Obsessiveness in Context

Obsessional neurosis is unquestionably the most interesting and repaying subject of analytic research. But as a problem it has not yet been mastered. It must be confessed that, if we endeavor to penetrate more deeply into its nature, we still have to rely upon doubtful assumptions and unconfirmed suppositions [Freud, 1925, p. 113].

Where do obsessional phenomena fit into the spectrum of psychological reactions? Are they, like schizophrenic reactions, automatically pathological? Or is it more appropriate to think about them as one would think of blood pressure or anxiety—that is, as parameters of functioning that characterize most—if not all—of us but that sometimes and for some people can run amuck? Sandler and Hazari's (1960) findings indicate that the latter might be the more appropriate perspective. On the basis of the responses of 100 patients to selected items from the Tavistock Self-Assessment Test (Sandler, 1954), they distinguished two clusters of characteristics, both of which they felt fall under the overall rubric of obsessional. Individuals in their “A” group were systematic, methodical, and thorough: They led well-ordered lives, were consistently punctual, disliked leaving tasks half done, were attentive to detail, found interruptions irksome, and had a strong aversion to dirt. These traits were often a source of pride and self esteem and were ego syntonic. The authors noted that these individuals bear a strong similarity to the “anal reactive” character of psychoanalysis. The type “B” individuals appeared less well integrated. They were afflicted by the intrusion of unwelcome thoughts and impulses. Such traits, however, were not necessarily symptomatic in the sense that the patients complained about them. They also occurred as character traits in “chronic worriers.” Sandler and Hazari also note that in characterizing someone as obsessive one is as likely to be praising that person as to be criticizing. When, for example, one is in need of major surgery,