The Emergence of a Stereotypic Movement during Intensive Short-Term Dynamic Psychotherapy in a Patient with Obsessive Compulsive Disorder: A Case Report

No previous research has investigated the emergence of stereotypic movements in patients during psychotherapeutic sessions, nor have such movements been mentioned in the numerous articles on Habib Davanloo's technique of intensive short-term dynamic psychotherapy. In this article, we present two clinical vignettes from early intensive short-term dynamic psychotherapy sessions, using Davanloo's technique, with a patient who was observed to have an emerging stereotypic movement. These vignettes, extracted from the videotaped sessions using audiovisual technology, concern a young woman who is known to have treatment-resistant obsessive-compulsive disorder. By presenting this case report, we aim to highlight the possibility of the occurrence of such a movement in response to specific interventions, and propose its clinical significance. We interpret this movement as being a tension-releasing mechanism that manifests in response to the therapist's exploration of the patient's emotions. We propose that the purpose of this stereotypic movement is to defend against the patient's actual experience of her repressed feelings. Clinical outcome of this case suggests that psychodynamic psychotherapy could be an effective intervention for patients with treatment-resistant obsessive-compulsive disorder.