Obsessive-compulsive states in childhood and their treatment

The object of this paper is to-discuss a problem with which consultant and general practitioner are alike faced, 'and to deal with the subject from the standpoint of general medicine in language from which, so far as possible, the more advanced psychological terminology has been eliminated. When it is realized that, failing correct and adequate treatment,compulsive states may 'persist throughout life, the importance of their recognition and treatment in childhood need hardly be stressed. It is not perhaps generally known that the cure of the obsessive states of childhood is cne ef the most satisfying, and even dramatic, things in medicine;' one of the too few instances in which psychological treatment approaches the realms of an exact science. Arising, as they do, from fear and uncertainty, mild, fleeting compulsive acts are relatively common in chi!dhood and respond readily to simple reassurance or to explanations which undermine the child's fears and satisfy his doubts. From time to time, however, the aid of the -practitioner is sought in cases of obsessivecompulsive neuroses which are of such intensity and permanence that the child is not only prevented from attending school or associating with other children, but is the despair of his parents, who, as daily observers of what appear to them to be unnecessary and meaningless repetitions and cere- monials, cannot conceal their disapproval or refrain from outspoken criticism of his behaviour.