It is widely agreed that obsessive-compulsive disorder involves irrationality. But where in the complex of states and processes that constitutes OCD should this irrationality be located? A pervasive assumption in both the psychiatric and philosophical literature is that the seat of irrationality is located in the obsessive thoughts characteristic of OCD. Building on a puzzle about insight into OCD (Taylor 2022), we challenge this pervasive assumption, and argue instead that the irrationality of OCD is located in the emotions that are (...) characteristic of OCD, such as anxiety or fear. In particular, we propose to understand the irrationality of OCD as a matter of harboring recalcitrant emotions. We argue that this account not only solves the puzzle about insight, but also makes better sense of how OCD sufferers experience and describe their condition and helps explain some otherwise puzzling features of compulsive behavior. (shrink)

An influential model holds that obsessive–compulsive disorder is caused by distinctive personality traits and belief biases. But a substantial number of sufferers do not manifest these traits. I propose a predictive coding account of the disorder, which explains both the symptoms and the cognitive traits. On this account, OCD centrally involves heightened and dysfunctionally focused attention to normally unattended sensory and motor representations. As these representations have contents that predict catastrophic outcomes, patients are disposed to engage in behaviors and mental (...) rituals designed to forestall these outcomes or to produce more precise information. The same representations also cause the cognitive traits characteristic of sufferers. (shrink)

Obsessive-compulsive disorder (OCD) is considered to be one of the more common serious mental disorders, with a prevalence rate of about 1% (Heyman et al. 2006). It is characterized by obsessions, or compulsions, or both. According to the DSM-IV (American Psychiatric Association 1994), obsessions are “recurrent and persistent thoughts, impulses, or images that are experienced at some time during the disturbance, as intrusive and inappropriate and that cause marked anxiety or distress.” Compulsions, on the other hand, are repetitive (...) behaviors (e.g., hand washing, ordering, checking) or “mental acts that the person feels driven to perform in response to an obsession, or according to rules that must be applied .. (shrink)

In this chapter we give an overview of current and historical conceptions of the nature of obsessions and compulsions. We discuss some open questions pertaining to the primacy of the affective, volitional or affective nature of obsessive-compulsive disorder (OCD). Furthermore, we add some phenomenological suggestions of our own. In particular, we point to the patients’ need for absolute certainty and the lack of trust underlying this need. Building on insights from Wittgenstein, we argue that the kind of certainty the (...) patients strive for is unattainable in principle via the acquisition of factual knowledge. Moreover, we suggest that the patients’ attempts to attain certainty are counter-productive as their excessive conscious control in fact undermines the trust they need. (shrink)

Obsessive-Compulsive Disorder and Uncertainty examines the intrapsychic features of the self as it presents within OCD compulsive doubting. Moshe Marcus and Steven Tuber suggest a phenomenological framework through which to consider the interplay between the cognitive as well as affective components required to make judgments.

Obsessions are internalized compulsions, and compulsions are externalized obsessions.

Epistemic akrasia is the phenomenon of voluntarily believing what you think you should not. Whether epistemic akrasia is possible is a matter of controversy. I argue that at least some people who suffer from obsessive–compulsive disorder are genuinely epistemically akratic. I advance an account of epistemic akrasia that explains the clinical data and provides broader insight into the nature of doxastic attitude‐formation.

Obsessive fears are unconscious desires. The woman who is obsessively afraid that her phone is tapped actually wants her phone to be tapped; that is, she wants someone to pay attention to her. A neurotic fear of such and such is actually an unconscious desire for such and such, this being the topic of this brutally honest exchange.

Obsessive-compulsive disorder (OCD) and other psychiatric disorders can interfere with a person’s capacity to control the nature of his mental states and how they issue in his decisions and actions. Insofar as this sort of control is identified with free will, and psychiatric disorders can impair this control, these disorders can impair free will. The will can be compromised by dysregulated neural networks that disable the mental mechanisms necessary to regulate thought, motivation, and action. Neural and mental dys-function result in (...) the maladaptive and pathological behaviors associated with these disorders. In “Obsessive-Compulsive Disorder, Free Will, and Control,” Gerben Meynen (2012) rightly .. (shrink)

My concern is this paper is to consider the nature of obsessive thoughts with the aim of getting a clearer idea about the extent to which they are rightly identified as passive or as active. The nature of obsessive thoughts is of independent interest, but my concern with the question is also rooted in a general concern to map the extent of mental activity, and to defend the importance and centrality of a view of self-knowledge that appeals to agency. I (...) hold that much of our mental lives is active, and that the distinctive knowledge we have of our own minds is in many cases best explained by appealing to agency. Along with many others, I take knowledge of our actions and activities to be distinctive. We know our actions and activities in a way that we do not know anything else, and in a way that is distinctively and essentially self-conscious. (shrink)

The present studies were motivated by the hypothesis that attenuated access to internal states in obsessive-compulsive (OC) individuals, which leads to extensive reliance on external proxies, may manifest in a maximizing decision making style, i.e., to seeking the best option through an exhaustive search of all existing alternatives. Following previous research, we aimed to explore the possible relationships between OC tendencies, seeking proxies for internal states, indecisiveness and maximization. In Study 1, we measured levels of OC tendencies, seeking proxies for (...) internal states, indecisiveness, maximization, depression and anxiety in an online Hebrew speaking sample (N = 201). In Study 2, we administrated the same questionnaires to an online English speaking sample (N = 240) and in addition, examined participants’ decision making strategies in a hypothetical situation. The participants in both studies were unscreened adults. Correlational and linear regressions analyses indicated that OC tendencies are related to maximization, even when levels of indecisiveness, depression and anxiety are controlled for. Moreover, the findings suggested that reliance on external proxies may partially account for the aforementioned association. Possible implications and future directions are discussed. (shrink)

ABSTRACT In American-British philosophy around the turn of the twentieth century, every philosopher and their dog had something to say on time. Thinkers worried about our experience of time, and the metaphysics of time. This introduction to the special issue, Time in American-British Philosophy 1880s-1930s, investigates that obsession, explaining how its philosophers spilled pints of ink on time, and produced the first-ever surveys of time. I historically contextualise their work and explore some of its driving causes, including experimental psychology of (...) time perception, and theological worries over evolution. This article concludes by surveying the rich, wide-ranging papers within this collection, covering time in Shadworth Hodgson, William James, Mary Calkins, Victoria Welby, Bertrand Russell, G. E. Moore, A. A. Robb, Alfred North Whitehead, Norman Kemp Smith, J. M. E. McTaggart, Karin Costelloe-Stephen, Hilda Oakeley, May Sinclair, and George P. Adams. (shrink)

The present study was motivated by the hypothesis that inputs from internal states in obsessive–compulsive individuals are attenuated, which could be one source of the pervasive doubting and checking in OCD. Participants who were high or low in OC tendencies were asked to produce specific levels of muscle tension with and without biofeedback, and their accuracy in producing the required muscle tension levels was assessed. As predicted, high OC participants performed more poorly than low OC participants on this task when (...) biofeedback was not available. When biofeedback was provided, the difference between the groups was eliminated, and withdrawing the monitor again reversed this effect. Finally, when given the opportunity, high OC participants were more likely than low OC participants to request biofeedback. These results suggest that doubt in OCD may be grounded in a real and general deficiency in accessing internal states. (shrink)

Although unsettling to many, Graham Greene's aesthetic obsession is not perverse or morbid but an impressive vision, a faithful intuition of the contemporary religious dilemma.

_Considers Bataille’s work from an explicitly philosophical perspective._.

In this paper, I will provide a phenomenological analysis of somatic obsessions at times present in obsessive–compulsive disorder. I will compare two different types of bodily obsessions, which have a different neurological-physiological underpinning: anguishing awareness of one’s own heartbeat and of one’s own breathing. In addition, I will contrast these two with how one experiences one’s own liver. I will use the concepts "tactility obsessions” and "motility obsessions”, which I have coined for the purpose of this (...) comparison. In other words, these are obsessions concerning the felt sense of one’s autonomous organs and obsessions concerning one’s ability to voluntarily move. Ultimately, I claim that the core lived experience in somatic obsessive–compulsive disorder should not only be understood as having to do with intruding and "distorted thoughts” concerning bodily processes, but could also be understood as having to do with a felt sense of our organs interrupting and intruding our daily lives. (shrink)

Talk.origins has now officially archived Richard Wein's critique of my book No Free Lunch at http://www.talkorigins.org/design/faqs/nfl. Prior to that, the critique went through several revisions. I take it the critique is now substantially finished. In any case, I am responding to Version 1.0 last modified 04.23.02. My response here is copyright © 2002 and may be reprinted only for personal use.

The history of mental illnesses is as old as human history. Mental disorders are affected by changing social and cultural factors during the historical process, and have been conceptually restructured and their definitions and classifications have been changed. The evolution of obssessive-compulsive disorders with roots as old as human history into modern concepts took place in the 19th century. The first scientific views on the spiritual origin of OCD belong to S. Freud. Freud observed that mental causes in OCD are (...) different from other mental disorders, and he examined obsession as a separate and specific disorder. Over time, it has been understood that OCD is a very common disorder. The American Psychiatric Association (APA) has classified OCD under an independent title in the latest version of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5) by removing it from the category of anxiety disorders. OCD is a mental disorder caused by mental actions such as obsessive thoughts (obsessions) and / or repetitive and compulsive behaviors (compulsion). The patient is often aware that such thoughts and behaviors are irrational and absurd. For this reason, he tries to get away obsessive thoughts that he finds contrary to his beliefs, opinions, moral values and logic from his mind. However, as he tries, obsessive thoughts become more and more frequent and create a great anxiety in the person. This time, the patient resorts to compulsions to alleviate the anxiety he feels or to get rid of it completely. As his compulsions repeat, his anxiety increases and he goes into a vicious circle. There are many symptom subgroups of OCD that seriously worsen the quality of life of the individual. One of these, and even the most overwhelming, is religious obsessions. It has been thought that there has been a relationship between religion and OCD for a long time in the psychology literature, and some remarkable studies have been conducted to clarify this relationship. Although there are many research findings showing that religion is an indispensable element in the protection of the mental health integrity of the individual, some forms of religious understanding and some experiences gained as a result of religious experiences may affect the concerns about OCD. This stage of religiosity is closely related to some sub-symptom groups of OCD. The explanations of the founder of the psychoanalytic method, Freud psychoanalytic method, and his followers made a great contribution to the understanding of OCD. However, since the psychoanalytic method exhibits a theoretically reductionist approach to religion, it is possible that the individual's devotion to religion is initially evaluated as a pathology or at least an important obstacle to insight. Today, cognitive behavioral psychotherapies are considered the most effective psychological treatment method for OCD, but their success rates in the treatment of religious OCD are low. Since religious OCD concerns often involve spiritual issues rather than concrete repeatable situations, behavioral methods can be quite difficult to apply in the treatment of religious OCD. Therefore, traditional psychotherapy approaches, even if they are not openly against religions, are insufficient to relieve the suffering in the lives of individuals with religious obsessions, as they generally neglect the religious dimension. Due to the vacuum that arises from restricting spiritual treatments to secular approaches, religious patients are threatened by the illegal practices of people who abuse religious feelings. Clinically, religious obsessions are more worrying and overwhelming. Therefore, their treatment is more difficult than others. Selective approaches that use different scientific disciplines together in the treatment of OCD and can stretch around religious beliefs and values can create more effective treatment models. Thus, the success rate in the treatment of religious OCD can be carried to higher levels thanks to the appropriate cooperation of the disciplines of medicine, psychology and theology. There is a rich religious cultural heritage that can support this collaboration in terms of theological disciplines. As an example, Abū Zayd al-Balkhī (d. 322/934), in his Maṣāliḥ al-abdān wa-l-anfus, probably made a clear distinction between neuroses and psychosis and classified neurotic disorders for the first time about ten centuries before Freud. In this study, the importance of approaching to religious obsessions as both a psychological disorder and a theological problem is emphasized. For this reason, cooperation of psychiatric and psychological approaches with spiritual counseling and guidance is recommended in the treatment of religious OCD. The difficulty in distinguishing whether the symptoms seen in a religious person are normal, natural religious thoughts and behaviors of religious life or abnormal appearances in the religious guise necessitates this interdisciplinary cooperation. (shrink)

People suffering from Obsessive-Compulsive Disorder (OCD) do things they do not want to do, and/or they think things they do not want to think. In about 10 percent of OCD patients, none of the available treatment options is effective. A small group of these patients is currently being treated with deep brain stimulation (DBS). Deep brain stimulation involves the implantation of electrodes in the brain. These electrodes give a continuous electrical pulse to the brain area in which they are implanted. (...) It turns out that patients may experience profound changes as a result of DBS treatment. It is not just the symptoms that change; patients rather seem to experience a different way of being in the world. These global effects are insufficiently captured by traditional psychiatric scales, which mainly consist of behavioural measures of the severity of the symptoms. In this article we aim to capture the changes in the patients’ phenomenology and make sense of the broad range of changes they report. For that we introduce an enactive, affordance-based model that fleshes out the dynamic interactions between person and world in four aspects. The first aspect is the patients’ experience of the world. We propose to specify the patients’ world in terms of a field of affordances, with the three dimensions of broadness of scope (‘width’ of the field), temporal horizon (‘depth’), and relevance of the perceived affordances (‘height’). The second aspect is the person-side of the interaction, that is, the patients’ self-experience, notably their moods and feelings. Thirdly, we point to the different characteristics of the way in which patients relate to the world. And lastly, the existential stance refers to the stance that patients take towards the changes they experience: the second-order evaluative relation to their interactions and themselves. With our model we intend to specify the notion of being in the world in order to do justice to the phenomenological effects of DBS treatment. (shrink)

In this article we examine obsessive compulsive disorder (OCD). We examine and reject two existing models of this disorder: the Dysfunctional Belief Model and the Inference‐Based Approach. Instead, we propose that the main distinctive characteristic of OCD is a hyperactive sub‐personal signal of being in error, experienced by the individual as uncertainty about his or her intentional actions (including mental actions). This signalling interacts with the anxiety sensitivities of the individual to trigger conscious checking processes, including speculations about possible harms. (...) We examine the implications of this model for the individual's capacity to control his or her thoughts. (shrink)

Obsessive doubt and commitment phobia are relationship wreckers. Written by an anxiety and obsessive-compulsive disorder (OCD) expert, Relationship OCD offers an evidence-based, cognitive-behavioral approach to finding relief from chronic relationship anxiety. Readers will learn to challenge the intrusive thoughts and worries that trigger harmful emotions, embrace the uncertainty inherent in all human connections, and discover a deeper sense of intimacy and trust.

Deep Brain Stimulation (DBS) is a relatively new, experimental treatment for patients suffering from treatment-refractory Obsessive Compulsive Disorder (OCD). The effects of treatment are typically assessed with psychopathological scales that measure the amount of symptoms. However, clinical experience indicates that the effects of DBS are not limited to symptoms only: patients for instance report changes in perception, feeling stronger and more confident, and doing things unreflectively. Our aim is to get a better overview of the whole variety of changes that (...) OCD patients experience during DBS treatment. For that purpose we conducted in-depth, semi-structured interviews with 18 OCD patients. In this paper, we present the results from this qualitative study.We list the changes grouped in four domains: with regard to (a) person, (b) (social) world, (c)characteristics of person-world interactions, and (d) existential stance. We subsequently provide an interpretation of these results. In particular, we suggest that many of these changes can be seen as different expressions of the same process; namely that the experience of anxiety and tension gives way to an increased basic trust and increased reliance on one’s abilities. We then discuss the clinical implications of our findings, especially with regard to properly informing patients of what they can expect from treatment, the usefulness of including CBT in treatment, and the limitations of current measures of treatment success. We end by making several concrete suggestions for further research. (shrink)

According to the traditional Western concept of freedom, the ability to exercise free will depends on the availability of options and the possibility to consciously decide which one to choose. Since neuroscientific research increasingly shows the limits of what we in fact consciously control, it seems that our belief in free will and hence in personal autonomy is in trouble. -/- A closer look at the phenomenology of Obsessive-Compulsive Disorder (OCD) gives us reason to doubt the traditional concept of freedom (...) in terms of conscious control. Patients suffering from OCD experience themselves as unfree. The question is whether their lack of freedom is due to a lack of will power. Do they have too little conscious control over their thoughts and actions? Or could it be the opposite: are they exerting too much conscious control over their thoughts and actions? -/- In this chapter, we will argue that OCD patients testify to the general condition that exercising an increased conscious control over actions can in fact diminish the sense of agency rather than increase the experience of freedom. The experiences of these patients show that the traditional conception of freedom in terms of ‘free will’ has major shortcomings. There is an alternative, however, to be found in the work of Hannah Arendt. She advocates a conception of freedom as freedom in action. Combined with phenomenological insights on action, Arendt’s account of freedom helps us to get a more adequate understanding of the role of deliberation in the experience of freedom. We argue that the experience of freedom depends on the right balance between deliberate control and unreflective actions. (shrink)

Obsessive compulsive disorder is a debilitating psychiatric condition where people become obsessed by remotely possible harm, error, bad luck, and compulsively repeat mental or behavioural rituals to neutralize these possibilities. This tendency to draw inferences on the basis of remote rather than more likely possibilities is termed 'inferential confusion' and can lead to immersion in possible worlds accompanied by feelings of dissociation between: knowing and doing, imagination and reality, and authentic and inauthentic self. These dissociation experiences in OCD may inform (...) us on the relational 'possibilistic' nature of consciousness. In a relational model of consciousness, the boundaries of consciousness are located between the person and the world, and shift according to the 'aboutness' of self-world interaction. A key element of 'aboutness' is projecting into the future to what is 'about to be', so sense of reality is constructed through a consensus about what could be, operationalized as a personal possibility distribution. Experiences such as derealization and depersonalization occur in OCD when there is a clash between personally possible worlds and the person ends up living in simultaneously a possible and an impossible world. Recognizing this confusion may be a key to alleviating dissociative symptoms. (shrink)

Over the last decade, there has been a growing consensus, including in Italy, that it makes sense to provide an objectively measurable empirical basis for educational policies and practices in order to escape from the uncertainty of practices based on individual experience or subjective values. The quantification of the social sphere, the “metric society” (Mau, 2019), and data-driven models of governance have led not only to “learnification”, a culture of performativity and standardised testing as the dominant model (Biesta, 2010), but (...) also to a loss of future-oriented visions as these latter are overwhelmed by statistical models of anticipation. The main aim of this paper is to critique the post-positivist epistemological assumptions of so-called Evidence Based Education as well as the neoliberal organisational models whose indiscriminate application to professionals in education robs these roles of professionalism. Secondly, based on the recent UNESCO report on the “Futures of Education”, it intends to discuss the dimension of the future as a key direction of meaning for educational policies and practices, held up as an alternative to anticipatory governance models (Robertson, 2022). (shrink)

Obsessive-compulsive disorder (OCD) is a deeply enigmatic psychiatric condition associated with immense suffering worldwide. Efficacious therapies for OCD, like exposure and response prevention (ERP) are sometimes poorly tolerated by patients. As many as 25 percent of patients refuse to initiate ERP mainly because they are too anxious to follow exposure procedures. Accordingly, we proposed a simple and tolerable (immersive yet indirect) low-cost technique for treating OCD that we call “multisensory stimulation therapy.” This method involves contaminating a rubber hand during the (...) so-called “rubber hand illusion” (RHI) in which tactile sensations may be perceived as arising from a fake hand. Notably, Jalal and Ramachandran (2015), showed that such fake hand contamination during the RHI provokes powerful disgust reactions in healthy volunteers. In the current study, we explored the therapeutic potential of this novel approach. OCD patients (n = 29) watched as their hidden real hand was being stroked together with a visible fake hand; either synchronously (inducing the RHI) (i.e., the experimental condition; n = 16) or asynchronously (i.e., the control condition; n = 13). After 5 minutes of tactile stimulation, the rubber hand was contaminated with fake feces, simulating conventional exposure therapy. Intriguingly, results suggested sensory assimilation of contamination sensations into the body image via the RHI: patients undergoing synchronous stimulation did not report greater contamination sensations when the fake hand was initially contaminated relative to asynchronous stroking. But contrary to expectations, they did so after the rubber hand had been contaminated for 5 minutes; as assessed via disgust facial expressions (a secondary outcome) and in vivo exposure (upon discontinuing the illusion). Further to our surprise, synchronous and asynchronous stroking induced an equally vivid and fast emerging illusion, which helps explain why both conditions initially (5 minutes after initiating tactile stimulation) provoked contamination reactions of equal magnitude. This study is the first to suggest heightened malleability of body image in OCD. Importantly, it may pave the way for a tolerable technique for the treatment of OCD—highly suitable for poorly resourced and emergency settings, including low-income and developing countries with minimal access to high-tech solutions like virtual reality. (shrink)

The dominant philosophical conceptions of obsessive-compulsive behavior present its subject as having a deficiency, usually characterized as volitional, due to which she lacks control and choice in acting. Compulsions (mental or physical) tend to be treated in isolation from the obsessive thoughts that give rise to them. I offer a different picture of compulsive action, one that is, I believe, more faithful to clinical reality. The clue to (most) obsessive-compulsive behavior seems to be the way obsessive thoughts, which are grounded (...) in an irrational cognitive style in matters of risk, danger, and responsibility, motivate compulsions through bizarre means–end reasoning. I show that the patient with obsessive-compulsive disorder (OCD) is not weak and passive with regard to the compulsive act; rather, the act is voluntary and regarded by the patient as an instrument of control. I also defend the idea that OCD-related cognitions are either beliefs or mental states with relevantly similar functional roles. (shrink)

Title: Rethinking Democracy: Freedom, Social Cooperation in Politics, Economy, and Society Publisher: Cambridge University Press ISBN: 0521386292 Author: Carol Gould Title: Democratic Theory and Socialism Publisher: Cambridge University Press ISBN: 0521335787 Author: Frank Cunningham.

This article discusses a puzzle arising from the phenomenon of insight in obsessive–compulsive disorder. “Insight” refers to an awareness or understanding of obsessive thoughts as false or irrational. I argue that a natural and plausible way of characterizing insight in OCD conflicts with several different possible explanations of the epistemic attitude underlying insight‐directed obsessive thought. After laying out the puzzle for five proposed explanations of obsessive thought and then discussing several possible ways that the puzzle might be avoided, I close (...) the article by arguing that we can avoid the puzzle by adopting a new positive view of insight‐directed obsessive thought. (shrink)

Although not often recognized as a major concern in his fecund writings, as Derrida himself indicates, Antonin Artaud accompanies his thought throughout his career. This essay explores that relationship by marking the various places where it appears, and by focusing on Derrida’s early discussions of Artaud. In them, Derrida traces the obsessive character of metaphysics as figured by Artaud’s word, a word that occurs as a speaking-writing-drawing. While Derrida’s discussions expose us to the physicality of Artaud’s word and with them (...) to a saying exterior to the metaphysical tradition. Derrida’s own obsession with the transcendental voice keeps him at a distance from engaging in the physicality and play of language one finds in Artaud’s words. (shrink)