[Psychotherapy in patients with obsessive-compulsive disorder]

The present paper is a study of the role of psychotherapy in the treatment of obsessive-compulsive disorders (OCD). It also includes an attempt to integrate several paradigms in order to obtain the best possible approach in helping each patient on an individual basis. The aim of this psychotherapy may limit itself to simple verifications in the pharmacotherapeutic follow-up, or it may be as ambitious as an attempt to modify the character structure of the individual. In the process of the latter case, one expects the defensive aim of symptoms to be no longer relevant, insofar as the patient successfully solves the conflicts that caused the symptoms. We can only use tags or labels to bear witness of the efficiency of such ambitious use of psychotherapy, and even these tags or labels seem to be concerned with compulsive personality rather than with OCD proper. At each end of the range of aims (encouraging the follow-up of pharmacotherapeutic or behavioral treatments vs character modification), the therapist is inevitably confronted with a multitude of features frequently present in the obsessive patient. Because it is a disorder which invades and influences the patient's feelings, thoughts, behavior and relationships with other people, the obsessive patient's mind is a constant prey to special problems at every meeting with his therapist, whether they be related to the administration of drugs or to a behavioral therapy regime. Obviously, such problems will multiply if one initiates systematic psychotherapy in such patients.(ABSTRACT TRUNCATED AT 250 WORDS)