2024 – UNIVERSITY OF LAUSANNE, SWITZERLAND
The fourth edition of OCD in Society was hosted by Elvis Coimbra-Gomes at the University of Lausanne (UNIL) on 7 June 2024. It was attended by ca. 30 people. The theme of the event was "The Language of OCD", which correlated with the Master seminar Elvis taught at UNIL. The goal was to think about how language is used in different contexts to achieve different purposes in relation to OCD. For instance, how is language used in the DSM 5 to describe the classification of OCD and what are the presuppositions behind the used language? How does the interaction between a psychologist and an OCD sufferer play out during therapy sessions? What kind of correlations exist between the sufferer’s use of language and their emotional mental state? How do OCD sufferers use language to describe their symptoms? What kind of metaphors are employed in such task? How do sufferers use language to perform (aspects of) their identity in relation to the feared possible selves that the OCD represents? What are the different ideologies that are drawn from to construct their identity? How is OCD discursively represented in the media or in literary works? What kind of discourses circulate on social media? What kind of language do OCD charities use in their advocacy work? What are the linguistic mechanisms involved in all of these different contexts (e.g., a focus on lexical choice, rhetorical strategies, linguistic transitivity, nominalization, narrative structure, appraisal/evaluative strategies, collocation, stance-taking, conceptual metaphors, recipient design, registers, genres, etc.). And finally, what can therapists gain from such interdisciplinary explorations? At the bottom, you can consult the posters Elvis' students designed about their personal research projects.
Watch the playlist of the recorded talks here:
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ACADEMIC SPEAKERS
Hazel Price is a Lecturer in English Language at the University of Salford, UK. Her research interests include health communication, critical discourse analysis and corpus linguistics. Her recent publications include the co-edited Communicating Linguistics: Language, Community and Public Engagement (2023), The Language of Mental Illness: Corpus Linguistics and the Construction of Mental Illness in the Press (2022), and the co-authored The Babel Lexicon of Language (2022).
What can language tell us about OCD?
Mental illness is an increasingly important social issue. In recent years, mental health charities and advocates have focussed on the responsible reporting of mental illness, particularly in the media (e.g. Mind’s (2023) guidelines for talking about mental health). In line with the increased importance of mental health and illness in social life, the topic has received increasing attention in recent years within linguistics (e.g. Collins & Baker, 2023; Price, 2022), with some researchers focussing specifically on the language used to discuss Obsessive Compulsive Disorder (OCD) (Coimbra-Gomes & Motschenbacher, 2019; Knapton, 2021; Price, 2023).
In this talk, I use computational linguistic methods to show how patterns in language can provide insight into public perceptions of OCD, and reveal how myths around OCD are created and reinforced. I demonstrate the value of prioritising language as an object of study in itself, arguing that language plays a major role in (i) public education in relation to OCD, (ii) understanding how people talk about their own experiences of OCD, and (iii) for identifying harmful and stigmatising discourses related to OCD.
Using a specialised corpus containing 45 million words covering a 30-year period of UK press reports on mental illness, I will explore changes in how OCD is reported in the media, and how press representations of OCD compare with representations of other mental health conditions.
REFERENCES
Coimbra-Gomes, E., & Motschenbacher, H. (2019) Language, normativity, and sexual orientation obsessive-compulsive disorder (SO-OCD): A corpus-assisted discourse analysis. Language in Society, 48(4), pp. 565-584.
Collins, L, & Baker, P. (2023) Language, Discourse and Anxiety. Cambridge: Cambridge: Cambridge University Press
Knapton, O. (2021) The linguistic construction of the self in narratives of obsessive- compulsive disorder. Qualitative Research in Psychology, 18(2), pp. 204-226.
Mind (2023) Media guidelines: ‘Talking about mental health’. Available at: https://www.mind.org.uk/media/u2dnynhm/mind-media-guidelines-talking-about- mental-health.pdf
Price, H. (2022) The Language of Mental Illness: Corpus Linguistics and Construction of Mental Illness in the Press. Cambridge: Cambridge University Press.
Price, H. (2023) ‘A corpus stylistic approach to analysing mental health’, in Burke, M. (ed) The Routledge Handbook of Stylistics (2nd Edition). Abingdon: Routledge.
Isabella Franco received her B.A. in English from Adelphi University’s Honors College in 2022, having minored in both studio art and psychology. She currently works in the book publishing industry, and she plans to pursue an M.F.A. in creative writing in the near future. Her undergraduate thesis is an exploration of obsessive-compulsive disorder viewed through the lens of media representation and misrepresentation. She wants to further experiment with blending her creative-writing pursuits and her personal experiences living with OCD; she is currently working on her first novel with this goal in mind.
What impact does media “representation” of OCD have on the diagnosis, treatment,
and stigmatization of OCD and other mental disorders?
Individuals living with mental disorders are not unfamiliar with the stigma that comes with it, and although more open conversations surrounding mental health are happening today, there are still a number of people who hold inaccurate biases against those personally affected—research indicates that more television viewing time is correlated with a poorer knowledge of OCD, suggesting that television and other forms of media are providing inadequate information regarding the disorder (McCarty et al., 2017).
The media is believed to be a major contributor to mental health stigma due to its portrayal of characters with mental illness and because of the “misinformation communicated, inaccurate use of psychiatric terms, and unfavorable stereotypes” (Ponzini & Steinman, 2021). Disability has been used as a crutch for literary narratives to lean on for representational power, a term often referred to as “narrative prosthesis,” and in literary and visual representations, narrative prosthesis is the exploitation of a character’s disability for the sake of turning it into a metaphorical opportunity (Davis et al., 1997, p. 276). Some media depictions of OCD have caused the disorder to become “synonymous with ‘good’ qualities such as cleanliness and order,” and although society may view this as a positive effect, “it erases the reality of OCD as a debilitating mental disability” (Kim, 2021).
In my paper entitled “Neat Freak: Understanding How Media Portrayal of OCD Can Negatively Impact the Stigma Surrounding Mental Health,” I dissect different forms of media—ranging from television and film, to literature and podcasts, to personal accounts from individuals living with OCD—in order to explore their varying representations of obsessive-compulsive disorder; unpack the harmful consequences that stereotypes have on individuals already diagnosed with OCD, those who have yet to be diagnosed, and those seeking treatment; and discuss how creating a supportive, judgement-free environment for individuals to share their experiences of living with a mental disorder is a primary way we can continue to destigmatize mental illness.
REFERENCES
Davis, L. J., Mitchell, D., & Snyder, S. (1997). Narrative Prosthesis. In The Disability Studies Reader (pp. 274–287). Routledge.
Kim, A. (2021). Chapter 5: The Metanarrative of OCD. In D. Bolt (Ed.), Metanarratives of Disability: Culture, assumed authority, and the normative social order. Routledge.
McCarty, R. J., Guzick, A. G., Swan, L. K., & McNamara, J. P. H. (2017). “Stigma and recognition of different types of symptoms in OCD.” Journal of Obsessive-Compulsive and Related Disorders, 12, 64-70. https://doi.org/10.1016/j.jocrd.2016.12.006.
Ponzini, G. T., & Steinman, S. A. (2021). “A systematic review of public stigma attributes and obsessive–compulsive disorder symptom subtypes.” Stigma and Health, 7(1), 14–26.
Silvia Tajonar García is a PhD Candidate in Social Sciences with specialty in Sociology at El Colegio de México Colmex). She received her bachelor's degree in Sociology from Universidad Nacional Autónoma de México (UNAM), and her master’s degree in social science with specialty in Sociology from El Colegio de México. Her dissertation addresses how social inequalities shape the illness experiences and therapeutic itineraries of people diagnosed with OCD in México.
Gender and Obsessive-Compulsive Disorder (OCD): Illness Narratives and Experiences of Women Diagnosed with OCD in Mexico City and its Metropolitan Area
In this presentation I aim to discuss some preliminary findings of my doctoral research, which addresses how social inequalities, particularly those related to gender, shape the illness experiences and therapeutic itineraries of different people living in Mexico City and its metropolitan area. In this opportunity, I will focus on illness experience and the role that language plays in it.
Analyzing in-depth interviews with women diagnosed with OCD, I will show how they use various languages (Bajtin,1991) to interpret, narrate and therefore construct their experiences of the disorder. Their narratives attest to the prevalence of gender roles and inequalities in Mexican society, which shape their illness experiences and the way they see themselves and perform their identities (Levy, 2005; Coimbra, 2021).
I draw on Kleinman’s (1997) approach to the “illness experience” (in Kleinman and Seeman, 2000:239), which, he argues, can be graphically represented as a triangle: on one side we have cultural frames; on the second one, we have social contexts, and on the third one we find subjectivity. This is a useful and comprehensive stance, which allows to understand the illness experience as a sociocultural process.
According to Kleinman and Seeman (2000:37-8), “illness narratives” constitute a valid way to access the illness experience, and, while I agree, I also wish to explore the performative dimensions of language and narratives. Regarding this, I follow Levy (2005:12), for whom narratives are much more than a “simple reflection of experience” and hold creative and transformative potential. Therefore, by analyzing these women’s narratives, we will understand how they relate to dominant moral values and social norms regarding genderized social roles (in arenas such as care providing, motherhood, sexuality, etc.); how they read their past selves through the lens of psychiatric categories and how they strive to craft future “recovered” selves through their narratives.
REFERENCES
Bajtin, M. (1991). Teoría y estética de la novela. España: Taurus Ediciones
Coimbra-Gomes, E. (2021). Language & Normativity in Sexuality & Gender-Related Obsessive-Compulsive Disorder: a Netnographic-Informed Corpus-Assisted Discourse Study. PhD Thesis. Queen Mary, University of London.
Kleinman, A. and Seeman, D. (2000). Personal experience of illness. In, Albrecht, G.L., Fitzpatrick, R. and Scrimshaw, S. C. (2000). Handbook of social studies in health and medicine. Sage Publications.
Levy, J. M. (2005). Narrative and Experience: Telling Stories of Illness. Nexus, 18.
Gabriele is a postdoctoral research fellow at Pontifical Gregorian University. His research, grounded in cultural anthropology, uses qualitative interviews and visual ethnography to unravel how CSA impacts survivors’ perception of safety within their personal spaces, particularly homes, which should be sanctuaries of safety yet may become complex sites of memory and trauma. Gabriele is involved not only as a researcher but also as an activist in this topic. He is a survivor and member of an Italian organisation supporting adults with a related experience, where he is a natural facilitator in mutual aid groups.
The Role of Language in the Spatial Experiences of CSA survivors with OCD: an Ethnographic Approach to Visual and Verbal Narratives
Our language is a potent force in shaping our understanding of self, others, and the spaces we inhabit. This is particularly evident in the narratives of individuals who experienced child sexual abuse (CSA) also grappling with Obsessive-Compulsive Disorder (OCD). Through in-depth qualitative interviews and visual ethnography, my research explores the multifaceted impact of CSA on survivors’ spaces and homes, emphasising the critical role of language in shaping their understanding of and interaction with environments.The study explores the convergence of linguistic expression in CSA survivors and their language patterns when manifesting OCD, focusing on how these groups use verbal and nonverbal communication to navigate ‘safe’ spaces—both tangible and digital. This analysis is revealing the nuanced ways language can create what constitutes a ‘safe’ place. It also offers therapeutic insights into how linguistic engagement can potentially foster healing. The feared ‘possible selves’ that OCD sufferers post-CSA seek to guard against (through compulsions and rituals) can transform their language into a tool for both expressing and managing their identities in relation to their disorder.
These narratives reveal a complex interplay between the cultural and psychological spatial practices of OCD, highlighting how specific spatial arrangements, sensory elements, and privacy aspects can trigger memories of trauma or, conversely, contribute to a sense of security and healing. Complementing interviews, visual ethnography provides a tangible lens to understand these altered perceptions and interactions with space. Photos, survivor-led video tours, and spatial mapping offer a visual and vibrant dimension to the narratives, elucidating how survivors with OCD reconstruct and reclaim their spaces. This visual aspect not only enriches the understanding of the survivors’ experiences but also challenges the audience to visually and empathetically engage with the realities of living with the dual impact of CSA trauma and OCD.
REFERENCES
Borrelli, D. F., Dell'Uva, L., Provettini, A., Gambolò, L., Di Donna, A., Ottoni, R., Marchesi, C., & Tonna, M. (2024). The Relationship between Childhood Trauma Experiences and Psychotic Vulnerability in Obsessive Compulsive Disorder: An Italian Cross-Sectional Study. Brain Sciences, 14(2), 116.
Caspi, A., Vishne, T., Sasson, Y., Gross, R., Livne, A., & Zohar, J. (2008). Relationship between childhood sexual abuse and obsessive-compulsive disorder: case control study. The Israel journal of psychiatry and related sciences, 45 3, 177-82.
Deblinger, E., Mannarino, A. P., Cohen, J. A., Runyon, M. K., & Steer, R. A. (2011). Trauma- focused cognitive behavioral therapy for children: impact of the trauma narrative and treatment length. Depression and Anxiety, 28(1), 67–75.
Foster, J., & Hagedorn, W. (2014). A Qualitative Exploration of Fear and Safety with Child Victims of Sexual Abuse. Journal of Mental Health Counseling, 36, 243-262.
Mathews, C., Kaur, N., & Stein, M. (2008). Childhood trauma and obsessive-compulsive symptoms. Depression and Anxiety, 25(9), 742-751.
Mullen, P., Martin, J., Anderson, J., Romans, S., & Herbison, G. (1993). Childhood Sexual Abuse and Mental Health in Adult Life. British Journal of Psychiatry, 163, 721-732.
Murphy, S., Kilpatrick, D., Amick-Mcmullan, A., Veronen, L., Paduhovich, J., Best, C., Villeponteaux, L., & Saunders, B. (1988). Current Psychological Functioning of Child Sexual Assault Survivors. Journal of Interpersonal Violence, 3, 55-79.
Ou, W., Li, Z., Zheng, Q., Chen, W., Liu, J., Liu, B., & Zhang, Y. (2021). Association Between Childhood Maltreatment and Symptoms of Obsessive-Compulsive Disorder: A Meta-Analysis. Frontiers in Psychiatry, 11.
Rukiye, A., & Erbay, L. (2018). Relationship between childhood trauma and suicide probability in obsessive-compulsive disorder. Psychiatry Research, 261, 132-136.
Dr. Jonathan Hoffman
Eva Surawy Stepney
Jonathan Hoffman, Ph.D., ABPP is a licensed psychologist and Board Certified in Behavioral and Cognitive Psychology. Dr. Hoffman is Chief Clinical Officer and Co-Founder at NeuroBehavioral Institute (NBI) and Co-Founder at NBI Ranch. He is a member of the IOCDF Scientific and Clinical Advisory Board, co-chair of the OCD and Autism Special Interest Group (SIG) and has served as a faculty member for the Behavior Therapy Training Institute (BTTI). His most recent writing collaborations were on OCD and eating disorders, OCD and autism, anxiety and nonverbal learning disorder, and the conceptualization of intrusive thoughts. He presents frequently on OCD-related topics for professional and public audiences.
Eva Surawy Stepney is a White Rose Arts and Humanities Research Council funded PhD candidate in the University of Sheffield History Department. Her research consists of a historical analysis of OCD in mid to late twentieth-century British clinical psychology, and what it can tell us about ideas of 'evidence' and therapeutics in psychology more broadly.
Have Obsessions Always Been Intrusive Thoughts? Experiential, Diagnostic, and Treatment-Related Considerations
We may take ‘intrusive thoughts’ as a descriptor for obsessions for granted these days. After all, that’s what it says in our diagnostic manuals. However, the term ‘intrusive thoughts’ has a fascinating backstory that seems all but forgotten. In this presentation, we aim to bring this little-known history back into the light and discuss the ramifications of utilizing this term on how OCD is presently conceptualized in the diagnostic nomenclature, treated, and, most importantly, experienced. The presenters are a historian and psychologist who have done a deep dive into this subject and are excited to share their findings and ideas on this topic with conference attendees, who may never think about ‘intrusive thoughts’ in the same way again. At least that’s what they’re hoping!
Matthew Hiller
Matt Hiller is a candidate in the joint social work and anthropology doctoral program at the University of Michigan and was a co-organizer for the 2021 and 2022 editions of the OCD in Society Conference. His doctoral research is supported by the National Science Foundation and is currently focused on the use of ketamine as a mental health treatment in the United States. In addition to this research, he also does work looking at the ways that social theory and philosophy can offer new frameworks for understanding OCD. Along with being a doctoral student, Hiller is a practicing psychotherapist and has undergone training with the Chicago Center for Psychoanalysis, the International OCD Foundation Behavioral Therapy Institute, and the Mood and Anxiety Disorders Program at the University of Illinois at Chicago Department of Psychiatry.
What Does it Mean to Call Thoughts Meaningless?
It is commonly claimed in OCD treatment and advocacy settings that intrusive thoughts are “meaningless.” In this talk, I explore what it means to call a thought “meaningless.” Drawing on semiotic theories, I explore three ways that signs take on meaning: indexicality, iconicity, and performativity (Pierce 1955, Austin 1962). The above claims about meaningless presume that intrusive thoughts are devoid of these sign functions. Counter to this view, I argue that sign meanings are inextricably bound to metapragmatic negotiations in social contexts (Silverstein 1993). Put simply, the meaning of things is always a matter of discussion and debate. As opposed to expressing a fundamental truth, I state that claims about the meaningless of intrusive thoughts advance a particular language ideology (Silverstein 1992). By briefly reflecting on my work treating OCD as a clinician, I explore the potentials and limits of this language ideology.
REFERENCES
Austin, J. L. (1962). How to Do Things with Words. 2nd ed. Cambridge, MA: Oxford University Press.
Pierce, C. (1955). “Logic as Semiotic.” In The Philosophical Writings of Pierce, edited by Justus Buchler. New York: Dover.
Silverstein, M. (1992). “The Uses and Utility of Ideology: Some Reflections.” Pragmatics, 2(3): 311–23.
Silverstein, M. (1993). “Metapragmatic Discourse and Metapragmatic Function.” In Reflexive Language : Reported Speech and Metapragmatics, edited by John Lucy. Cambridge: Cambridge University Press.
Simon Savitt
Simon Savitt is an OCD sufferer living in New York City. He graduated from The City College of New York in 2020 with a BS in Physics. Although he was diagnosed with OCD early on and introduced to first line treatments, he remained treatment-refractory for many years. After attending residential programs at both Rogers OCD Center and McLean OCDI where he struggled to see results with habituation-based ERP alone, he incorporated adjunct modalities that he credits with accelerating his OCD recovery. He advocates for the use of ACT, I-CBT, Positive Affect Treatment, and the Inhibitory Retrieval approach to ERP in the treatment of OCD. His goals as an OCD advocate are to share educational material on lesser-known modalities and to highlight comedians and artists whose performances are inspired by their experiences with OCD. You can follow his OCD advocacy work at ocd.community.
The Language of OCD Treatment: A Patient's Perspective
With the increased popularity of Inference-based CBT among OCD practitioners in the US, patients must learn to navigate conflicting definitions of common psychology terms across treatment modalities. For example, ERP uses the Intolerance of Uncertainty construct as the basis of its response prevention techniques, where uncertainty is conceptualized as a general fear of the unknown, whereas in I-CBT it refers to situations in which there is insufficient information but can which ultimately be resolved by gathering the relevant facts. The phrases that are repeated to patients to present treatment techniques differ greatly between modalities. ERP advocates for the use of active exposures or "lean-ins" that trigger distress using phrases such as "maybe, maybe not". In contrast, I-CBT prefers that patients seek a return to the certainty they held before the obsessional doubt sequence was initiated. Some modalities use simplified language to present an idea. MCT and I-CBT both contain a technique where alternate scenarios are considered to weaken catastrophic "what-if" obsessions, but what MCT calls verbal reattribution, I-CBT calls rehearsing the "alternative story". Whether patients are instructed to literally speak while performing exposures is a distinguishing factor between ERP approaches. The Inhibitory Retrieval/Learning approach suggests the use of affect labeling during exposure work, versus traditional ERP where verbalizing was often considered unhelpful as it was thought to prevent habituation. How modalities refer to each other is also an important focus. Positive Affect Treatment, which targets anhedonia by instructing patients to increase positive affect, reframes ERP as a "negative affect treatment" due to its focus on decreasing negative affect. This dichotomy in which valence is approached is one of many ways in which these modalities attempt to distinguish themselves from one another and demonstrate their efficacy. I believe that collecting and clarifying the similarities and differences in language between modalities is an important effort that will aid both clinicians and patients in practicing techniques across all treatment approaches.
Master Students' Presentations
Elvis Coimbra-Gomes is teaching this year a Master seminar called "The Language of Obsessive-Compulsive Disorder". As part of the assignment to pass this seminar, 15 students will present a talk or posters of their original research project that explores OCD from linguistic and semiotic perspectives.
Anna Novikova
With a background in International Relations, Anna is currently pursuing her master's degree in English at the University of Lausanne. Her diverse academic experience enables her to conduct interdisciplinary research in various domains. As a part of her studies at UNIL, she is attended the seminar "The Language of OCD".
Linguistic Expression of the Relation towards the Self and Magical Thinking OCD sufferers in the USA and Russia: a Comparative Linguistic Study
In order to understand the emotional and cognitive dimensions of the OCD, Anna's study explores the linguistic patterns of American and Russian-speaking magical thinking OCD sufferers, By analyzing the most frequent n-grams, concordance lines and normalized frequencies, Anna observed similarities as well as differences in the expression of distance-taking strategies (e.g., helping OCD sufferers to dissociate from their feared selves), as well as the search for control, and the notion of shame. The findings suggest that cultural and linguistic contexts influence the manifestation of OCD symptoms, which can be used in future research in psychology, linguistics and AI-training. Download the slides here.
POSTERS
MULTIMODAL DISCOURSE ANALYSIS
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Andreia Abreu Remigio, Multimodal Discourse Analysis of Children's Picture Books about OCD. Download.
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Lucy Desarzens, OCD and Horror Movies: an Analysis of Sensorial Modalities and Language in the Representation of Obsessive-Compulsive Episodes. Download.
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Loréane Holzer, How TikTok Videos Challenge OCD Stereotypes. Download.
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Emilie Mottier, The Cinematographic Representation of OCD in the TV Show "Pure". Download.
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Samantha Stutz, The Comical Portrayal of OCD: A Multimodal Analysis of the Representation of Comic Characters Through Time. Download.
LINGUISTIC / DISCOURSE ANALYSIS
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Charlynn Alpstäg, Youtube Narrative of OCD: Conceptualizing Threats in Activity Episodes. Download.
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Essia Brirmi, Teen OCD: Unveiling Teenagers' OCD Experiences Through Metaphorical Language. Download.
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Julia Cerutti, Exploring the Use of Language Used by ROCD Sufferers. Download.
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Sandra Camelia Duma, Words into Reality: Transitivity and Agency in Online Discourse on Manifestation and Obsessive-Compulsive Disorder. Download.
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David Hasler, Metaphorical Representations of OCD in Online Videos: A Cross-Linguistic Analysis of English and French Discourse. Download.
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Cécile Moulin, Understanding Pure OCD through Chrissie Hodges' Language. Download.
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Carlo Rossel, Verbalization of Gender Identity OCD. Download.
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Lio Roy, Chaos vs. Order: Dichotomic Personification of OCD to Illustrate Ego-Dystonicity. Download.
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Liam Seydoux, Conceptual Metaphors in Songs about Obsessive-Compulsive Disorder. Download.