Obsessive-compulsive symptoms have long held interest for psychoanalysts. Currently, pharmacological and behavioral treatments are commonly viewed as the standard of care, and psychoanalytic clinicians are often uncertain of how best to approach these patients. The successful two-year psychoanalytic treatment of a ten-year-old boy with obsessive-compulsive disorder, who remained symptom-free eight years after termination, is reported. While this is but a single case, its outcome implies that for some patients psychoanalysis may be the treatment of choice.
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References
1.
American Academy Of Child And Adolescent Psychiatry (1998). Practice parameter for the assessment and treatment of children and adolescents with obsessive-compulsive disorders. Journal of the American Academy of Child and Adolescent Psychiatry37(Suppl.):27—45.
2.
American Psychiatric Association (2004). Practice Guidelines for the Treatment of Psychiatric Disorders. Washington, DC: American Psychiatric Association.
3.
Arciniegas, D. (2001). Neuropsychiatry: An Introductory Approach. Cambridge: Cambridge University Press.
4.
Bibring, E. (1937). Therapeutic results of psychoanalysis. International Journal of Psychoanalysis18:170—189.
5.
Bird, B. (1972). Notes on transference: Universal phenomenon and hardest part of analysis. Journal of the American Psychoanalytic Association20:267—301.
6.
Bornstein, B. (1953). Fragment of an analysis of an obsessional child: The first six months of analysis. Psychoanalytic Study of the Child8:313—332.
7.
Castelnuovo-Tedesco, P. (1989). Thoughts on patient care and the emperor's new clothes. Psychosomatics30:318—321.
8.
Chused, J. (1988). The transference neurosis in child analysis. Psychoanalytic Study of the Child43:51—81.
9.
——— (1999). Obsessional manifestations in children. Psychoanalytic Study of the Child54:219—232.
10.
Esman, A. (1989). Psychoanalysis in general psychiatry: Obsessive-compulsive disorders as a paradigm. Journal of the American Psychoanalytic Association37:319—336.
11.
Fonagy, P., & Target, M. ( 1996). Predictors of outcome in child psychoanalysis: A retrospective study of 763 cases at the Anna Freud Centre. Journal of the American Psychoanalytic Association44:27—77.
12.
Freud, A. (1965). Normality and Pathology in Childhood: Assessments of Development. New York: International Universities Press.
13.
——— (1966). Obsessional neurosis: A summary of psychoanalytic views as presented at the Congress. International Journal of Psychoanalysis47:116—122.
14.
Freud, S. (1909). Notes upon a case of obsessional neurosis. Standard Edition10:153—318.
15.
——— (1913). The disposition to obsessional neurosis. Standard Edition12:317—326.
16.
——— (1926). Inhibitions, symptoms and anxiety. Standard Edition20:75—175.
17.
Glover, E. (1935). A developmental study of the obsessional neurosis . International Journal of Psychoanalysis16:131—144.
18.
Hitschmann, E. (1924). Heightened instinctual life and obsessional neurosis in a child. International Journal of Psychoanalysis5:332—343.
19.
Jellinek, M., & Mcdermott, J. (2004). Formulation: Putting the diagnosis into a therapeutic context and treatment plan. Journal of the American Academy of Child and Adolescent Psychiatry43:913—916.
20.
Jenike, M. (1986). Psychotherapy of the obsessional patient. In Obsessive-Compulsive Disorders: Theory and Management, ed. M. Jenike, L. Baer, & W. Minichiello.Littleton, MA: PSG Publishing, pp. 113—123.
21.
Joseph, B. (1966). Persecutory anxiety in a four-year-old boy. International Journal of Psychoanalysis47:184—188.
22.
Kestenberg, J. (1966). Rhythm and organization in obsessive-compulsive development. International Journal of Psychoanalysis47:151—159.
23.
Leonard, H.L., & Swedo, S.E., (2001). Pediatric autoimmune neuropsychiatric disorders associated with streptococcal infection (PANDAS)International Journal of Neuropsychopharmacology4:191—198.
24.
——— ——— Lerane, M.C., ET AL. (1993). A 2- to 7-year follow-up study of 54 obsessive-compulsive children and adolescents. Archives of General Psychiatry50:429—439.
25.
Loewald, H. (1960). On the therapeutic action of psycho-analysis. International Journal of Psychoanalysis41:16—33.
26.
March J., & Leonard, H. (1996). Obsessive-compulsive disorder in children and adolescents: A review of the past ten years. Journal of the American Academy of Child and Adolescent Psychiatry35:1265—1273.
27.
——— ——— & Swedo, S. (1995). Neuropsychiatry of obsessive-compulsive disorder in children and adolescents. Comprehensive Therapy21:507—512.
28.
Marks, I. (1981). Review of behavioral psychotherapy: I. Obsessive-compulsive disorders. American Journal of Psychiatry138:584—592.
29.
Morgenthaler, F. (1966). Psychodynamic aspects of defense with comments on technique in the treatment of obsessional neurosis. International Journal of Psychoanalysis42:203—209.
30.
Pitman, R. (1987). Pierre Janet on obsessive-compulsive disorder (1903). Archives of General Psychiatry44:226—232.
31.
Ritvo, R. (2001). In defense of the case study. AACAP News32:66—67.
32.
Salzman, L., & Thaler, F. (1981). Obsessive-compulsive disorders: A review of the literature. American Journal of Psychiatry138:286—296.
33.
Sokolnicka, E. (1922). Analysis of an obsessional neurosis in a child . International Journal of Psychoanalysis3:306—319.
34.
Strachey, J. (1934). The nature of the therapeutic action of psycho- analysis. International Journal of Psychoanalysis15:127—159.
35.
Tyson, P. (1996). Neurosis in childhood and analysis. Journal of the American Psychoanalytic Association44:143—165.
36.
——— (2002). The challenges of psychoanalytic developmental theory. Journal of the American Psychoanalytic Association50:19—52.
37.
Tyson, R., & Tyson, P. (1986). The concept of transference in child psychoanalysis . Journal of the American Academy of Child and Adolescent Psychiatry25:30—39.
38.
Weisman, P. (1954). Ego and superego in obsessional character and neurosis. Psychoanalytic Quarterly23:529—543.
