Brief History of OCD

Historical records show that OCD symptoms can be seen as far back as the 14th century. The Roman Catholic Church originally coined the term “scrupulosity” to refer to an excessive worry about one’s religious sins, leading to compulsive behaviors aimed at seeking atonement. Many famous religious figures wrote about “scrupulosity.” For example, in 1678, enlightenment thinker John Locke wrote, “I cannot imagine that God, who has compassion upon our weakness and knows how we are made, would put poor men, nay, the best of men, those that seek him with sincerity and truth, under almost an absolute necessity of sinning perpetually against him, which will almost inevitably follow if there be no latitude at all allowed as in the occurrences of our lives.”

During the 18th and 19th centuries, doctors started identifying symptoms that are familiar to us today, such as obsessive handwashing, checking, obsessions over catching syphilis, and aggressive or sexual thoughts. During this period, the view of scrupulosity changed from being a religious issue to a medical one. Famous French psychiatrist Jean Etienne Dominique Esquirol described OCD in his 1838 psychiatric textbook as a kind of monomania, a kind of partial insanity.  As mental institutions grew, more individuals diagnosed with scrupulosity were admitted to asylums. However, by the late 19th century, scrupulosity was no longer classified as a type of insanity. 

The early 1900s marked the beginning of our current understanding of OCD. This was significantly influenced by psychiatrists Sigmund Freud and Pierre Janet's groundbreaking work. Freud described the obsessive behaviors of his patients using the term “Zwangsneurose.” Later, New York and London translated this term as "obsession" and "compulsion," respectively. Eventually, a compromise between these translations led to the term "obsessive-compulsive" as the diagnosis.

By the 1970s, behavioral therapy had gained popularity to treat OCD. The emergence of behavioral therapy to treat OCD gave way to what is now known as exposure and response prevention therapy, the most effective treatment for OCD.