A Psychophysical Window onto the Subjective Experience of Compulsion.

In this perspective, we follow the idea that an integration of cognitive models with sensorimotor theories of compulsion is required to understand the subjective experience of compulsive action. We argue that cognitive biases in obsessive–compulsive disorder may obscure an altered momentary, pre-reflective experience of sensorimotor control, whose detection thus requires an implicit experimental operationalization. We propose that a classic psychophysical test exists that provides this implicit operationalization, i.e., the intentional binding paradigm. We show how intentional binding can pit two ideas against each other that are fundamental to current sensorimotor theories of compulsion, i.e., the idea of excessive conscious monitoring of action, and the idea that patients with obsessive–compulsive disorder compensate for diminished conscious access to “internal states”, including states of the body, by relying on more readily observable proxies. Following these ideas, we develop concrete, testable hypotheses on how intentional binding changes under the assumption of different sensorimotor theories of compulsion. Furthermore, we demonstrate how intentional binding provides a touchstone for predictive coding accounts of obsessive–compulsive disorder. A thorough empirical test of the hypotheses developed in this perspective could help explain the puzzling, disabling phenomenon of compulsion, with implications for the normal subjective experience of human action.