Obsessive-Compulsive Disorder: Current Views

Obsessive-compulsive disorder has been of central interest to psychoanalysis since Freud's early papers, most particularly in the “Rat Man” case. This early literature spelled out with great clarity the presumed development, psychodynamics, and meaning of obsessional and compulsive symptoms. Unfortunately, since Anna Freud's 1969 review of the subject, virtually nothing has appeared in the psychoanalytic literature that has added to our understanding of the disorder or enhanced the very limited therapeutic influence of psychoanalysis in such cases. Meanwhile, there has been an avalanche of contributions from biological psychiatry and behavioral psychology that have propounded different theories of pathogenesis and have laid claim to significant therapeutic effectiveness. If psychoanalysis is to have credibility in this field, it will have to enlist itself in multidisciplinary research efforts directed toward enriching our knowledge about the psychodynamics and the biological substrate of this illness (more common than once believed) and the efficacy of our efforts to treat it.     

Ernst Kris and the art of the mentally ill1

Ernst Kris, a gifted art historian as well as an eminent psychoanalyst, had little regard for the aesthetic value of the spontaneous artistic products of the mentally ill, considering them to be of interest only for the insight they might provide about the patient's psychopathology and unconscious conflicts. Recent scholarship and developments in the art world warrant a critical review of his position, which appears to have derived from his adherence to classical and Renaissance criteria. The works of two untrained and psychiatrically disturbed artists are offered as evidence of their potential aesthetic worth.     

ITALO SVEVO AND THE FIRST PSYCHOANALYTIC NOVEL

The first fictional work that used psychoanalysis as a central plot device was La Coscienza di Zeno (Confessions of Zeno) , published in 1923 by Ettore Schmitz, a Triestino Jewish businessman who wrote under the pseudonym of 'Italo Svevo'. This paper describes Svevo's background, his relations with such important literary figures as James Joyce and with such central figures in Italian psychoanalysis as Dr Edoardo Weiss. It seeks to demonstrate to the Anglophone reader the particular psychoanalytic elements in the novel and to relate them to Svevo's personal experience (including his indirect contacts with Freud) and to the intellectual currents of the period in a city which had, until the aftermath of the First World War, been a crossroads of European culture.     

Rescue fantasies

The concept of "rescue fantasy" is examined as it has evolved since Freud introduced it in 1910. Originally designating the wish in certain men to rescue "fallen women," the term has more recently come to refer primarily to the therapist's conscious or unconscious aims with regard to his patient, particularly in the context of child analysis or therapy. The varying drive elements and defensive operations at work in this compromise formation are discussed, and some recent sociocultural influences and analogues are suggested.     

Some reflections on boredom.

Boredom is a complex mental phenomenon, incorporating both affective and cognitive components, which cannot be understood within the confines of conflict theory alone. The paucity of fantasy in the bored person may reflect a developmental ego defect as well as, or instead of, the commonly-cited impulse-defense conflicts. The need for externally-supplied stimulation characteristic of persons with a field-dependent cognitive style, and/or characterological passivity may be among the significant predisposing factors for the development of boredom, and phase-specific factors may encourage its occurrence at particular periods of life. Boredom in the analyst, too, is multiply determined; the analytic situation itself contains features that contribute to it.     

Psychoanalysis and general psychiatry: obsessive-compulsive disorder as paradigm

To certain areas once dominated by psychoanalytic conceptualizations of psychopathology and pathogenesis, general psychiatry has in recent years made significant contributions. The obsessive-compulsive disorder is cited as an example, and illustrations of such contributions are described and discussed. Some implications for psychoanalytic theory and research are suggested.