Obsessive-compulsive (DOC) disorder is characterized by the presence of obsessions and compulsions.
In fact, the person tends to catastrophically interpreted intrusive thoughts that we can all have, favoring the structure of obsessions, which cause discomfort and that are managed through dysfunctional strategies such as compulsive behaviors. But the latter are counterproductive and increase the salience of intrusive thoughts.
In addition to the classic symptoms, studies emerged from the studies patients with obsessive compulsive disorder they have more likely an insecure (anxious) attachment style. This is important in that if more attention was paid to the attachment of these subjects, it could also improve the outcome of the therapy.
The attachment system is in fact a motivational system that guides children to maintain proximity to those who take care of them, in case of danger or need.
The quality of these interactions leads to the formation of Internal operating models (Moi). These contain cognitive-emotional information on how we expect that the partner will respond to requests for support or protection or to the method with which we will receive care, love and support. During all development and adulthood, the moi tend to consolidate and become a real attachment style. That is, a stable cognitions and behaviors that are expressed in intimate relationships.
The attachment styles They can therefore be safe or insecure (anxious or avoidance) or disorganized. Research has shown how theanxious attachment play an important role in the psychopathology of several mental disorders, including the Obsessive Compulsive Disorder (DOC).
For most people, experiences that challenge sensitive domains for the self (for example having had a blasphemous thought for a very religious person), they are managed with coping strategies aimed at dissipating unwanted intrusive thoughts and promoting the restoration of emotional stability, without structuring themselves in obsessions.
It seems that the insecure attachment, also characterized by a poor emotional regulation capacity, can affect the ability to use the above coping strategies by contributing to the Development of obsessive compulsive disorder.
Chronic activation of the system of insecure attachment And in particular the anxious one can increase the readiness in acting (carrying out compulsions to restore safety), attention to intrusive thoughts (which are more likely to become obsessions), in particular those who threaten the sense of the self. These aspects can also have an impact on the treatment and construction of the therapeutic alliance.
A therapist should therefore consider the internal operating models of the DOC patient And to be a safe basis for him, favoring empathy, support and unconditional positive acceptance, aspects that should challenge the pre -existing relational patterns. For example, the fear of abandonment should be addressed to the exploration between this fear and the beliefs of obsessive compulsive disorder Related.
In conclusion, cognitive behavioral therapy, an election approach for this disorder, should be accompanied to a work on the patient’s insecure anxious attachment style, in order to encourage complete remission of symptoms, also starting from the basic patterns of the subject.
BIBLIOGRAPHY
Doron, G. et. Al (2011). Adult Attachment Insecurities are associated with compulsive obsessive disorder. Psychology and Psychotherapy: Theory, Research and Practice.
