Epilogue

Our Purpose for this Issue is simple. What might we elicit today from psychoanalysts concerning their views on Freud's historic obsessional neurosis? What is important to them, if anything, about the redefined obsessive-compulsive disorder (OCD)? What will they say when presented with accumulating, reasonable, and thoughtful nonanalytic clinical and basic science research that suggests a biological basis for OCD and documents the reduction of symptoms by behavioral and pharmacotherapy methods? Given the paucity of analytic claims of cure for OCD, do these findings preempt or negate the Freudian explanation for the obsessional neurosis or other neuroses, when considering psychogenesis (genetic, dynamic, and structural hypotheses), the “choice of neurosis” or the basis of therapeutic action? At present are there any analysts employing psychoanalytic principles to think about a theory for OCD, or are there any that apply the psychoanalytic procedure to treat OCD? Finally, how would they respond to Esman's challenge to integrate the findings of neuroscience within the theory and method of psychoanalysis, and is OCD an example to explore in particular?

We interdigitate these questions in the Prologue to introduce the reader to our diverse authors and their points of reference to these questions. A great deal of evidence supports a biological basis for OCD, but the unique symptomatology, developmental, and traumatic histories have rich, if complicated, psychological appeal that reaches beyond the historic Freudian obsessional neurosis and beyond the means of research and conclusions of current neuroscience.

Esman documents and announces the challenge to integrate psychoanalytic theory and neuroscience of findings, first in 1989— with no response—and again in this issue: analysts have abandoned thinking about OCD or making any claims about its treatment let alone its cause. Lam and Steketee speak of the reduction of symptoms and not their elimination. Their extensive summary