OCD is
characterized by recurrent obsessions and/or compulsions that cause
marked distress and/or interference in one's life (see March and
Leonard 1996). Such patients often suffer from intrusive and unpleasant
thoughts, which they try to neutralize by performing repetitive
behaviors in order to avoid mounting, at times overwhelming, anxiety.
Children suffering with OCD most often struggle against their symptoms
and know how senseless much of it seems. As Evan tearfully told
me, "You know, most kids don't have to do these things."
Ever since Freud (1909) described his treatment of a patient he
called the "Rat Man," psychoanalysis has been fascinated by obsessive-
compulsive symptomatology. Children suffering from similar
symptoms were reported as early as 1922 (Sokolnicka) and 1924
(Hitschmann). In Freud's attempt to understand the psychic determinants
of the crippling symptoms of the Rat Man, he emphasized the
role of early, perhaps traumatic, sexual exposure and......
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