Page No 197-206.
R. Tripathi and S. Mehrotra
National Institute of Mental Health and Neuro Sciences (NIMHANS), Bangalore
Repetitive thoughts (RTs) are normal phenomena; however, these also form
essential features of various psychiatric syndromes. This paper describes two
unusual adult cases of repetitive thoughts. Both the cases were characterized by
emergence of repetitive images and thoughts that were intrinsically pleasurable
and were in consonance with developmental concerns in early adulthood. The RTs
were not considered irrational by the individuals. The immediate consequences
described were that of pleasure and relief. The RTs acquired an intrusive quality
over time. The increasing frequency of intrusions was accompanied by decreasing
sense of control, heightened impairment in overall functioning and distress although
the RTs continued to be described as giving pleasure during their occurrence.
Despite warranting clinical attention, the presentation of the cases was atypical in
various ways and did not adequately match the criteria for any diagnosis. The
phenomenological description highlights the evolution of repetitive thoughts in terms
of qualities such as intrusiveness, ego-syntonicity as well as co-occurrence of
positive & negative affective tones. Using existing theoretical frameworks, the
possible psychological mechanisms underlying these presentations are discussed.
The paper raises several questions on repetitive, intrusive thoughts that need to be
addressed through further research.