Obsessive Compulsive Neurosis in Identical Twins

Abstract

This paper reports a case which is noteworthy for two unrelated reasons, one genetic and the other therapeutic. The genetic interest lies in the rare instance of an identical twin with obsessive compulsive neurosis whose twin brother had a similar illness. The therapeutic interest focuses on clinical changes which occurred during unsuccessful treatment by desensitization and by aversion relief. These changes aid our understanding of compulsive behaviour and the difficulties in its treatment. At one stage in treatment independence was noted between anxiety and compulsions which suggested that compulsive behaviour need not always be maintained by its anxiety-reducing properties. The case history will first be described and discussed from the genetic point of view. The second part of this paper will focus on the unrelated aspect of treatment.