momentary safety from conflict but interferes severely as growth and development.  Repression above all is justly held responsible for damage to the personality.

Defence and Mental Illness

No neurosis maintains its structure   by employing one defence mechanism only, but always a combination of several.   Although defence mechanisms are an integral part of every neurotic structure, the presence of defensive activity in the mind is in itself no sign of pathology.  In cases where the defence is successful in controlling tensions, no symptomatology develops, although the effect may be crippling to the ego and impoverishing for instinctual life.

Where the defence mechanisms fail to ward off anxiety and “unpleasureâ€� and where repressed matter returns to consciousness, the ego is forced to multiply and over intensify its defensive efforts and to over stress the use of the various mechanisms.  It is in these instances, that, finally, the formation of neurotic symptoms is resorted to.  Such symptoms are compromise formations which express and represent at the same time the defensive tendencies of the ego and the pleasure seeking tendencies of the id.  Psychoses signify a sever breakdown in the defence system, characterised by the preponderance of the primitive mechanisms.


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