LENA DUNHAM’S SELFIE: Exercise Is Great. OCD Needs Much More.



As a psychoanalyst who treats OCD, I want to chime in here. I certainly don’t think Lena Dunham’s Instagram post intends to give the impression that exercise is the answer to anxiety, OCD, or depression. Not with her years of struggle with disturbing thoughts that lead to OCD. There’s no question that exercise helps the brain and brings relief. Yet, with all the talk about the symptoms of OCD, there’s not enough understanding of what underlies them.

Current theories tend toward the genetic and biologic with psychoanalytic understanding falling out of favor – in our culture in general these days. Genetics, individual pre-disposition, and biology may very well play some role in OCD. But, in my clinical experience what underlies OCD are fantasies and anxieties about aggression, anger, and sex that are controlled with tormenting OCD rituals.

Psychoanalysis is no longer a silent analyst leaving patients to work problems out on their own. What OCD sufferers need is an active and engaged analyst who understands the nature of their often rigorously cut off and compartmentalized feelings, and helps to resolve them. Without question, the treatment of choice for OCD is psychoanalytic therapy.

I haven’t watched Girls, but now I’m very curious about Lena Dunham’s character, Hannah. Stayed tuned until next Wednesday – same place, same time. I’m going to watch some episodes of Girls and show you how I might understand Hannah’s OCD if I had her on my analytic couch.

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