A clinical approach from RDC-IPITIA Barcelona
At RDC-IPITIA, we conceptualize Obsessive-Compulsive Disorder (OCD), or obsessive neurosis, as the expression of a deep internal conflict between a person’s vital drives and a rigid, punitive moral instance that psychoanalytic tradition has referred to as the Superego. From this perspective, obsessive suffering does not arise solely from intrusive thoughts or compulsive behaviors, but from a psychological structure characterized by fear, guilt, and constant self-monitoring.
Vital drives can be understood as the forces that push human beings toward full living: developing, enjoying, loving, defending their interests, and occupying their place in the world. Among these we find the sexual drive, understood broadly as eros or the impulse toward life, pleasure, creativity, and connection with others. We also find the aggressive drive, understood not as destructive violence, but as assertiveness, self-affirmation, determination, healthy ambition, and the strength to defend one’s positions and achieve goals.
However, many individuals with OCD develop an excessively rigid Superego. This psychological structure is formed in childhood through relationships with authority figures, especially parents, educators, and other significant references. When these experiences are marked by excessive demands, fear of mistakes, criticism, or guilt induction, the child may internalize an extremely severe moral code. As a result, the person learns to distrust their own desires, emotions, and natural impulses.
The outcome is a permanent conflict. On one side, there are legitimate needs for freedom, expression, and self-assertion. On the other, there is an internal voice that judges, forbids, and punishes. Anxiety emerges precisely from this inner struggle. Obsessions and compulsions often represent attempts to resolve or neutralize this tension.
Within this model, one of the fundamental goals of treatment is to progressively weaken the power of this rigid Superego and strengthen the person’s connection with their own desires, needs, and values. This is where the concepts of transgression and rebellion become particularly relevant.
Transgression as an act of psychological freedom
The word transgression often triggers rejection because it is automatically associated with immoral or antisocial behavior. However, from our therapeutic perspective, to transgress means something very different. It means questioning and challenging those internal prohibitions that unjustifiably restrict individual freedom.
Many people with OCD live under extremely strict internal rules. They must be perfect, excessively responsible, incapable of making mistakes, always considerate of others, and constantly vigilant about any possible harm they might cause. These demands create a heavy emotional burden and keep the anxiety system activated.
Therapeutic transgression consists of consciously engaging in actions that the Superego considers unacceptable but that are, in reality, part of a normal, healthy, and psychologically balanced life. This may involve expressing an opinion that will not please everyone, setting boundaries, prioritizing one’s own needs, making mistakes without compulsively trying to correct them, or accepting that it is impossible to control all consequences of one’s actions.
Therapeutic transgression rarely appears as major acts of rebellion. More often, it takes the form of everyday decisions that allow the person to recover psychological freedom. For example, it may involve deciding not to go every Sunday to have lunch with one’s parents when, in reality, one would prefer to spend the day at the beach, while facing the guilt this may generate. It may also mean choosing a university degree that is truly meaningful and motivating rather than one considered safer or more appropriate by others. Likewise, it may involve allowing oneself to explore creativity, despite having been told for years that “it is useless” or that “you cannot make a living from it.”
In all these cases, the conflict does not lie in the behavior itself, but in the anxiety, fear, and guilt that arise when the person stops automatically obeying external expectations and begins to listen to their own needs. Therapeutic transgression consists precisely in passing through these emotions without retreating, gradually strengthening the capacity to act from one’s own identity rather than from fear of disapproval or punishment.
When the person engages in these acts of transgression, fear and guilt inevitably arise. However, this is precisely where the therapeutic value of the experience lies. By remaining firm in the face of these emotions and observing that the feared consequences do not occur, the person begins to dismantle the beliefs that sustain their anxiety and progressively weakens the authority of the internal judge that has governed their life for years.
Transgression thus becomes a practical exercise in psychological freedom. The person stops automatically obeying the voice of fear and begins to act according to their own criteria, needs, and legitimate desires.
From our clinical experience, many people with OCD do not only suffer from obsessions and compulsions, but also because they have built a life excessively adapted to the expectations of others. We often meet individuals who have learned to be good, responsible, compliant, and correct, but who have gradually lost contact with their own desires. In these cases, transgression is not merely a tool for symptom reduction, but a path toward the recovery of authenticity. The person begins to discover who they are beyond fear, guilt, and internalized demands. They begin to build a life chosen by themselves rather than one determined exclusively by the need to avoid conflict, rejection, or disapproval.
Rebellion in the face of fear and guilt
Rebellion represents a further step beyond occasional transgression. It is an existential attitude of questioning and emancipation from the internal norms that restrict personal development.
Many people with OCD organize their lives around two major fears: the fear of causing harm and the fear of disapproval. They fear harming others, being bad people, making mistakes, being selfish, or being judged negatively. As a result, they develop constant monitoring of their thoughts, emotions, and behaviors.
The problem is that the more a person tries to eliminate doubt and guarantee absolute safety, the more obsessive functioning is reinforced. The nervous system learns that there is a permanent threat and maintains high levels of anxiety.
Therapeutic rebellion involves adopting a different stance. It means consciously deciding that one’s life will not be governed by fear or by the constant need for approval. It means accepting that it is impossible to control everything, that mistakes will sometimes be made, and that it is not always possible to please everyone.
In this context, rebelling means taking responsibility for living according to one’s own values and needs, even if this involves anxiety, guilt, or uncertainty. It means abandoning automatic obedience to internal demands and developing the courage required to hold one’s own position in the face of fear.
From this perspective, recovery from OCD requires developing the ability to tolerate uncertainty, confront irrational guilt, and accept the risks inherent in freedom. The person learns to act in accordance with their authentic values even when their emotional alarm system suggests otherwise.
Toward a reduction of trait anxiety
At RDC-IPITIA, we consider that the ongoing work of transgression and rebellion can produce profound changes in a person’s psychological and emotional functioning. As the dominance of the rigid Superego decreases, the nervous system stops interpreting certain situations as permanent threats.
As a consequence, trait anxiety gradually decreases—that is, the general tendency to respond with anxiety across many life situations. When baseline anxiety decreases, obsessions lose intensity and frequency, and compulsions are no longer needed as coping mechanisms.
Clinical experience shows that many people begin to feel freer, more spontaneous, and more connected to their true desires. They learn to live more authentically, develop a stronger sense of identity, and become less dependent on the constant search for certainty and approval. As this process progresses, the nervous system stops automatically reacting to old threat stimuli, progressively reducing overall anxiety levels.
As a consequence of this profound transformation, obsessions and compulsions begin to decrease in both intensity and frequency and, in many cases, eventually disappear, as they no longer occupy the center of the person’s mental life. When fear and guilt stop governing behavior, OCD progressively loses the psychological ground on which it was sustained.
In conclusion, transgression and rebellion are not invitations to irresponsible behavior, but rather a process of psychological liberation from excessively rigid internal norms. They are tools aimed at recovering freedom, spontaneity, and the ability to live in accordance with one’s own values. From our therapeutic perspective, facing fear and guilt in a conscious and determined way can become one of the most effective paths to weaken obsessive functioning and move toward a fuller, more authentic, and freer life.
The fundamental question is not how to eliminate all anxiety, but what kind of life one would be willing to live if fear and guilt stopped making decisions in their place.
Barcelona, June 2026
www.ipitia.com
