Obsessions The Twisted Cruelty

This book explores the interrelatedness between obsessive compulsive disorders, thinking disorders, and depression. The issue is considered both from a psychiatric viewpoint and from a psychodynamic perspective. The age of the cases presented in the book ranges from childhood through adolescence to adulthood. Obsessions: The Twisted Cruelty is a challenging contribution to contemporary clinical debate, especially regarding the role of analytically-oriented psychotherapy in the treatment of OCD, and how to deal with the psychiatric treatment and combine the two approaches, while keeping the focus on the transference-countertransference interplay. After the first theoretical chapter, the relationship between obsessions and thinking impairments is discussed, with specific reference to delusional ideation. A section entitled "the anal conundrum" follows. Encopresis and anal masturbation during childhood are discussed, as well as the identification of the child with a maternal "faecal object. The last section explores the connection with depression, and some specific features of sadism.

Foreword , Introduction , Theory: Models and Perspectives , Psychiatric contributions: classifications and treatments , Psychoanalyses: symptoms, structures, and contexts , The Psychotic Threshold: OCD and Thinking Disorder , Intersections , The case of Marcelino: early adoption and ongoing intrusion , Marco and Maria: OCD and developmental breakdown at puberty , Pharmaco-psychotherapy: the combined transference , Interlude: lie and obsession—variations on a folie à deux , The Anal Conundrum , Introduction to Part III , The arrogance of power: Pasolini’s Salò , Encopresis, obsessional control, and the development of sexual promiscuity , Anal stench: Alex and the gas of solitude , The Depressive Threshold , Introduction to Part IV , Sonia: the king-size coffin—Imprisonment 1 , Fabio: the right to be furious—Imprisonment 2

Francesco Bisagni