Murphy Helen, Perera-Delcourt Ramesh
School of Psychology, University of East London, UK.
Psychol Psychother. 2014 Mar;87(1):111-25. doi: 10.1111/j.2044-8341.2012.02076.x. Epub 2012 Oct 12.
While there has been an abundance of quantitative studies that examine the clinical features and treatment modalities of obsessive-compulsive disorder (OCD), only a few qualitative research studies examining the experience of OCD have been documented. Our objectives were to explore and understand psychosocial aspects of OCD and to provide qualitative accounts of the condition and its treatment rather than concentrating on its psychopathology. We also wanted to locate the role cognitive behavioural therapy (CBT) played in the condition for our participants.
Data for the study came from a series of nine semi-structured interviews carried out with individuals who self-identified as having OCD. Participants were recruited through two leading UK-based OCD charities.
We used interpretative phenomenological analysis (IPA) to analyse the accounts and participants gave feedback as to the validity of the themes in early stages of analysis.
We report two superordinate themes--Having OCD (with subordinate themes 'wanting to be normal and fit it', 'failing at life' and 'loving and hating OCD') and The Impact of Therapy (with subordinate themes of 'wanting therapy', 'finding the roots' and 'a better self').
Having OCD as a condition meant that individuals experienced a sense of overwhelming personal failure matched against age appropriate life cycle goals. This crisis of the self was bolstered by public and self-stigma about the condition. While clinical diagnosis and therapeutic interventions were significant, participants reported dialectical tensions experienced with OCD, pointing to the complexity of psychological functioning in the condition.
虽然已有大量定量研究探讨强迫症(OCD)的临床特征和治疗方式,但仅有少数定性研究记录了强迫症患者的经历。我们的目的是探索和理解强迫症的社会心理方面,提供对该病症及其治疗的定性描述,而非专注于其精神病理学。我们还想确定认知行为疗法(CBT)在我们的参与者的病情中所起的作用。
该研究的数据来自对九名自我认定患有强迫症的个体进行的一系列九次半结构化访谈。参与者通过英国两家主要的强迫症慈善机构招募。
我们使用解释现象学分析(IPA)来分析这些描述,并且参与者在分析的早期阶段就主题的有效性提供了反馈。
我们报告了两个上位主题——患有强迫症(其下位主题为“想要正常并融入其中”“在生活中失败”以及“爱恨交织的强迫症”)和治疗的影响(其下位主题为“渴望治疗”“找到根源”以及“更好的自我”)。
患有强迫症意味着个体体验到一种与适合年龄的生命周期目标相悖的压倒性个人失败感。公众和自我对该病症的污名加剧了这种自我危机。虽然临床诊断和治疗干预很重要,但参与者报告了与强迫症相关的辩证紧张关系,这表明该病症中心理功能的复杂性。