While walking on the street, I repeatedly turn around to check behind me—over and over again. I wonder if I have harmed someone… Did I bump into someone and make them fall? Did I hurt an elderly person or a child? I know it sounds strange, but I cannot stop myself.
I have to wash my hands very frequently, and this bothers the people at home. I cannot wear colorful clothes; they must be either white or black, and if I wear an outfit that day, I must wash it as soon as I get home. I dry it overnight and feel compelled to wear the same clean clothes again the next day. For months, I walk around in the same clothes because they are “clean.” I do not find the house clean enough, and because of this, I argue with my mother. When my dirty laundry mixes with the dirty laundry of other family members—my mother, father, or siblings—I panic, because I believe if our clothes mix, I might harm them in some way. This terrifies me.
I am deeply afraid of harming the people around me. It feels as if anyone who comes into contact with me will somehow be harmed by me, or that I am causing harm without realizing it. Sometimes, when I am with my friends, I call them repeatedly after they go home—just to check if they arrived safely. Only after confirming they are home do I feel relieved. Because if anything happened to them after being with me, it would be my fault.
I hold my urine until the point where I almost wet myself; only then can I go. I do not know why. I rarely use bathrooms outside the home. If I am forced to use one, I must clean the toilet seat and the area thoroughly, and even then, I can use it only with great distress.
I used to drive, but I no longer do. Because when I had to reverse, constantly turning around and checking the mirrors exhausted me—I kept thinking I might have run over someone or hit someone. I eventually stopped driving entirely. I was also worn out from checking my sides, behind me, and in front of me constantly in traffic.
I cannot relax—because I do not know what it means to feel relaxed. I walk fast as if I am running or escaping. If someone in front of me is walking slowly and blocking my way, I become irritated. But then I try to correct this thought, because I fear that if I think badly of them, something bad might happen to them—and it would again be my fault.
It feels as though I must be in control of everything in my life, and everything must remain under my control. I cannot touch many things because my hands will get “contaminated,” and then I must wash them repeatedly and a certain number of times. I avoid touching surfaces. It feels as if touching anything is forbidden. Oddly, I like following rules—rules make me feel safe.
Now that I think about it, these behaviors began when I was very young. For example, in adolescence I would try to walk without stepping on the lines on the road, or I would silently count odd and even numbers in my mind. Everything had to be even; if it was odd, it meant bad luck. My mother is also a meticulous person, but I have surpassed her—she even tells me, “You have outdone me.”
The story above reflects only some of the complaints frequently shared by many patients who come to the clinic with obsessive–compulsive disorder. Obsessive–compulsive structure—known in Turkish as “tendency toward obsession and compulsion”—is very common in hospitals and clinics. This condition often causes significant social and economic difficulties in individuals’ lives. Conceptualization and scientific discussion of this condition dates back to 1838, when Esquirol classified Mademoiselle F.’s “partial insanity” as a type of “reasoning or impulse monomania.” Before this, obsessive–compulsive behaviors had long been explained in social or religious terms. Esquirol defined “impulse monomania” as involuntary, uncontrollable, and impulsive activity. Here, the concept of “impulse” is crucial. In this writing, I will attempt to evaluate this condition from a psychodynamic perspective. Since psychodynamic therapy emerges from psychoanalysis, I will inevitably refer to impulses. Because unless the underlying dynamics of a condition are understood and worked through, all interventions will remain at the symptomatic level; the unconscious roots of the condition will remain unresolved.
If we look carefully, the complaints above all reflect central themes: touching or not touching, isolation, contamination, impurity. Therefore, I will examine these concepts under subheadings using psychodynamic explanations.
Taboo
The meaning of a taboo splits in two opposing directions. On one hand, it signifies something “sacred” or “divine,” and on the other, something “mysterious,” “dangerous,” “forbidden,” or “impure.” Thus, a taboo refers to something one must not approach, and it fundamentally expresses prohibitions. Taboo restrictions differ from religious or moral prohibitions; they do not originate from divine command (Freud, The Origins of Religion). Wundt (1906) described taboos as humanity’s oldest unwritten laws. According to Freud, the person who violates a taboo becomes taboo themselves. In obsessive–compulsive structures, individuals exert tremendous effort to avoid becoming taboo. They create personal taboos and prohibitions, and—much like members of a primitive tribe—they adhere rigidly to these self-created rules (even when their explanations are conscious, the underlying process is unconscious).
The archaic self of the obsessive–compulsive individual resembles the thought system of primitive tribal communities. It is as if their mindset has regressed into an archaic identity. The most striking similarity between obsessive taboos and primitive taboos is that both lack identifiable motives and appear irrational in origin. Once they emerge, they persist irresistibly. There is no need for an external threat because there is an inner certainty that violating the taboo will result in catastrophic consequences (“something terrible will happen to my loved ones”). The exact nature of this harm is unknown; understanding comes only through acts of atonement or rituals. In taboo, the central theme is touching—not touching what is forbidden. In obsessive–compulsive structure, touching and avoiding touch become core dynamics.
Obsessive prohibitions easily shift over time and may attach themselves to new objects. OCD patients live as though they carry a contagious and dangerous substance, which they can transmit to others through touch. One of my patients once said he felt as if he were “cursed,” and that this curse would spread to anyone or anything he touched.
I will give an example that shows the striking similarity between OCD patients’ beliefs about contamination and the beliefs of indigenous tribes regarding taboo violations.
Frazer and Taylor (1870) describe: A New Zealand chief will not blow on a fire because his sacred breath will pass into the fire, then into the pot above it, then into the meat cooking inside, and finally to the person eating the meat—causing their death due to the chief’s sacred (taboo) breath.
A remarkable parallel exists between the chief’s statement and what one of my patients said:
My patient explained: “If I cough or make a sudden movement, or if my hand touches my underwear, semen may get on my hand. And if semen gets on my hand and I touch another man, and he later touches a woman, she may get pregnant from my semen.” Touching his underwear is akin to violating a taboo; touching someone afterward would “transmit” the contamination. This clearly reflects both the contagiousness of taboo and the belief that the person who violates it also becomes taboo. Ritual cleansing—washing—is the most common act of atonement. These rituals occur in structured forms: washing hands or body a specific number of times (five, ten, etc.), entering the bathroom with the right foot first, placement of soap, how it is held—everything must follow a strict order.
If we summarize the common features of taboo practices and obsessive–compulsive behaviors:
- 1 — The prohibitions lack a clear or identifiable motive
- 2 — They persist without any external enforcement
- 3 — They easily shift objects and involve fear of contamination
At this point, I would like to continue explaining obsessive thoughts further.
In France, instead of the term “obsessional neurosis,” the condition is described as a persistent state in which the individual’s mental functioning becomes blocked—an ongoing state of being stuck. The person cannot move psychologically. This state of “stuckness” is an accurate description of neurosis: a narrow tunnel of unending conflict between opposing forces—desire and prohibition, love and hate. To maintain emotional balance between these contrasts, compulsions arise. For example, insisting on even numbers can be seen not only as striving for fairness but also as an attempt to maintain equilibrium. This excessive effort resembles the “voluntary sufferers” described in psychosomatic illnesses. In OCD, this struggle suppresses the functionality of impulses and at times nearly eliminates them. This is why obsessional neurosis is, at its core, a symptom complex rooted in intense instinctual conflict.
Isolation
When speaking about the prohibition of touch, we see that concepts such as dirtiness, cleanliness, and purity influence even thought itself. Because certain ideas or impulses are considered forbidden, the individual isolates thoughts from emotions and behaviors, preventing connections among them. It is as if these thoughts are open electric wires—touching each other would cause an explosion of overwhelming energy. This gives us an idea of the magnitude of energy beneath the obsessive structure.
The difference is similar to focusing on an object versus being unable to think of anything except that object. (This is why it is sometimes said, “The love of an obsessive is eternal.”) Becoming excessively attached to an object—or rather the idea of the object—helps isolate emotions and thoughts from each other. Obsessions occupy time and prevent investment in desires or impulses.
Investing in thoughts—more accurately, obsessive thoughts—is central to obsessive neurosis. In hysteria, repression is directed toward ideas; in obsessionality, repression is directed toward affects. Because of this, some severely obsessive individuals—whose affect is almost entirely blunted—can be difficult to distinguish from psychosis. However, isolation and affect suppression differ fundamentally from the extinguishing of impulses seen in psychosis. Overinvestment in thought and words occurs through undoing and isolation.
