The self in psychological disorders: The example of obsessive-compulsive spectrum disorders

Research on the self has led to a better understanding of psychological function and dysfunction. In particular, scholars increasingly highlight ruptures of the self in the understanding and treatment of psychological disorders. While there is an emerging literature on the importance of self across disorders, this chapter presents evidence from studies of self-construals in obsessive-compulsive spectrum disorders (OCSD) such as obsessive-compulsive disorder (OCD), body dysmorphic disorder (BDD) and hoarding disorder (HD). Self-constructs have been implicated in both the conceptualisation and diagnosis of psychological disorders such as OCD (e.g., the ego dystonicity of obsessions and compulsive behaviour in defining OCD). With the focus on the self, its ruptures and related constructs such as early schemas and attachment styles, practitioners and researchers have been able to enhance understanding of underlying mechanisms of psychological disorders (e.g., self-ambivalence in the etiology of OCD). Ultimately, by embedding the self into treatment and engagement formulations, practitioners might also be able to increase treatment acceptance by 'treating the person instead of the disorder' and, hence, advance the effectiveness of evidence-based interventions.