Obsessive-Compulsive Disorder: The Underlying Role of Diminished Access to Internal States

Nira Liberman*, Amit Lazarov, Reuven Dar

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review


We suggest that individuals with obsessive-compulsive disorder (OCD) experience difficulty accessing their internal states, including their feelings, emotions, preferences, and motivations. Instead, they rely on proxies to inform them of these states—that is, discernible substitutes in the form of fixed rules and rituals, observable behavior, and indexes. The Seeking Proxies for Internal States (SPIS) model of OCD proposes that compulsions, obsessions, indecision, and doubt result from seeking and using such proxies. The SPIS model not only accounts for these OCD symptoms but also sheds new light on normal processes of action control, metacognition, decision-making, and introspection.

Original languageEnglish
Pages (from-to)118-124
Number of pages7
JournalCurrent Directions in Psychological Science
Issue number2
StatePublished - Apr 2023


  • Obsessive-compulsive disorder
  • SPIS
  • action control
  • biofeedback
  • decision-making
  • doubt
  • emotional intelligence
  • introspection
  • metacognition
  • self-awareness


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