Beyond Symptom Classification: Analyzing Subjectivity of People Diagnosed with Obsessive Compulsive Disorder Through Lacanian Discourse Analysis Perspective

Abstract

Intrusive thoughts and repetitive behaviors are very diverse and occur in numerous forms but people with such different forms of symptoms are diagnosed under the category of obsessive-compulsive disorder (OCD) in the symptom-based system. The social constructivist approach, which is having an increasingly and substantial impact on psychotherapy research, emphasizes the subjectivity of individuals since the therapeutic field focuses on one-on-one work. Although studies on psychotherapy and language use are expanding, specifically the subjectivity of people labeled with the obsessive-compulsive disorder has not yet been studied by using a combination of qualitative, discursive, critical, and language-based perspectives. The main purpose of this study is to critically evaluate the symptom-based diagnosis in the therapeutic process especially OCD symptoms, with a particular emphasis on the subjectivity of people and their discursive practices. For this aim, interviews were conducted with six participants, who diagnosed with OCD and selected via purposive sampling method. As for the qualitative analysis, critical and Lacanian Discourse Analysis perspectives were utilized. The analysis revealed that the participants’ basic signifiers, positioning, and relationships with the Other were quite distinct, although they were all diagnosed under the same category of OCD. Additionally, differentiated discourses of the patients and gender differences emerged crucial issues, that were discussed considering literature. These findings suggested that individuals should be carefully listened to within their subjectivity and psychological structures rather than being broadly categorized based on their symptom similarity. Based on the findings, the current study presents a diagnostic debate and key clinical implications.