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This report is based on our observations following six exploratory meetings.
The idea for our joint research into obsessional thinking grew out of our shared interest in two particular cases referred to this Clinic for analysis during adolescence. Theyrefused analysis and had to be persuaded to attend twice-weekly treatment. William (aged17) remained in treatment for 1 year; Ben (aged 15) remained for 18 months until he left school. They sought help again about a year after termination. The therapist (Mrs Cohen) asked Dr Rodriguez de la Sierra to follow them up and offer treatment if possible in the Adult Psychiatric Department of the hospital where he works, focussing attention on the return of the symptom and the unresolved transference. (In making this request, the value of a change from a female to a male therapist - mother to father -was a consideration.)
Both boys had terminated treatment suddenly, ostensibly due to work and career commitments. William was due to join the armed forces and felt he had his incestuous and paedophiliac obsessive thoughts under control, and did not want his chances of his longed-for career spoilt by a psychiatric record. Ben found himself relieved of torment and was moving on to college and work.
We found that a common feature in these and other such patients - unlike the obsessivecommunicator, Arthur, reported on below - was the wish to terminate the treatment, to get rid of the therapist as soon as the tormenting thoughts have been got rid of. The danger with these patients is an early flight into health.
As well as the fear of losing control and going mad, and the shame of the disgusting or sadistic thoughts, they all kept their treatment a secret, even from their own siblings - but they confided in their parents, to the last detail. Our interest lay in the part that obsessional thinking plays in defending not only against homosexual anxieties but also against panic at the thought of separating from the parents. Although William tol