Obsessive-compulsive disorder (OCD) is often associated with repetitive behaviours such as checking, counting, cleaning, or seeking reassurance. However, behind these behaviours can be a distressing world of intrusive thoughts, anxiety, shame, and an overwhelming sense of responsibility.
From a psychoanalytic perspective, OCD can be understood not simply as a collection of symptoms, but as an attempt to manage difficult internal experiences.
Understanding OCD Through Early Relationships
John O'Connor (2007) proposes that obsessional thinking may develop partly in relation to the early interpersonal environment. He focuses particularly on the balance between protection and exposure.
A child's early caregivers provide a psychological “protective screen”, helping them manage experiences and emotions that they are not yet able to tolerate alone. Ideally, this protection gradually allows the child to explore the world while maintaining a sense of safety.
According to O'Connor (2007), difficulties may occur when this balance becomes disrupted.
Some children may experience excessive protection, learning that the outside world is dangerous and that certain subjects should be avoided.
Others may experience insufficient protection and become exposed to experiences, responsibilities, or parental emotions that are beyond their developmental capacity.
These experiences may contribute to a lasting sense that the world, and one's own thoughts and impulses, are difficult to control.
Importantly: This does not mean that overprotective or difficult parenting causes OCD. O'Connor presents this as one pathway among many. Research provides some support for an association between parenting experiences and OCD, but the evidence is more complicated than a simple cause-and-effect explanation.
What Does the Research Tell Us?
Chambless et al. (1996) examined parental bonding in adults with OCD.
People with OCD were more likely to describe their parents as using affection-less control, combining lower perceived warmth with greater control.
However, these parenting reports were not associated with the type or severity of OCD.
This finding supports the relevance of early relationships while also showing why we should be cautious about claiming that parenting styles directly produce OCD.
More recent research has provided further evidence for a relationship between parenting and OCD.
Wilcox et al. (2008) examined approximately 1,200 adults from 465 families and found associations between parental overprotection and OCD in offspring.
The researchers also found evidence that genetic and environmental factors may operate together.
Importantly, they concluded that prospective research was still needed to establish the direction of causality.
This fits with O'Connor's argument that early relationships may contribute to vulnerability without being a complete explanation for the disorder.
Defence Mechanisms: When Thoughts Become Threats
A psychoanalytic understanding also asks what purpose compulsions might serve.
O'Connor (2007) suggests that compulsive rituals can function as a substitute for a protective psychological shield.
When frightening thoughts or impulses feel intolerable, checking, counting, cleaning, or rumination may provide an attempt to control or neutralise them.
What if a compulsion is not simply a behaviour, but an attempt to create a sense of safety?
This idea can be compared with Rachman's (1998) cognitive theory of obsessions.
Rachman (1998) proposed that intrusive thoughts are not necessarily abnormal in themselves; rather, problems arise when the person interprets these thoughts catastrophically.
An unwanted thought may become especially threatening when it is interpreted as evidence that the person is dangerous or responsible for preventing harm.
Compulsions then become attempts to neutralise the perceived threat.
The two perspectives are different, but they can complement one another.
A cognitive approach focuses on how intrusive thoughts are interpreted in the present, while O'Connor's psychoanalytic approach asks how a person's capacity to tolerate difficult feelings and experience safety may have developed over time.
Developmental Issues: Responsibility and Control
O'Connor also discusses situations in which children take on responsibility for problems within their family.
A child who feels responsible for protecting a vulnerable parent, managing family distress, or preventing something terrible from happening may develop an exaggerated sense of personal responsibility.
This idea is particularly relevant to OCD because responsibility and the need to prevent harm are common themes in obsessional thinking.
Salkovskis (1985) similarly proposed that intrusive thoughts become especially problematic when they are connected to an exaggerated sense of responsibility for preventing harm.
It is important to remember: Not everyone with OCD has experienced parentification, trauma, or overprotection. OCD is a complex disorder with multiple contributing factors. Childhood experiences may influence how people learn to understand danger, responsibility, and their own thoughts, but they should not be treated as a universal explanation.
Looking Beyond the Compulsion
A psychodynamic approach to OCD does not simply ask, “Why does this person keep checking?”
It also asks:
“What does the checking protect the person from?”
From O'Connor's perspective, a compulsion may represent an attempt to create an internal sense of protection that was not sufficiently developed through early relationships.
Understanding the function of the compulsion can therefore provide another way of understanding the person's distress.
A More Balanced Understanding of OCD
OCD may involve a painful struggle between thoughts, feelings, responsibility, and the need for safety.
O'Connor's theory offers one way of understanding this struggle by focusing on protection and early relationships, while cognitive research highlights the importance of how intrusive thoughts are interpreted and neutralised.
Considering these perspectives together provides a more balanced understanding of OCD, one that recognises the importance of developmental experiences without reducing the disorder to childhood or parenting alone.
References
Chambless, D. L., Gillis, M. M., Tran, G. Q., & Steketee, G. S. (1996). Parental bonding reports of clients with obsessive-compulsive disorder and agoraphobia. Clinical Psychology & Psychotherapy, 3(2), 77–85. View research
O'Connor, J. (2007). The dynamics of protection and exposure in the development of obsessive-compulsive disorder. Psychoanalytic Psychology, 24(3), 464–474. View research
Rachman, S. (1998). A cognitive theory of obsessions: Elaborations. Behaviour Research and Therapy, 36(4), 385–401. View research
Salkovskis, P. M. (1985). Obsessional-compulsive problems: A cognitive-behavioural analysis. Behaviour Research and Therapy, 23(5), 571–583. View research
Wilcox, H. C., Grados, M., Samuels, J., Riddle, M. A., Bienvenu, O. J., Pinto, A., Cullen, B., Wang, Y., Shugart, Y. Y., Liang, K.-Y., & Nestadt, G. (2008). The association between parental bonding and obsessive compulsive disorder in offspring at high familial risk. Journal of Affective Disorders, 111(1), 31–39. View research
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