Obsessions and compulsions have likely been around since humans first roamed the earth. In the 6th/7th century AD, John Climacus, a monk living in the Sinai Desert wrote of worshippers who were troubled by intrusive “blasphemous thoughts”, which kept them from their prayers and plunged many into despair. Some of the world’s great artists and thinkers are believed to have suffered from Obsessive Compulsive Disorder (OCD) including Michelangelo, Martin Luther, Charles Darwin, and Beethoven. Darwin reportedly worried that his children would inherit the condition and tried to prevent such thoughts by “closing his eyes firmly” (to no avail). More recently, the industrialist and film producer Howard Hughes famously suffered from contamination fears, and numerous current celebrities have talked about living with OCD including Charlize Theron, Jessica Alba, David Beckham, and Justin Timberlake.
As with any mental health condition, the treatment and conceptualization of OCD has changed over time. In the 1600’s, obsessive thinking was seen as a spiritual and moral issue and was often associated with “religious melancholy”. Many Catholic theologians of the time advised strict obedience to one’s spiritual teacher as a way to overcome scruples (doubt or hesitation about the morality of one’s actions). In the 1700’s, some doctors reportedly used bloodletting, enemas, and laxatives to try and relieve patients of obsessional thinking. In the 1800s, many doctors viewed obsessions and compulsions as the product of a disordered intellect, and some OCD sufferers were locked up in insane asylums. Around 1900, Sigmund Freud posited that obsessions and compulsions were maladaptive responses to unacceptable violent or sexual urges. Freud’s view dominated the mental health field throughout the first half of the 20th century. Seen as a symptom of subconscious problems, obsessions and compulsions were often treated via psychoanalysis. This had the adverse effect of encouraging clients with OCD to dive deeper and deeper into analysis of their thoughts, which caused their OCD to get worse.
With the emergence of behavioral therapy in the 1960’s and 1970’s, things began to change. Around this time, some therapists were having success treating phobias with an approach called systematic desensitization. Rather than looking for the “root cause” of a person’s obsessions, these therapists gradually exposed their clients to their fears while they were engaged in some sort of relaxation activity. Out of this, emerged Exposure and Response Prevention, which is considered the “gold standard” for OCD treatment today.
John “Andy” Bradshaw, Associate Marriage & Family Therapist #101517 (supervised by Dino Di Donato, MFT #39831) focuses on the treatment of OCD and anxiety at Market Street Center for Psychotherapy. You can contact him at (510) 599-9845 or firstname.lastname@example.org.