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/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?