ABSTRACT
The relation between obsessive-compulsive symptoms and depressive illness has long been recognized, but the relationship with schizophrenia is less common and less understood in psychiatry. The psychotherapy first began a month before the summer vacation on a twice-weekly basis. Alec was clearly very relieved to disclose his anxieties and dietary practices. He assured the therapist that he would return to therapy when he had achieved this aim. Alec was more overtly psychotic, preoccupied with what seemed to be an entirely new delusional system, centring on cosmic forces and the activities of extraterrestrial beings. He developed a compulsive interest in opening and closing doors, an activity that could eventually be understood in retrospect as the first overt manifestation of the magical thinking, obsessions, and compulsions that later came to dominate his world. Periods of progression and regression often alternated as his thinking in the areas of conflict became less psychotic, less fear-laden, less wish-fulfilling, and less anxious.
