ABSTRACT This paper presents a case study of a six-year-old boy who, unusually, had intensive psychoanalytic psychotherapy as a form of treatment for OCD. Obsessive-compulsive disorder (OCD) can be clinically diagnosed as a psychiatric condition from the age of four or five. The standard treatment for OCD in the NHS tends to be a combination of cognitive and behavioural therapies. This little boy suffered classic symptoms of OCD, which included repetitive intrusive thoughts, compulsions, and ritualistic behaviour. After just over two years of psychoanalytic treatment, his distressing symptoms were alleviated, and in the follow-up sixteen months later, the symptoms had not re-emerged. This paper highlights the psychoanalytic approach used in this case, focusing on the meanings and possible aetiology of paediatric OCD. Using the qualitative research approach of thematic analysis, three main themes that emerged in this work are discussed, by referring to clinical examples from the child’s therapy. Based on the findings, I suggest that the contribution and maintenance of early onset OCD in this boy, to some extent camouflaged infantile relationship struggles, particularly in relation to oedipal difficulties. I will describe a ‘turning point’ in the therapy, to further illustrate my formulation, as well the demonstrating the complexity of the process of change in child psychotherapy, as evidenced in this case.

中文翻译：

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“心灵的打嗝”：对一个患有强迫症的小男孩的心理治疗

摘要 本文介绍了一个 6 岁男孩的案例研究，他不寻常地接受了强化精神分析心理治疗，作为治疗强迫症的一种形式。强迫症（OCD）从四五岁起就可以在临床上被诊断为精神疾病。NHS 中强迫症的标准治疗往往是认知和行为疗法的结合。这个小男孩患有强迫症的典型症状，包括重复的侵入性想法、强迫行为和仪式行为。经过两年多的精神分析治疗，他的痛苦症状得到了缓解，在16个月后的随访中，症状没有再出现。本文重点介绍了本案例中使用的精神分析方法，重点介绍了儿科强迫症的含义和可能的病因。使用主题分析的定性研究方法，通过参考儿童治疗的临床实例，讨论了这项工作中出现的三个主要主题。基于这些发现，我认为这个男孩早发性强迫症的贡献和维持，在某种程度上掩盖了婴儿时期的关系斗争，特别是与俄狄浦斯困难有关。我将描述治疗中的一个“转折点”，以进一步说明我的表述，以及证明儿童心理治疗变化过程的复杂性，正如本案例所证明的那样。在某种程度上伪装了婴儿时期的关系斗争，尤其是与俄狄浦斯问题有关的斗争。我将描述治疗中的一个“转折点”，以进一步说明我的表述，以及证明儿童心理治疗变化过程的复杂性，正如本案例所证明的那样。在某种程度上伪装了婴儿时期的关系斗争，尤其是与俄狄浦斯问题有关的斗争。我将描述治疗中的一个“转折点”，以进一步说明我的表述，以及证明儿童心理治疗变化过程的复杂性，正如本案例所证明的那样。