Brief Dynamic Psychotherapy in a Case of Obsessive Compulsive Disorder

Abstract

A 57 years old married, retired official of Indian Railway service presented with two months complaints of recurrent fears of circulation of a duplicate CD of one of his presentations in an international conference, recurrent thoughts that the years of winning medals during his tenure in Indian Railways service were misrepresented in the records as early years. He recognized these fears as irrational, intrusive causing irritability and extreme anxiety, as he felt an urge to go and check the records, and feared it would cause humiliation. A diagnosis of obsessive compulsive disorder predominantly obsessions were made. Patient refused medication and a keen interest to receive insight. Patient had strong ego functions, stable heterosexual partnership, was open to interpretations and therapeutic contract of ten sessions of David Malan's school of brief dynamic therapy was initiated. Unconscious therapeutic alliance dominated over resistance. Displacement, isolation of affect and undoing were the neurotic defenses interpreted by the therapist. Therapeutic focus was relief of obsessions occurred by 9th session and therapy was successfully terminated.

Research on psychotherapy in India: A systematic review

“…Vyjayanthi[ 95 ] has described the application of brief dynamic psychotherapy in a case of OCD. Most interpretations about the patient’s problems and the defense mechanisms elicited with the explanations surrounding them do not fit into the established psychodynamic definitions of the defense mechanisms.…”

“…Errors happened in the areas of the therapist’s understanding of the basic premise of therapy, theoretical underpinnings of the therapy, gross neglect of therapy structure, use of non-specific terminologies and poor descriptions, over-inclusiveness, use of outdated techniques like JPMR. [ 23 24 25 26 27 28 48 49 51 52 53 54 77 78 79 80 81 82 84 85 86 87 88 89 90 91 92 95 96 97 98 99 100 ]…”