A Specific Developmental Deficit in Obsessive-Compulsive Disorder: The Example of the Wolf Man

289  Dr. Meares is Professor of Psychiatry, University of Sydney; Academic Head, Western Area of Sydney Mental Health Services. In this paper I suggest that the origins of the “contamination/ cleaning” form of obsessive compulsive disorder (OCD) include a developmental history characterized by marked overprotectiveness allied with parental failure to respond to core aspects of the child’s personal reality. The combined effect of these parental behaviors is likely to impede the establishment of a mature conception of the boundary between inner and outer worlds. The consequence of such a deficiency is the persistence of the magical form of thinking which is essential to the production of OCD. In addition, the individual is left with a disruption of personality development, the main features of which include timidity and falseness. The Wolf Man provides an example of both the characteristic development history in OCD and its consequences. Treatment based on this theoretical background may provide benefit not predicted by current psychoanalytic pessimism.