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Purpose <p>To propose a diagnosis-specific, testable recursive affective-regulatory framework explaining why compulsions persist despite preserved insight in obsessive–compulsive disorder (OCD).</p> Methods <p>Conceptual synthesis of cognitive, habit-learning, and affect-regulation literatures, translated into operational definitions, falsifiable predictions, and pragmatic treatment implications.</p> Results <p>The present paper proposes that preserved-insight OCD arises from a recursive failure of affective symbolization in which proto-symbolic dissonance is sealed by shame, organized via magical thinking, amplified through responsibility valuation, maintained by pathological discursive saturation (rumination, mental checking, reassurance loops), and stabilized by habit-like proceduralization. The paper provides an operationalization table, 12 numbered falsifiable predictions, and three study designs (ecological momentary assessment, habit-bias paradigm, brief desaturation trial).</p> Conclusions <p>By distinguishing pathological from therapeutic discursive saturation and specifying measurable pathways, the framework clarifies mechanism, generates testable hypotheses, and motivates a preliminary three-phase sequencing proposal that may support exposure and response prevention (ERP) preparedness.</p>

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A Testable Recursive Affective-Regulatory Framework for Obsessive–Compulsive Disorder: Symbolic Integration Failure, Inflated Responsibility, and Discursive Saturation

  • 期刊论文

  • 发表日期：

    2026年6月15日

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  • Rafael Tonella Vezzoli

摘要

Purpose

To propose a diagnosis-specific, testable recursive affective-regulatory framework explaining why compulsions persist despite preserved insight in obsessive–compulsive disorder (OCD).

Methods

Conceptual synthesis of cognitive, habit-learning, and affect-regulation literatures, translated into operational definitions, falsifiable predictions, and pragmatic treatment implications.

Results

The present paper proposes that preserved-insight OCD arises from a recursive failure of affective symbolization in which proto-symbolic dissonance is sealed by shame, organized via magical thinking, amplified through responsibility valuation, maintained by pathological discursive saturation (rumination, mental checking, reassurance loops), and stabilized by habit-like proceduralization. The paper provides an operationalization table, 12 numbered falsifiable predictions, and three study designs (ecological momentary assessment, habit-bias paradigm, brief desaturation trial).

Conclusions

By distinguishing pathological from therapeutic discursive saturation and specifying measurable pathways, the framework clarifies mechanism, generates testable hypotheses, and motivates a preliminary three-phase sequencing proposal that may support exposure and response prevention (ERP) preparedness.