A Review of The Contributions of Adulthood Attachment Orientations to Development of Obsessive-Compulsive Disorder: An Illustration of Psychotherapy Integration

Öz

Obsessive-compulsive disorder (OCD) is one of the most disabling and highly prevalent anxiety disorders. Cognitive models of OCD propose that negative evaluation of intrusions occur as a consequence of underlying maladaptive beliefs, such as inflated responsibility, overestimation of threat, intolerance for uncertainty, perfectionism, the need to control thoughts, and over-importance of thoughts. Although cognitive models have enhanced the knowledge and treatment of OCD, they have been criticized for focusing largely on maintaining and exacerbating factors of OCD-related beliefs and neglecting the developmental and motivational factors, such as early attachment and parenting behaviors (Doron & Kyrios, 2005; O'Kearney, 2001). It is argued that consideration of underlying vulnerabilities, such as attachment insecurities and early experiences of parenting may lead to a broader understanding of the development and maintenance of OCD-related beliefs and symptoms. Thus, the current paper consists of four main parts reviewing the roles of attachment insecurities, self-views, and parental attitudes in the development of obsessive-compulsive symptomatology. In order to demonstrate the importance of understanding these factors while dealing with a patient having OCD, the case of Ms. D. is illustrated. Ms. D., who is directed into our clinic with the diagnosis of obsessive-compulsive disorder, is a 21 years old, second-year university student. Her obsessions have involved the theme of contamination and that her entire body would be invaded by germs. In response to these obsessions, her compulsions have involved washing hands, using disinfectants, and cleaning the furniture in her house with a rigid routine after coming from the outside.

Anahtar Kelimeler

• Obsessive-compulsive disorder,Insecure Attachment,Parental Attitudes

Yetişkin Bağlanma Biçimleri ile Obsesif-Kompulsif BozuklukArasındaki İlişkinin İncelenmesi: Psikoterapi UygulamasınaBir Örnek

Öz

Obsesif-kompulsif bozukluk (OKB), bireylerin işlevselliğinde gözle görülür bozulmaya sebep olan oldukça yaygın anksiyete bozukluklarından biridir. Bilişsel modellere göre OKB semptomlarının şiddetlenmesinde, istem dışı girici (intrusif) düşüncelerin işlevsel olmayan inançlar sonucunda hatalı olarak yorumlanması ve bu düşüncelere atfedilen önem, önemli bir rol oynamaktadır. İşlevsel olmayan inançların oluşumunda rol oynayan bağlanma örüntüsü ve ebeveyn tutumları gibi gelişimsel faktörlerin incelenmesi ve altta yatan süreçlerin de anlaşılmasıyla birlikte bilişsel modeller temelinde oluşturulan tedavi yöntemlerinin geliştirilebileceği öne sürülmektedir. Bu makalede, bazı temel terminolojik açıklamalarla birlikte, obsesif-kompulsif belirtiler ile kişilerin bağlanma örüntüleri ve benlik algıları arasındaki ilişki ampirik çalışmalardan elde edilen bulgular ve klinik deneyim bazında incelenmiştir. Son kısımda ise, OKB tanısı ile takip edilen bir vaka anlatılarak, bu konunun psikoterapi açısından önemi ve uygulamanın nasıl yapılacağı tartışılmıştır.

Anahtar Kelimeler

• Obsesif-kompulsif bozukluk, güvensiz bağlanma, ebeveyn tutumları

Kaynakça

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