6 - Cognitive style/deficit approaches to OCD

Summary

Reed's account

Reed's hypothesis of the central problem

A number of authors (for example, Beech and Perigault, 1974; Beech and Liddell, 1974; Carr, 1974; Volans, 1974, 1976; Reed, 1985, 1991) have suggested that a generalised cognitive style or deficit in OCD sufferers may be responsible for the occurrence of OCD symptoms. Reed's ideas represent the most fully worked out contribution from this school. He advances what he terms a “cognitive-structural approach” (Reed, 1985) to explain both the obsessional personality (and personality disorder) and OCD. In what follows, the term obsessional will be used generically, as it is by Reed, to cover OCD, the obsessional personality/personality disorder, and the person who exhibits either of these. Unlike many of the approaches discussed in other chapters of this book, Reed's account has not been subject to widespread critical discussion; particularly detailed consideration of this account is therefore offered here.

What, then, is the central problem in obsessional disorders, according to Reed? His attempts to answer this question in just a few words tend to be a little cryptic. For example, he suggests that obsessional traits and symptoms reflect difficulties in “spontaneous categorizing and integration” (1985, p. 220) leading to attempts to compensate for these difficulties by “the artificial over-structuring of input, of fields of awareness, of tasks and situations” (p. 220); there is, he argues, a “maladaptive over-defining of categories and boundaries” (1969b, p. 787). Reed states that the central phenomenon of these disorders “may thus be seen as a striving towards boundary fixing or the setting of limits in the cognitive/ perceptual modalities” (1985, p. 220).