As neuroscience research has uncovered the genetic/biological basis of obsessive-compulsive disorder (OCD), a broad consensus has been reached that behavior therapy and a selective serotonin reuptake inhibitor are the treatments of choice for the condition. Nevertheless, psychoanalytically informed approaches still have much to offer in an overall treatment plan. The biologically determined symptoms have unconscious meanings to the patient that may lead the patient to be highly invested in maintaining the symptoms. Also, psychodynamic factors may be involved in triggering an exacerbation of the symptoms. Moreover, the compulsions and obsessional thoughts almost always have interpersonal meanings that need to be addressed. Family members and others, including treaters, may feel compelled to accommodate themselves to the illness as a response to coercive behaviors by the patient. Finally, the characteriological features of individuals with OCD tend to undermine treatment efforts in many cases and may require psychoanalytically informed therapy to deal with them.