The Freudian Revolution:
Early 20th Century

Two figures dominated the early 20th century history of Os and Cs: the French psychiatrist Pierre Janet and the Austrian psychiatrist Sigmund Freud. While Janet expanded on existing medical ideas,¹ Freud represented a significant break from the past, a paradigm shift.

Sigmund Freud around age 35

Freud interpreted Os and Cs symbolically. This can be seen in his interpretation of a young woman's compulsive bedtime ritual. The 19-year-old could not go to sleep until she made sure the clocks and watches in her room would not wake her up, arranged her pillows in exactly the right way, and took a dozen other steps as part of what Freud termed her "sleep-ceremonial." Freud interpreted the fluffy bedding as a symbol of pregnancy and the clocks as symbols of the female genitals, as he explains: "Clocks and watches—though elsewhere we have found other symbolic interpretations for them—have arrived at a genital role owing to their relation to periodic processes and equal intervals of time," wrote Freud. "Our patient gradually came to learn that it was as symbols of the female genitals that clocks were banished from her equipment for the night."²

Freud's approach, or offshoots of it, continued to be taught in medical schools up to the 1970s,³ although, of course, other ideas and approaches also existed.⁴

For the clergy, Freud's overly sexual interpretation of Os and Cs must have been hard to stomach. The clergy resumed their own writing on the subject and offered useful advice about "scruples" (a term for Os and Cs) in books by Patrick Gearon (1921), Dermot Casey (1948) and others.⁵

Freud called the illness Zwangsneurose. In England this term was translated as "obsession" and in America it became "compulsion." The term "obsessive-compulsive disorder" was eventually adopted as a compromise.⁶

¹Pierre Janet (1903).

²Sigmund Freud (1917). See also Dolnick, 1998, p. 251.

³Osborn, 1998, p. 228.

⁴See Jakes, 1996.

⁵Patrick Gearon (1921) and Dermot Casey (1948).

⁶More about the origin of the term "obsessive-compulsive disorder." See also Berrios, 1996, p. 141.