Psycho-social causes of Obsessive Compulsive Disorder

According to Freud’s psychoanalytic view, a person with Obsessive Compulsive Disorder (OCD) has been unable to cope with instinctual conflicts of the Oedipal Stage or has regressed back to an earlier stage of psycho – sexual development. Specifically, such a person is thought to be fixated in the anal stage of development (about 2 years), when children are thought to derive psycho – sexual pleasure from defecation. This is also the time at which parents are often attempting to toilet train their children which involve learning to delay or control these urges. If parents are too harsh in this training, they may give rise to rage in the child as well guilt and shame about these drives.

According this theory, the intense conflict that may develop between impulses of the Id and the Ego leads to the development of defence mechanism that may ultimately produce obsessive–compulsive symptoms.

The dominant behavioural view of obsessive – compulsive disorder derives from O. H. Mower’s Two process theory of avoidance learning (1947). According to this theory, neutral stimuli become associated with aversive stimuli through a process of classical conditioning and come to elicit anxiety. For example, touching a door knobs or shaking hands might become associated with the ‘scary’ idea of contamination and getting ill because of the infection. Once having made this association, the person discover that the anxiety produced by shaking hands or touching a door knob may be reduced by an activity like hand washing. By washing his or her hands extensively the anxiety would be reduced and the washing response would be re-enforced, making it more likely to occur again in the future when anxiety about contamination was evoked in other situations. Once learned, such avoidance responses are extremely resistant to extinction. The obsessive compulsive disorder becomes a defence mechanism against any such anxiety.