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Magical thinking in obsessive-compulsive disorder

Lucas, David; (2020) Magical thinking in obsessive-compulsive disorder. Doctoral thesis (Ph.D), UCL (University College London).

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Magical thinking is a widely recognised but barely understood symptom of obsessive-compulsive disorder (OCD). Since Freud published his famous case study of the “Rat Man” more than a century ago, little of note has been written about its distinctive phenomenology, whilst progress towards identifying its developmental and neurobiological origins has been fitful. This thesis proposes a new conceptual framework for understanding the delusions of agency, causation and association which characterise the symptom formation, based on a content analysis of semi-structured interviews with 14 OCD individuals and a systematic review of historical cases reported by child and adolescent psychotherapists working at a leading UK clinic. The framework is rooted in two contemporary models of the mind with demonstrable links to Freudian theory: the neuropsychoanalytical ideas of Solms, Panksepp and others and the free-energy formulation of Friston and colleagues. We conceptualise the early obsessional fears of magical thinkers as the anticipation of a high-entropy state, described by Freud as the “death complex”, demanding repeated action – no matter how irrational – to restore homeostasis and a feeling of safety. Following Solms and Panksepp, we consider the apparent shift from goal-directed behaviour to stimulus-response habits in the documented cases as a means of regulating negative affect through the automatisation of safety-seeking behaviour. Such efforts are continually disturbed, however, by intrusive thoughts and “not just right” experiences, which we link to excessive attention – and attribution of salience – to sensory signals associated with the original prediction of harm.

Type: Thesis (Doctoral)
Qualification: Ph.D
Title: Magical thinking in obsessive-compulsive disorder
Event: UCL (University College London)
Language: English
Additional information: Copyright © The Author 2020. Original content in this thesis is licensed under the terms of the Creative Commons Attribution 4.0 International (CC BY 4.0) Licence (https://creativecommons.org/licenses/by/4.0/). Any third-party copyright material present remains the property of its respective owner(s) and is licensed under its existing terms. Access may initially be restricted at the author’s request.
UCL classification: UCL
UCL > Provost and Vice Provost Offices
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Brain Sciences
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Brain Sciences > Div of Psychology and Lang Sciences
URI: https://discovery.ucl.ac.uk/id/eprint/10092237
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