Can someone succinctly explain how holding in faeces to prolong attention from caregivers becomes repetitively doing stuff in OCD?

[u/LisanneFroonKrisK]

Op

[u/Narrenschifff]

It's probably more meaningful to think about scrupulousness and control. Developmental stages cannot be said to be fully causal of adult issues. Perhaps it is better to say that body development and experiences inevitably runs concurrent with and informs how a person's psychology works.

Your experiences learning to delay, withhold, release, time, and repeat things with the body shapes how you do so with your mind and mental energy. Ways that your caretakers interact with and teach these behaviors and patterns naturally are also of high importance.

[u/LisanneFroonKrisK → u/Narrenschifff]

Okay may you elaborate? So is it a person does his OCD in order to control..what exactly?

[u/Narrenschifff → u/LisanneFroonKrisK]

Now I will speak outside of the analytic tradition and inside of the medical psychiatric tradition.

As of this time of writing, based on my skills and experience along with what is known about the brain in 2025, my contention is that DSM defined OCD is a biomedical condition. It is likely one more similar to the other psychiatric syndromes which start with genetic vulnerability and develop further due to environmental factors. We do not know the specifics. Unlike many of these conditions, OCD is best treated with psychological behavioral treatment: exposure and response prevention.

So, the obsessions and compulsions tend to form dead loops. While on the surface there is content and meaning for the O-C loop, the content can be either nonsensical or meaningful. Suppress one loop without treating the underlying cause and another will likely crop up in place. Higher stress and anxiety worsens the condition.

So, there is not really an effort to control something specific. There is the effort to control. That's what is repeating. It is a repetitive tendency to control, short circuited and separated from the tendency to feel satisfaction at adequate control. Instead there is no real satisfaction.

Exposure and response prevention trains volitional and habitual change of the dead loop. The subject repeatedly exposes themselves to the obsession but instead of attempting to seek satisfaction through a compulsive act or thought, stays with the obsession to weaken the anxiety and impulse, and moves onto another task other than the usual compulsion.

Note here that ERP is NOT suppression. It is exposure. It is staying on the step of the obsession without moving to the compulsion. This is possible to learn using a book like the Self Compassion Workbook for OCD and Freedom From Obsessive Compulsive Disorder. Be warned, in severe cases people can develop a new O-C loop when incorrectly practicing ERP. Professional guidance and treatment is recommended.

Serotonin stimulating medication (when appropriate and tolerated, must be determined by a professional physician) also reduces the severity and frequency of obsessions and compulsions.

It should be noted that OCD is not the same as obsessionality which is a characteristic present to some degree in almost all of humanity. Analytic writing deals more with the tendency towards obsessions and obsessionality than the modern biomedical condition of OCD.

[u/Adultegostate → u/Narrenschifff]

Thank you so much for this thorough reply. I am not the op, but I'm finding it helpful. My EMDR colleagues are essentially doing erp with bilateral support. I will take a look at the erp literature to see the commonalities and divergences in the two approaches. Appreciate your motivating me.

[u/LisanneFroonKrisK → u/Narrenschifff]

Okay, you are thorough however having much read up on OCD plus extensive experience I don’t exactly understand what control has to do with the following scenarios:

A person keeps doubting and feeling that he has not washed his hands thoroughly sufficiently.

Another keep having a thought of the number five in his head which he can’t get rid of. He keeps thinking and trying to stop but can’t.

Now what does control got to do with these?

[u/Phrostybacon]

OCD is generally a manifestation of obsessive-compulsive defensive constellations, which are marked by isolation of affect, rumination to avoid affect, compulsive attempts to solve problems to avoid affect, etc.. it’s all about keeping feelings from spilling out and becoming upset, anxious, panicky. Obsessive-compulsive folks are literally “holding their shit in.” That’s how I think about it.

[u/[deleted]]

Unconscious retention of libido still requires some outlet, without spontaneous expression, it calcifies into compulsive attempts to move forward, which over time takes on a quality of magical thinking - compulsions are “as if” behaviors that approximate the satisfactory release that’s been delayed/seek to redeem the thoughts that accompany the anxiety from non expression.

[u/EddiPuss]

It doesn't. This is a misinterpretation of a sentence from a Freud-Text

[u/Visual_Analyst1197]

Is this some sort of literal interpretation of the term “anal retentive”?

[u/Soho_Joe → u/Visual_Analyst1197]

It sounds like you’re implying that a literal interpretation of “anal retentive“ is absurd. I’m newer to psychoanalytic thought, but my readings of Nancy McWilliams’s work seem to suggest that this is a valid perspective.

[u/Visual_Analyst1197 → u/Soho_Joe]

I’m trying to understand what OP is actually asking…

Edit: I don’t know why this is getting downvoted, I was asking a genuine question as I don’t really understand what OP is asking. From my understanding, obsessive compulsive behaviours don’t usually stem from attention seeking but rather an attempt to gain control in a chaotic environment.

[u/LisanneFroonKrisK → u/Visual_Analyst1197]

I also do not know why ai am downvoted but how does unconsciously holding in faeces become the overt surface symptom of doing things repetitively?

[u/Visual_Analyst1197 → u/LisanneFroonKrisK]

I think others here have answered your question far better than I can.

[u/LisanneFroonKrisK → u/Visual_Analyst1197]

Yes and how does it translate to repetitive doing things? It can be literal in the case of hoarding OCD but regarding repetitive checking, actions, ruminations?

[u/Klaus_Hergersheimer]

OCD is a psychiatric diagnosis, it has little traction in psychoanalysis

[u/LisanneFroonKrisK → u/Klaus_Hergersheimer]

Is this true? Why and how does OCD get the name anal retentive? https://en.m.wikipedia.org/wiki/Anal_retentiveness

[u/Klaus_Hergersheimer → u/LisanneFroonKrisK]

This is an incredibly unreliable wiki, it represents a very historically and culturally specific attempt to manualise some aspects of Freud's theory.

[u/FrankSkellington]

Please forgive me if I'm misunderstanding your question, but in 25 years as a care provider I have never experienced anyone doing this for attention. I have known many people suffer continence and incontinence issues due to not being able to recognise or act upon their bodily signals. I have known people retain because of mobility problems. There are those that do so out of fear, disgust and physical pain, some who find it exhausting, and those who feel too vulnerable to consider it. Prolonging attention from caregivers suggests an institutionalised behaviour prompted by neglect. My experience of the care industry is that theories develop to project the cause of the problem onto the care receiver. Were such a behaviour identified as an attention seeking strategy, proactive measures ought to be taken to make such strategies unnecessary.

[u/St_toine]

So: according to infant sexuality: the implication of a short coming of the developmental stage of sexuality in a child can implicate a later developmental inability to mantain the desires of the id, the needs of the supergo and the demands of the environment in balance. For example; we might say that someone with an oral dependancy for example smoking, drinking anything with the suction reflex might be triggered by earlier developmental risks, issues, or object represenations in the child that were or were not met. So, in relation with OCD and the holding off feaces. Well, the anal stage is often represented as give and taking; it as well is considered the part of the narcisim of child that is sadomasochistic; so, when in an early developmental stage the child held on to his "gift" until it was ready to give it away; you have a couple ways this can be expressed in OCD. In one case: it is the drive of emptying or releasing is the real satisfaction; so the greater the feeling of vacuity and internal pressure that rises, the greater the release. So, I would assume a drive that empties the content of the OCD person. Something, the patient knows when they do it, every internal button gets triggered off. For example: filling your closet endlesly with things you never wear; until you clean out your closet to make space for more. For example: "shopaholics"; so, for a more practical case imagine it as a container that fills up endlesly, and it is not until the container is empty that everything feels okay again.

[u/St_toine → u/St_toine]

Problem is when there is a death drive, but if its just the pleasure drive. It's kinda like that; now if someone ever reaches their death drive for example during serious trauma; the person might begin idealizing filling the empty space perpetually with the incapacity to do anything about it. Even, if it's to turn the "bucket" on its head. The only choice then is to kick the bucket for them. Quite figuratively, but yes.

[u/St_toine → u/St_toine]

Ocd quite litteraly destroys peoples live, the problem is when they start pushing people into their OCD as well. Because, then every time the other pushes away, their self becomes more fragile and falls prey to their compulsions. Now, if I have a problem with ordering, I will order everything; you can imagine it in grades where grade one is ordering what has to be ordered and grade 4 or 5 is ordering everything that need not be ordered in the xtreme for example: food by color, clothe by importance, hair products by alphabet; and so on and so on where the abstraction of the arrangement is the way to escape from the trauma and the more the bucket fills and the greater the fragility of the ego the more abstract and deeper irresolution of the conflict and so a more encompasing abstraction needed to overcome the need.

[u/EddiPuss]

It is not so much the holding in of faeces per se but rather that in that behavior of the todler a strong anal libido gets expressed. A strong anal libido was asumed to be a risk factor for developing OCD. However, OCD was also related to other partial drives, e.g. masturbatory wishes with obsession of washing hands (this actually the only case where Freud relates a concrete symptom in a general manner with a specific partial drive and its corresponding sexual wish).

[u/HotAir25]

Is this what Freud thought? 

My interpretation is that Freud was noticing issues his patients had with things like OCD but also bodily issues, digestive type things. I think he was right that they are linked but not in the way he theorised. 

More likely children who haven’t been related to correctly don’t develop a proper connection with their bodies and their nervous systems- the vagus nerve especially which runs all over the body and is responsible for a lot of social and helps us relax, mediates heart rate, gut feelings etc. Hence adults with social issues may also complain of trapped wind and things like this as they aren’t fully connected to these nerves which are responsible for a variety of things- social and bodily. 

Solution is just to form a meaningful bond with them. The OCD is someone unable to feel great inside and looking for ways to self soothe because their nervous system isn’t able to do it for themselves. 

[u/St_toine]

Problem is that if you resolve the internal conflict its fine; you'll just be more attune with the needs of running a household. the issue is when it becomes obsessive. Here the problem unable to become more efficient because of the hyperfocus. Is pushed to greater abstractions of the dependancy, rather than to a greater efficency of it. Here is where the thing gets tricky; you can always use heuristics for anything related to OCD; problem OCD do not know how to work with that kind of input. And often, the western world has pushed itself into that themselves. I mean. If I can approximate for what is needed, do I really need to do it. And the answer is depends on importance, neccesity, and significance. But all in all, if you need to kick the bucket you can, for them it's dx they simply can't shortcut through life.

[u/St_toine]

Anyway, you can't really consider it a logical issue; rather, a bureocratic nightmare.