Defence Mechanism which explains “compulsions” in a patient with obsessive-compulsive disorder?
**Core Concept**
Obsessive-compulsive disorder (OCD) is a psychiatric condition characterized by unwanted, intrusive thoughts (obsessions) and repetitive behaviors (compulsions) that an individual feels compelled to perform. The defence mechanism underlying compulsions in OCD is a classic example of a maladaptive coping strategy.
**Why the Correct Answer is Right**
Compulsions in OCD are often a manifestation of the defence mechanism known as **repression** is incorrect because repression typically refers to the unconscious pushing away of painful memories or desires. The correct defence mechanism underlying compulsions in OCD is actually **reaction formation**. This involves the unconscious transformation of an unacceptable thought or impulse into its opposite, often resulting in a compulsive behavior that serves as a counterbalance to the original thought. In OCD, the individual may feel compelled to perform rituals or behaviors that are excessive and unreasonable, but provide a sense of relief or temporary reprieve from their obsessive thoughts.
**Why Each Wrong Option is Incorrect**
**Option A:** **Regression** is incorrect because regression refers to a defence mechanism where an individual reverts to an earlier stage of development, often in response to stress or anxiety. This is not directly related to compulsions in OCD.
**Option B:** **Denial** is incorrect because denial is a defence mechanism where an individual refuses to acknowledge or accept an uncomfortable reality. While denial can be a feature of OCD, it is not the underlying defence mechanism driving compulsive behaviors.
**Option C:** **Projection** is incorrect because projection is a defence mechanism where an individual attributes their own unacceptable thoughts or feelings to someone else. This is not relevant to the compulsive behaviors seen in OCD.
**Clinical Pearl / High-Yield Fact**
It's essential to remember that compulsions in OCD serve as a maladaptive coping strategy, providing temporary relief from the individual's obsessive thoughts. A key clinical feature of OCD is the presence of a **ritualistic quality** to the compulsive behavior, which is often excessive and unreasonable.
**Correct Answer: C. Reaction formation. Reaction formation is a defence mechanism in which an individual transforms an unacceptable thought or impulse into its opposite, often resulting in compulsive behaviors seen in OCD.**