Damián Ruiz
Almost twenty years ago, when a young man came to my private practice in Barcelona telling me that he had been suffering from and treating OCD for years and that his level of distress was unbearable, I began a process of theoretical investigation through all kinds of readings, except for the cognitive-behavioral line, which has never interested me.
(I will mention here a significant fact)
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When I was a young adjunct professor at the Faculty of Psychology at the University of Barcelona, the head of the Personality Department, to which I belonged, told me that if I wanted to continue as a professor, I had to pursue a PhD in “hard Cognitivism.” I don’t think I gave it much thought. I didn’t want to do it. This does not mean that, had I done it, I would necessarily have remained there, but my decision was very clear.
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I do not believe in any therapeutic approach that does not consider the unconscious, and even less in those that focus primarily on the symptom.
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The obsessive symptom is like a fever — what must be sought is its cause.
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From that point on, my full respect to the professionals of that psychological school.)
What happened is that, driven by the two motives that most inspire me in my profession:
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Empathy toward the suffering of others
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Interest in psychological challenges
I gradually progressed in what would eventually become an integrative and eclectic therapeutic procedure in which elements from the theories of Carl G. Jung, primatology, Theodore Millon’s perspective, certain concepts from Alexander Lowen and Wilhelm Reich, and — if you will allow me — also, conceptually, from Friedrich Nietzsche, converge.
And so I began to work therapeutically. I sincerely believe that this methodology is highly effective in many cases. However, the omnipresent influence of behaviorism in Spain and its “official status,” both academically and in the public healthcare system, leaves very little room for alternative approaches — regardless of the fact that, at the time, I presented — together with members of the team I directed — statistically proven results on the reduction of trait anxiety in patients with OCD at the European Psychology Congress held in Moscow in 2019.
As we all know: if an official therapy does not work for a patient, the issue is minimized; but if the same thing happens with a new approach, it is magnified.
In any case, there are no miracles: the fact that I fully trust and can affirm that there have been, and continue to be, very good results in the treatment of OCD does not mean that this has been true for all patients treated — but it has been true for a rather considerable percentage of them.
And what is this therapy based on?
Starting from the possible genetic predisposition to OCD, what matters is finding the cause or causes that may have triggered it (AND THERE ARE ALWAYS CAUSES), usually in childhood or adolescence — or understanding what kind of treatment the person received from parents or guardians: both excessive rigidity and anxiogenic overprotection can activate obsessive disorder, even years later.
Once the origin is known, we must identify which emotions or drives have been blocked, and in which aspects fear and/or guilt have taken hold.
OCD is an anxiety disorder with underlying depressive components, and the two emotions beneath it are — I repeat — fear and/or guilt. People with OCD, beyond their mental or behavioral rituals, think instead of live, and live trying to prevent anything negative from happening.
Therefore, if this is so, the most logical approach is to work on these two emotions, to which I add a third: desire. Because the absence of desire — in the sense of motivation or passion — implies a lack of authentic connection with existence.
And what is the therapeutic procedure, in summary?
Removing the obsessive symptom from the center of attention.
Focusing on what has been repressed — what frightens, what is feared, and what generates guilt — and gradually activating it.
The content of OCD — whether related to sexual orientation*, contamination, order, or any other theme — is always metaphorical, never literal.
In my sessions, I speak very little about OCD, because what I aim to do is to develop the healthy side that has been blocked in each patient — often psychologically constrained.
To overcome OCD, one must return to existence in a clearly active way, and — even if it sounds naïve — it is essential to recover a certain joy of living. As the psychic field expands with new and engaging content, anxiety begins to diminish, and from a certain point on, OCD naturally declines.
It should be clarified that sexual-orientation OCD has nothing to do with egodystonic homosexuality. In the first case, the patient can never reach a conclusion; they may spend years checking themselves without ever establishing a stable criterion. In the second, the patient knows they are attracted to people of the same sex — that is, they do not doubt it — but they cannot accept or integrate it due to various prejudices.
The first must be helped to overcome OCD; the second must be helped to accept their sexual orientation and live it fully.
Damián Ruiz
www.damianruiz.eu