Clinical Movement Toward Integration With Obsessive Personality Disorder: The Fear of Losing Love and the Need for Control

Case material is used to illustrate a Kleinian-informed psychoanalytic approach to working with a patient captured by obsessive cycles of controlling others along with the threat of losing their love. Obsessive disorders involve either controlling the self and the other or feeling confined and controlled by the self and the other. These phantasy states bring on intense fear of difference, fear of the unknown, and fear of abandonment. During treatment, as the patient improves, there is often a fluctuation between more disturbed and more balanced mental experiences of life. The Kleinian-informed psychoanalytic approach demonstrated in this case material aims to address this lack of psychological integration and help patients regain or discover psychological clarity, stability, and balance in how they feel, think, and relate.