ABSTRACT
Despite Freud's groundbreaking conceptualization of obsessional neurosis, psychoanalysis has fallen out of favor as a treatment for obsessive-compulsive disorder (OCD), often considered ineffective or harmful. This chapter aims to illuminate the failure through the linguistic-existential perspectives of Ludwig Wittgenstein and Søren Kierkegaard. According to Wittgenstein, the labeling of inner states through language facilitates the impression that they exist as factual entities that can be exposed through introspection. However, since we can never transcend language, any attempt to reach what allegedly lies underneath is doomed to fail, only generating further verbal constructions. I propose that this process is at the crux of obsessive rumination. Patients search in vain for their “true” intentions or feelings, only to end up experiencing their psyche as alien and impenetrable. Unfortunately, classic psychoanalytic techniques aggravate this dynamic by encouraging patients to uncover unconscious, “hidden” psychological material. The psychoanalytic treatment of OCD could benefit from considering Kierkegaard's notion of existential certainty, based on commitment rather than on evidence. OCD patients must act upon life's most fateful concerns amid tormenting doubt, not amenable to resolution through the uncovering of psychological truths. Our therapeutic role is to support them as they undertake this crucial, albeit terrifying, leap of faith.
