IL PAZIENTE OSSESSIVO: RAPPRESENTAZIONI RELATIVE ALL'INTERVENTO DI AIUTO E IMPASSE TERAPEUTICHE.

This paper describes the impasses occurring in the treatment of Obsessive-Compulsive Disorder, being the special object of our analysis the patient's representations. In particular we shall try to answer the following questions: how does the obsessive-compulsive patient evaluate the psychological help provided by the psychotherapist? Which are the peculiar evaluations that hinder or even nullify this kind of help? We shall answer starting from one of the most substantiated thesis in the field of clinical cognitivism, the one according to which the obsessive symptomatology can be traced back to evaluations due to an hypertrophic sense of responsibility (Arntz et al. 2007; Ladouceur et al. 1997; Lopatka & Rachman 1995; Mancini et al. 2004; Salkovskis 1985, 1989; Salkovskis & Forrester 2002; Shafran 1997) and more specifically to a fear of moral guilt (Basile e Mancini 2011; Gangemi et al. 2007; Mancini 2005; Mancini & Gangemi 2004; Mancini et al. 2008; Rachman 1993; Shafran et al. 1996; Shapiro & Stewart 2011). We shall maintain, consistently with the above-mentioned thesis and on the basis of the clinical observation, that it is possible to explain most of the resistances to change and of the relational deadlocks as effects of evaluations amenable to those very same psychological structures implied in the genesis of the obsessive symptomatology (Saliani & Mancini 2010) and we shall provide, through clinical examples and excerpts of self-dialogue reported by patients, a thorough description of these kind of evaluations occurring in the various phases of treatment. [ABSTRACT FROM AUTHOR]