A behavioural interpretation of obsessive-compulsive neurosis

Criticism by family and friends is a powerful means of eliminating socially undesirable habits, but it is liable to fail if the action in question is subject to undelayed reinforcement. The agent then claims that he is under “compulsion” to act as he does. The effect of the criticism is to add a sympathetic component to the compulsive behaviour, and if the agent admits the justice of the criticism, the emotion associated with this sympathetic response is “guilt”. The appropriate treatment is to subject the compulsive habit to negative reinforcement. Successful treatment of a case of trichopilomania is described. The patient, a woman of 40, had been plucking out her eyebrows compulsively for a period of 31 years. She was instructed to arrest at its commencement each movement of her hand to her forehead for the purpose of plucking. Cure was essentially complete in ten days. Three months later the eyebrows were fully grown and, contrary to deductions from psychoanalytic theory, no substitute symptoms had developed. A prediction, drawn from the author's behavioural theory of perception, that an itch in the brows that had always preceded plucking would disappear with the extinction of the compulsive habit, was confirmed.     

Solutions to neurosis: A theology of self

For Karen Horney neurosis is a serious impediment to health and wholeness and has the power to place a person in bondage. Yet the situation is far from hopeless, for strivings and anxieties contain intrinsic value and can be directed positively to the purpose of human maturity. The theory lends itself to a strong theology of the self, and thus encourages the pastoral counselor who cooperates with the inherent strengths of the person in his or her drive toward health.     

A comparison of flooding and thought stopping in the treatment of obsessional neurosis

Flooding in vivo and thought stopping were compared in patients with obsessional neurosis, in a cross-over design. It was hypothesized that the two techniques would have different effects on symptomatology. However, although both seemed to be effective treatments, there were no significant differences between them. Reasons for this finding are discussed. There was, however, a slight tendency for flooding to produce more overall improvement, and a greater reduction in avoidance behaviour. There was also a tendency for the first treatment to produce more effect. A worthwhile clinical finding was that a fair amount of improvement occurred after only eight out-patient sessions.     

The transference neurosis in Freud's writings

This paper reviews the evolution of the concept of transference neurosis in Freud's writings. It suggests that the language in which the concept of the transference neurosis is originally expressed by Freud includes an idea of the analyst as aggressively pursuing the analytic cure by waging a solitary battle against the patient's disease. With the representation of the death drive and the larger role accorded to sadism as its external manifestation in Freud's revised drive theory of 1920, the patient becomes the ally; resistance, in the sense of the conservative forces, not disease, in the sense of libidinal conflict, becomes the enemy. It is thus difficult to speak of a transference neurosis in the circumscribed way Freud originally meant it, and he ceased to use the term after 1926 rather than redefine it to fit his broader perspective. In this broader perspective, relative resolution of conflict replaced radical liberation of the patient from disease. That Freud did not redefine the term does not imply that he discarded it, or that we necessarily should. This paper suggests that Freud implied a functional distinction between transference as transforming agent and transference neurosis as result of that transformation. That distinction defines psychoanalytic cure in terms of the understanding of a symbolic transformation which is, through the transference neurosis, reexperienced as part of the psychoanalytic process.