As a result of Freud’s examinations regarding obsessional-compulsive symptoms, he identified two important elements. First, it is striking that there is a constant effort against what is repressed in these symptoms. The conflict increasingly begins to resist the repressing forces with greater power. The second is the fact that the ego and the superego play a major role in the formation of these symptoms.
It is also a fact that the superego becomes harsher in compulsion neurosis. Obsessive neurosis is a struggle against the emergence of repressed and forbidden material that is not consciously recognized. Obsessions are generally related to religious, moral, in other words, social and normative values. The obsessions of a person who is extremely strict and sensitive about religious values will revolve around religion and its derivatives, surrounding the individual and causing distress. There is always a main moment-symptom, a primary obsession.
Later symptoms will again be derivatives of this main obsession and will continue to trouble the person frequently, and when necessary, appear in different forms by changing shape. When considering the characteristics of these symptoms, their relationship to social and moral values shows, as Freud stated, that they are indeed produced by the superego. Everyone has a past and a memory in which the past is recorded. Some experiences, memories, emotions, and thoughts are pushed down under newer memories and experiences. If this material has not been repressed but merely accumulated beneath, it can be recalled, and the person may remember them. Naturally, these recollections come to consciousness through associative links triggered by life events. However, some memories, emotions, thoughts, etc., are forced to be repressed at the period in which they were felt and experienced due to the mental conditions of that time. What is repressed is forbidden and should not be thought about. Therefore, they are forgotten and pushed far back. These repressed materials begin, after a while, to exert pressure on consciousness.
That is, they want to find a place for themselves within the conscious level. Their desire to surface can also be triggered by certain current, life-related events. For instance, during a period of intense anxiety, these materials may be triggered. This is why, for some patients, we prefer to simply say “it happened due to stress” and try to make sense of something seemingly meaningless. Although stress does have an effect on the psychic structure, it is not the true origin of certain obsessions and intrusive thoughts that trouble us. These already exist, are repressed, and are waiting for the ego’s moment of weakness to emerge.
The ego, in an attempt to protect itself, uses certain sensitivities of the superego to prevent this repressed material from surfacing. To reduce the pain that arises from repression, the ego produces symptoms that occupy the person, create distress, and ease the burden created by repression. Why would a person’s ego produce symptoms of illness? Why would someone need a debilitating issue like an obsession that interferes with daily life?
Anxiety is a state felt at the conscious level. Symptom formation serves to eliminate anxiety. Thus, the first felt state in some psychological disorders is anxiety. An obsessive–compulsive patient wants to wash their hands after touching something, and if this desire is prevented, they become overwhelmed by uncontrollable anxiety. Here, the compulsion to wash hands becomes both the aim and the result because its core function is to block anxiety. The thought “If I don’t wash my hands, something bad will happen to my loved ones” decreases temporarily after washing, giving a short-term sense of relief. This is why, in psychotherapy, even though individuals want treatment, they simultaneously want to preserve the old state; this seeming contradiction actually has internal logic. As stated by an obsessive–compulsive client who inspired this article: “I have preserved my obsessions for years,” “I didn’t pick these up from the street.” This reflects that unless the true source of anxiety—unknown to consciousness—is found, the person does not want to let go of their obsessions.
The unconscious conflict behind the emergence of psychological symptoms and the lack of pleasure created by this conflict lead to substitute pleasures forming in the symptom. Ultimately, symptoms serve as methods of warding off anxiety. When anxiety is perceived as danger, the symptoms created by the psychic structure aim to protect the ego from this danger. In this sense, the symptoms of illness actually prevent greater damage to the ego. They originate from the ego and serve to protect it. Seen in this equation, a complex situation emerges. Understanding and treating disorders—and explaining why symptoms may appear suddenly without a major external cause—indicates that the psychic structure is not simple. When symptoms are abruptly suppressed, a greater danger arises for the ego, which may approach disintegration. Therefore, the emergence of symptoms prevents the psychic state from progressing to much more dangerous stages. As a simple analogy, a warning light in your car may be annoying at the moment, but is beneficial in the long run to avoid being stranded. What matters is understanding the meaning behind the signal when it appears.
This absolutely does not mean that one must live with an illness. On the contrary, it emphasizes the importance of examining symptoms at the moment they arise. It highlights how they should be approached and the necessity of avoiding the idea of “fix it immediately.” It should be remembered that the formation of a problem is a process that takes years. Moreover, the emergence of a problem may sometimes be the product of unconscious conflicts. Anxiety creates the symptom, and during illness, the person feels anxiety about their condition. While the ego tries to minimize the tension of anxiety (such as an obsessive person washing their hands, a panic attack patient focusing on their heart or the fear of a heart attack, or a depressed patient becoming inactive and losing motivation), it also attempts to use anxiety merely as a signal. As a whole, inspired by Freud’s ideas and simplified by me, this process shows that the inability to obtain instinctual pleasure seeks other outlets. Substitute pleasures appear in symptoms. For example, individuals with obsessions about cleanliness and order want to be seen as clean and tidy, replacing internal pleasure with an external, social pleasure to compensate for the lack of internal satisfaction.
Source
Freud Sigmund. Anxiety. Dergah Publishing, April 1972
