Psychodynamic Perspective of Sexual Obsessions in Obsessive-Compulsive Disorder

Obsessive-compulsive disorder (OCD) is a disorder that is characterized by the presence of obsessions and compulsions. OCD can occur in a wide range of subtypes, which may include sexual OCD, i.e., the occurrence of intrusive sexual thoughts. People with sexual OCD may experience unwanted obsessive sexual thoughts about a family member, dead or inanimate objects, animals, God, or children, which can range from mild to severe levels of occurrence. The psychodynamic perspective on OCD suggests that the content of obsessive thinking is commonly drawn from primitivized sexuality and aggression. It further suggests that in the absence of key relationships that include emotional proximity, mirroring and containment, and attunement, a child experiences a void-like state. Consequently, the anxiety that arises in the child leads to a form of liveliness in a "dead" inner world. However, it occurs out of a sense of abandonment and loss of good objects, and ultimately out of fear of annihilation. As a result, the child resorts to maladaptive defense mechanisms. The study attempts to explore the adverse early childhood experiences such as parental neglect, mother-father conflict, and lack of parental love and care leading to fixation in psychosexual stages of development, which further leads to the adoption of maladaptive defense mechanisms that in turn further contribute to the development of obsessional personality traits. This study aims to explain the psychodynamic perspective on the emergence of sexual obsessions by proceeding with a case study approach by taking a diagnosed case of OCD. A comprehensive psychodiagnostic assessment was conducted with the help of Draw-a-Person Test, Thematic Apperception Test, Rotter's Incomplete Sentence Blank, and Million's Comprehensive Multiaxial Inventory. The analysis of the assessment protocol revealed a strong relationship between the defense mechanism, personality traits, and the development of obsessive symptoms.