Obsessive Compulsive Disorder
By: Giovanni J.R.C.
-----Obsessive Compulsive Disorder is defined as a disorder that compels a person to commit ritualistic actions that prevent them from functioning in normal society. Though many speculate about the origin of such a disorder, the most prominent of “arguers,” namely Sigmund Freud and Judith Rapoport, claim two such distinct theories for the cause of such a disorder. Comparatively, though Freud’s theory of “psychological trauma” shows many examples and probable answers to the origins of OCD, Rapoport’s “physiological stimulus” also gives compelling information.
-----Obsessive Compulsive Disorder, or Obsessive Neurosis (as Sigmund Freud refers to it), is seen (by Freud) as an effect of past traumatic experiences. According to him, a person with such a past is then liable to go through unexplainable ritualistic motion often times unconsciously which then debilitate the person from functioning in a normal society. Freud begins his argument by establishing the subconscious. He claims that the subconscious is the screening mechanism for acceptable and conversely unacceptable behavior. He adds that there are times when we fail to control the subconscious thus influencing us to commit parapraxes (slips of the tongue). Furthermore, the unchecked subconscious then becomes a sort of channel for the person’s past traumatic experience thus surfacing via an obsessive act. This theory is summed-up in one of Freud’s lectures in psychoanalysis, “In both cases (referring to his case studies), there was no true amnesia, no missing memory, but a connection (subconscious) may have been broken which ought to have sought for the reemergence of the memory” (Freud, 351). He also claims that such past experiences, somehow, become a sort of bondage that the patients are caught in and thus subconsciously reenact such events and try to resolve them unconsciously (Freud, 338). Through the above statement, it may be said that unexplainable, obsessive, actions as triggered by the subconscious (as influenced by past experiences) is the actual cause of Obsessive Compulsive Disorder. To support this, Freud gives numerous examples as a basis for his deductions. One such example was that of a woman who had past relational problems with her husband. As a result of this, she was found to have unexplainable ritualistic practices hence giving her problems as to fitting in with normal society. Freud’s study of this individual’s problem led him to the conclusion (which incidentally complimented his theory) that the woman’s past traumatic experience (the impotence of her husband) caused her to commit such bizarre acts in order to unconsciously resolve the problem (Freud, 323).
-----However, Judith Rapoport, physician and author of the book, The Boy Who Could Not Stop Washing, strongly argues Freud’s theory. She believes that OCD is not caused by psychological stimulus but instead a physiological disorder. “One of the more direct biological findings is the discovery and the re-discovery that obsessions and compulsions are strongly associated with neurological disorders” states Rapoport (Rapoport, 15). She continues by saying that though she was trained as an advocate of Freudian philosophy, she no longer believes in examining the rituals, and studying the roots of the actions for she claims that there are none. She adds that OCD is merely caused by malformations in the brain that cause hormonal imbalance thus creating “tics” in the brain. Rapoport quotes, “The parts of the brain that seemed abnormal in the PET scans of the patients are the same parts that are affected by the encephalitic type of Parkinson’s and by Tourette’s syndrome” (Rapoport, 118). Rapoport furthers her argument by saying that drugs like Anafranil, and others, directly affect or sometimes even cure OCD, giving evidence to physiological connections. She strengthens this reasoning by referring to one of her case studies quoting, “We think that Anafranil increases serotonin, amphetamine, and dopamine in the basal ganglia. These are the parts of the brain that we believe don’t function well in Obsessive Compulsive Disorder” (Rapoport, 118). Another point she brings to surface is that most, if not all, patients that she encountered had a history of OCD in the family giving evidence that it can be hereditary, therefore physiological. An example of such a claim lies in one of her studies on the patient named Dr. S. A 36 year old OCD sufferer, Dr. S. believes that his son, two brothers, nephew, father and grandfather all suffer from OCD, thus showing OCD’s further connection to the physiology of the brain.
-----Freud and Rapoport give two very different explanations of the same problem. Though both of their explanations somehow attempt to discredit one and the other, it seemed more plausible that maybe both explanations, in some respects, are correct. This is due to the fact that all examples given by both researchers were all irrefutable and hence give evidence to both theories.
-----Upon coming to the conclusion that both respective arguments hold true, we now can state that there is an underlying connection between the psychological and physiological aspects of OCD. In theory, the patient may, at first, have experienced a certain trauma that may leave a form of psychological scar in the person that may be triggered by the memory of the past traumatic experience. Upon constant encounters with this certain stimulus, the person will then eventually learn to react until he or she becomes programmed subconsciously to react a certain manner without the slightest thought (functional autonomy). With the knowledge that our physiological bodies can be constantly reprogrammed and re-adjusted (ie. The metabolism of our bodies can be constantly re-adjusted by changing our eating habits and levels of physical exertion) we can then claim that if a person is trained and conditioned long enough physiologically to react to certain stimuli, the physiology of the person’s body will eventually adjust to such a programming that the brain will have certain adjustments according to the changes (ie. A person living in a low altitude environment moves to a place of higher altitude, though his physiology is used to living in an area with normal atmospheric levels, eventually after a certain time of reprogramming, there will be certain adaptations in the person’s physiology that will eventually enable him to live in a different environment that has a thinner atmosphere).
In
conclusion, it is difficult to regard either one theory to be false especially
since both show compelling arguments as to why they may be true. Freud’s theory of OCD by psychological
stimuli and Rapoport’s argument that OCD is
physiologically originated can only be considered both, if not true, partially
true in claiming the causes of Obsessive Compulsive Disorder. Therefore, we can only speculate that there
is a link between both explanations and though this may bring more complexity
to the already well argued problem, it only seems more logical that somehow a
psychological stimulus may begin the symptoms of OCD and then lead to the
disorder’s reprogramming of the brain thus making it more susceptible to
medication, than claiming that OCD is exclusively caused by psychological
stimuli and can only be cured through psychological means or that OCD is due to
malformations in the brain and thus can only be relieved through medication.