Objective: Ritual is a central feature of obsessive-compulsive disorder (OCD) and is found in other psychiatric conditions. Defined in a general sense, it is seen in the everyday behaviour of animals and of humans, in secular ceremonies, and in religion. This paper examines the various types of ritual. It considers the common features and differences.
Method: Material from psychiatric, biological, sociological, anthropological and religious studies literature is reviewed and discussed.
Results: The term ‘ritual’ describes a wide variety of phenomena. These include the rituals of OCD and range from relatively simple animal signals to profoundly meaningful human behaviour. A common feature is stereotyped physical activity which conveys information. Some clinical, developmental, evolutionary and religioud historical evidence suggests that stereotyped motor behaviour may be the primary phenomenon.
Conclusions: The study of ritual in all its manifestations provides insight into the basis of important human behaviours. Obsessive-compulsive disorder is a likely paradigm for this study. Psychiatry, with its clinical orientation and biopsychosocial perspective, is a discipline within which the study might occur.
RapoportJLSwedoSLeonardH.Obsessive–compulsive disorder. In: RutterMTaylorEHersovL, eds. Child and adolescent psychiatry: modern approaches. 3rd ed.Oxford: Blackwell Science, 1994.
2.
ZetinMKramerMAObsessive–compulsive disorder. Hospital and Community Psychiatry1992; 43:689–699.
3.
JenikeMAObsessive–compulsive disorder. In: Kaplan HI, Saddock BJ. Comprehensive textbook of psychiatry. 6th ed.Baltimore: Williams and Wilkins, 1995.
4.
FallonBALiebowitzMRHollanderEThe pharmacotherapy of moral or religious scrupulosity. Journal of Clinical Psychiatry1990; 51:517–521.
5.
American Psychiatric Association.Diagnostic and statistical manual of mental disorders. 4th ed.Washington, DC: American Psychiatric Association, 1994.
6.
World Health Organization.The ICD-10 classification of mental and behavioural disorders. Clinical descriptions and diagnostic guidelines. Geneva: World Health Organization, 1992.
7.
FreudS.Notes upon a case of obsessional neurosis. In: Freud S. Complete psychological works. Standard ed.Vol. 10. London: Hogarth, 1955.
8.
FreudA.Obsessional neurosis: a summary of psychoanalytic views as presented at the Congress. International Journal of Psychoanalysis.1966; 47:116–122.
9.
NemiahJCUhdeTWObsessive–compulsive disorder. In: Kaplan HI, Saddock BJ. Comprehensive textbook of psychiatry. 5th ed.Baltimore: Williams and Wilkins, 1989.
10.
FreudS.Civilisation and its discontents. (StracheyJ, trans., ed.) New York: WW Norton, 1961.
11.
MearesR.A pathology of privacy: towards a new theoretical approach to obsessive–compulsive disorder. Contemporary Psychoanalysis1994; 30:83–100.
12.
EsmanAHPsychoanalysis and general psychiatry: obsessive–compulsive disorder as paradigm. Journal of the American Psychoanalytic Association1989; 37:319–336.
13.
JoffeRTSwinsonRPReganJJPersonality features of obsessive–compulsive disorder. American Journal of Psychiatry1988; 145:1127–1129.
14.
BaerLJenikeRicciardi MAIIStandardised assessment of personality disorders in obsessive–compulsive disorder. Archives of General Psychiatry1990; 47:826–830.
15.
MavissakalianMHamannMSJonesB.Correlates of DSM-III personality disorder in obsessive–compulsive disorder. Comprehensive Psychiatry1990; 31:481–489.
16.
PollittJ.Natural history of obsessional states. British Medical Journal1957; 1:194–198.
17.
PollittJ.Obsessional states. British Journal of Hospital Medicine1969; 2:1146–1150.
18.
KarnoMGoldingJSorensonSBurnamA.The epidemiology of obsessive–compulsive disorder in five US communities. Archives of General Psychiatry1988; 45:1094–1099.
19.
BlackA.The natural history of obsessional neurosis. In: BeechHR, ed. Obsessional states. London: Methuen, 1974:19–54.
20.
SwedoSERapoportJLLeonardHLenaneMCheslowD.Obsessive–compulsive disorder in children and adolescents. Clinical phenomenology of 70 consecutive cases. Archives of General Psychiatry1989; 46:335–341.
21.
DouglassHMMoffittTEObsessive–compulsive disorder in a birth cohort of 18-year-olds: prevalence and predictors. Journal of the American Academy of Child and Adolescent Psychiatry1995; 34:1424–1431.
22.
RasmussenSATsuangMTClinical characteristics and family history in DSM-III obsessive–compulsive disorder. American Journal of Psychiatry1986; 143:317–322.
23.
PitmanRKJenikeMANormal and disordered compulsivity: evidence against a continuum. Journal of Clinical Psychiatry1989; 50:450–452.
24.
GrahamP.Child psychiatry. A developmental approach. 2nd ed.Oxford: Oxford University Press, 1991.
BergCZRapoportJLWhitakerAChildhood obsessive–compulsive disorder: a two-year prospective follow-up of a community sample. Journal of the American Academy of Child and Adolescent Psychiatry1989; 28:528–533.
27.
LeonardHGoldbergerELRapoportJLCheslowDLSwedoSEChildhood rituals: normal development or obsessive–compulsive symptoms?Journal of the American Academy of Child and Adolescent Psychiatry1990; 29:17–23.
28.
JenikeMABaerLMinichielloWE, eds. Obsessive–compulsive disorders: theory and management. 2nd ed.Chicago: Year Books Publishing, 1990.
29.
RasmussenSAEisenJLEpidemiology of obsessive compulsive disorder. Journal of Clinical Psychiatry1990; 51(Suppl. 2):10–13.
30.
RobertsonMMThe Gilles de la Tourette syndrome: the current status. British Journal of Psychiatry1989; 154:147–169.
31.
RapoportJLThe biology of obsessions and compulsions. Scientific American1989; 260:63–69.
32.
DunnAJGreenEJIsaacsonRLIntracerebral adrenocorticotropic hormone mediates novelty-induced grooming in the rat. Science1979; 203:281–283.
33.
GispenWHIsaacsonRLACTH-induced excessive grooming in the rat. Pharmacology and Therapeutics1981; 12:209–246.
34.
McFarlandD, ed. The Oxford companion to animal behaviour. Oxford: Oxford University Press, 1987.
35.
CurtisHBarnesSNAnimal behaviour and its evolution. In: Biology. 5th ed.New York: Worth, 1989:1052–1083.
36.
HarréRLambR, eds. The dictionary of ethology and animal learning. Oxford: Blackwell Reference, 1986.
37.
McKinneyWTAnimal research and its relevance to psychiatry. In: Kaplan HI, Saddock BJ. Comprehensive textbook of psychiatry. 6th ed.Baltimore: Williams and Wilkins, 1995.
38.
JurmainRNelsonH.Fundamentals of primate behaviour. In: Introduction to physical anthropology. 6th ed.Minneapolis, MN: West, 1994:229–264.
39.
GardnerR.Sociobiology and its applications to psychiatry. In: KaplanHISaddockBJ. Comprehensive textbook of psychiatry. Vol. I. 6th ed.Baltimore: Williams and Wilkins, 1995:365–375.
40.
BarrowsEMAnimal behaviour desk reference. Boca Raton, FL: CRC Press, 1995.
41.
LehrmanDSSemantic and conceptual issues in the nature–nurture problem. In: AronsonLRTobachELehrmanDSRosenblattJS, eds. Development and evolution of behaviour. San Francisco: WH Freeman, 1970.
42.
TinbergenN.Curious naturalists. New York: Doubleday, 1968.
43.
ImmelmannKBeerC.A dictionary of ethology. Cambridge, MA: Harvard University Press, 1989.
44.
MarmorJ.Some observations on superstition in contemporary life. American Journal of Orthopsychiatry1956; 26:119–130.
45.
BeckerJ.Superstition in sport. International Journal of Sports Psychology1975; 6:148–152.
46.
BuhrmannHGZauggMKReligion and superstition in the sport of basketball. Journal of Sport Behaviour1983; 6:146–157.
PennerHHRites and ceremonies. The concept and forms of ritual. In: Encyclopaedia Britannica. Vol. 26. 15th ed.Chicago: Encyclopaedia Britannica, 1992:778–781.
49.
DonovanP.Zeal and apathy: the future. In: DonovanP. ed. Religions of New Zealanders. Palmerston North, New Zealand: The Dunmore Press, 1990:253–265.
50.
BellahRNThe broken covenant. American civil religion in time of trial. New York: Seabury Press, 1975.
51.
HillMZwagaW.Civil and civic: engineering a national religious consensus. New Zealand Sociology1987; 1:25–35.
52.
EliadeM.Shamanism: archaic techniques of ecstasy. Princeton: Princeton University Press, 1964.
53.
KievA.Curanderismo. Mexican-American folk psychiatry. New York: The Free Press, 1968.
54.
KatzR.Boiling energy. Community healing amongst the Kalahari Kung. Cambridge, MA: Harvard University Press, 1982.
55.
KapfererB.A celebration of demons: exorcism and the esthetics of healing in Sri Lanka. 2nd ed.Washington DC: Smithsonian Institution Press, 1991.
56.
LadermanCRosemanM.The performance of healing. New York: Routledge, 1996.
57.
HortonR.Ritual man in Africa. In: LessaWAVogtEZ, eds. Reader in comparative religion. 4th ed.New York: Harper Collins, 1979.
58.
OttoR.The idea of holy. (HarveyJW, trans.). 2nd ed.London: Oxford University Press, 1950.
59.
StrengFJRites and ceremonies. The sacred or holy. In: Encyclopaedia Britannica. Vol. 26. 15th ed.Chicago: Encyclopaedia Britannica, 1992:770–773.
Levi-StraussC.The effectiveness of symbols. In: Structural anthropology. New York: Doubleday Anchor Books, 1967.
76.
RappaportRAAdaptation and the structure of ritual. In: JonesBlurton NReynoldsV, eds. Human behaviour and adaptation. London: Taylor and Francis, 1978.
77.
LeachERRitualisation in man in relation to conceptual and social development. In: LessaWAVogtEZ, eds. Reader in comparative religion. 4th ed.New York: Harper Collins, 1979.
78.
GoffmanE.Interaction ritual. Essays on face-to-face behaviour. New York: Anchor Books, Doubleday, 1967.
79.
TurnerV.The ritual process. Structure and anti-structure. London: Routledge and Kegan Paul, 1969.
80.
TurnerV.From ritual to theatre. The human seriousness of play. New York: PAJ Publications, 1982.
81.
StaalF.Rules without meaning. Ritual, mantras and the human sciences. New York: Peter Lang, 1989.
82.
MullenPEPsychoanalysis: a creed in decline. Australian and New Zealand Journal of Psychiatry1989; 23:17–20.
83.
KluckhohnC.Myths and rituals: a general theory. In: LessaWAVogtEZ, eds. Reader in comparative religion. 4th ed.New York: Harper Collins, 1979.
84.
WallworkE.Sigmund Freud: the psychoanalytic diagnosis–infantile illusion. In: JohnsonRA, ed. Critical issues in modern religion. 2nd ed.Englewood Cliffs, NJ: Prentice- Hall, 1990.
85.
SilvaP.The Dunedin Multidisciplinary Health and Development Study: a 15 year longitudinal study. Perinatal Paediatric Epidemiology1990; 4:76–107.
86.
TurnerV.Body, brain and culture. In: Turner V. The anthropology of performance. New York: PAJ Publications, 1986.
