Journal of Psychotherapy Integration, Vol 35(2), Jun 2025, 99-121; doi:10.1037/int0000365
The following evidence-based case study is presented in order to describe the successful treatment of a case of postpartum obsessive-compulsive disorder in 24 sessions by integrating elements of exposure with response prevention with intensive short-term dynamic psychotherapy. Exposure with response prevention is considered a first-line treatment for obsessive-compulsive disorder, but it has not been shown to have any impact on attachment insecurity, which is a common comorbidity of obsessive-compulsive disorder. Intensive short-term dynamic psychotherapy is a type of brief psychodynamic (PD) therapy that can help patients resolve attachment traumas by experiencing unconscious, mixed feelings toward attachment figures (past, current, and transferential). Outcome data from this case (self-report measures and clinical interviews) demonstrate dramatic reductions in obsessive-compulsive symptoms, anxiety, and representational risk, as well as improvement in mentalization and parental reflective functioning, and improvements overall in attachment-based behaviors between the mother and her children. Clinical vignettes will provide some examples of the PD work along with summarizations of other therapeutic processes. An explanation of how experiential PD and behavioral techniques can work together to address attachment dynamics and obsessive-compulsive symptoms is discussed in order to demonstrate specifically how the therapeutic process led to these outcomes. (PsycInfo Database Record (c) 2025 APA, all rights reserved)