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Forced Thoughts and Actions: Understanding and Treating Compulsive Neuroses in Children and Adolescents

  • Post category:Disorders
  • Reading time:5 mins read

Repressed Anxiety and Compulsive Behavior

Repressed and unconsciously hidden anxiety manifests itself sometimes in compulsive thoughts or actions. Forced thoughts (obsessions) are such psychic contents that are imposed on the patient with irresistible force. He sees their meaninglessness, rejects them from himself, gets angry at them, and is unhappy about them but cannot get rid of them. The more persistently he pursues them from within, the more they haunt him.

The same goes for forced actions (compulsions). These are actions that the patient must perform even though he does not want to; if he does not carry them out, he is tormented by restlessness and anxiety.

Forced Thoughts and Their Effects

By forcing thoughts and actions, the neurotic masks his emotional difficulties in front of himself and others.

Even though his compulsions hurt him, he still does them because he doesn’t want to face the fact that he can’t solve life’s problems, is helpless and unwilling, and has other emotional problems.

Forced Actions and Their Effects

In childhood, many kids have mild, harmless compulsions that aren’t quite psychoneuroses yet. So many children have to count the objects they pass, count the cars they encounter, walk on the sidewalk, say certain words, whistle a melody, etc. This happens more often to boys than to girls. It doesn’t last long and doesn’t change anything.

True forced neuroses appear, although rarely, only at the end of childhood, i.e., at puberty. The child then becomes obsessed with thoughts and actions that hurt, upset, and make him feel bad about himself. This takes away his mental peace, makes it harder for him to focus at work, and makes him even more shy and quiet. Coercion, on the other hand, can help a child deal with the anxiety that rules his or her emotional life, at least temporarily.

Compulsion as a Way of Masking Emotional Difficulties

At the dispensary, we met three patients with forced neurosis.

Case 1

The first was a 10-year-old boy who “had to” look at all the drawers in the house every hour and count the things in them, even though he already knew exactly how many there were in each drawer. He suffered from strong jealousy towards his younger brother, became very irritable, defiant, and restless, and also got tics.

Case 2

Another of our patients, a 12-year-old boy, kept opening and closing the door in the apartment, “had to” smell everything he took in his hands, and washed his hands every hour, although he did not soil them with anything. Those compulsions arose when he became jealous of his mother’s lover. His mother was the only person with whom he had a good emotional relationship and who was a counterbalance to his nervous grandmother and grumpy aunt, with whom he also lived, who bothered him all day with objections, admonitions, and sermons.

When the mother, who was otherwise divorced, found a partner, she no longer had much time for her son. He became depressed and stopped going to school. He also developed compulsive neurosis, which he treated by calling his mother again.

Case 3

The third patient was an 18-year-old boy. He was raised by very ambitious parents who wanted a “perfect son.” He developed into a very obedient, calm, serious, withdrawn, and conscientious child. But at the time of puberty, there was a growing resistance to parental perfectionism. He felt an increasing need to learn some subjects less, to behave more freely, to participate with comrades in their antics, and to use lascivious expressions. But a strong sense of guilt was born of it.

Emotional Conflicts and Unconscious Compromises

Both phobias and compulsive neuroses require a thorough look at the young person, his development, and his life circumstances, as well as psychotherapy that lasts for a long time. In addition, it is necessary to rehabilitate interpersonal relationships in the patient’s environment.