Jean Cottraux

Internal Enemies Publication date : March 20, 2005

All of us are confronted on a daily basis with aggressive, repugnant, or antisocial thoughts, which seem to surge into our minds and that we repress. We may be afraid of driving over a pedestrian in a moment of inattention, of uttering an obscenity in public, or of catching an infectious disease. More often than not, we ignore our fears; we may sometimes play around with them, but usually it is easy enough to redirect our thoughts. But for some people, struggling against disturbing thoughts is a major task. Obsessive subjects are convinced that their fears will come true, and so they try to conjure them with quasi-magical behaviour: they may constantly wash their hands in order to deny fears of infection, or keep checking that they have switched off the gas because they are afraid of being responsible for a catastrophe. Jean Cottraux's study of several clinical cases enables him to describe how obsessive-thought processes function. Why do some people become obsessed with cleanliness, fear of causing accidents, or the idea that they are guilty of some fault or imperfection? Where should the line be drawn between "normal" obsessions, from which everyone suffers to a greater or lesser degree, and pathological obsessions? When should measures be taken to treat those who suffer from obsessions? Why have obsessive-compulsive disorders become so common (2.5% of the population now suffer from them)? In this excellent analysis of obsessive-thought processes, health-care professionals, patients and their families will find a detailed review of the results of recent scientific research, as well as a simple and practical listing of the latest medication-such as serotoninergic antidepressants which act on behaviour and cognition.

Doctor Jean Cottraux is a clinical psychiatrist and lecturer at the Université de Lyon I. He heads the unit for the treatment of anxiety at Lyon's neurological hospital. One of the most renowned French specialists of obsessive-compulsive disorders, he is the author of more than ten books on psychiatry, including Les Thérapies Cognitives et Comportementales (Masson, 1995) and Les Thérapies Cognitives (Retz, 1992).