Finding Relief from OCD

It is relatively easy to diagnose the perpetual hand washer, or the trichotillomaniac who pulls out all her hair, you see the evidence of this. But what of the people like my dear friend Mary who lives with the recurrent thought in her head "there is more and more to be done" hence the endless cleaning. She gets the societal rewards and the inner torment? Not nice. I went on a web site for people who self identified as compulsive cleaners and the answers from other people at the site were "come over to my house" just like I thought. No support or understanding. 

Our mind wants a job, and as Norman Doige says in The Brain that Heals Itself, "the brain is more like a living creature with an appetite, one that can grow and change itself with proper nourishment and exercise." If someone has been a chronic worrier, and that's how her brain has been nourished, the mind automatically will dive for that part of the brain, the one with the huge, long established groove for worrying. Sadly this is a seemingly inescapable route and you might be asking, 'how can I prevent this'?

"Worry is interest paid on trouble before it comes due."
William Ralph Inge

Happily, with the modern aid of PET scans on the brain, patients tested prior to and after psychotherapy showed that their brains normalized after treatment. Good news, talking therapy works! Of course, since this is my profession I was pleased to report this study. The truth is many other methods can also work to calm the agitated brain. Prayer, meditation, exercise, chanting, swimming, singing, love making and a good hearty discussion with a treasured friend also calms the agitated brain.

The toughest people to help, those who have extremely agitated brains, are the unfortunates who have full blown OCD--obsessive compulsive disorder. As I mentioned in the past two posts there is a continuum of OCD. Some clients have cases of OCD that are not so pronounced while others are profoundly affected. The people that have severe cases have brains whose frontal lobes are very activated. Why this is, we don't exactly know. Heredity does play in as a component.

Here's an example of what can happen. Let's say someone with OCD is at a friend's house and accidentally drops a glass which shatters. Part of their brain registers that a mistake has been made. Then it sends a signal to the deepest part of the cortex which in turn triggers the "dreadful anxiety that something bad is going to happen unless we correct the mistake" says Doige. In a normal brain this works rather quickly and the issue is resolved  by apologizing, picking up, then sweeping up the broken glass to a feeling of relief. With our OCD person the process gets stuck and the dreadful feeling and anxiety increases, no relief in sight or in mind. Hence the endless rethinking the event, over apologizing, never letting it rest and basically torturing themselves long after the glass shattered. I call this 'the rumination rumba'.

Numerous other examples of what OCD people do with their ruminations and anxiety are: hand washing, hair pulling, counting their steps, checking and re checking their work etc.  Some of this can be physiological. I have known entire families that have anxiety disorder.  How to get unstuck? There is a method to overcome the "sticky" brain and get some relief. 

Get thee to a good counselor. After acknowledging that excessive worry is a symptom of OCD, explains Doige, "the next step is to refocus on a positive, wholesome, ideally pleasure giving activity." [Pick your pleasure: friends, music, books, helping someone, cuddling a grandchild, singing, gardening, praying, yodeling...] Let me add numerous studies have shown that it takes about 20 minutes for the redirected focus to enable a compulsion or addiction to subside. This trick of refocusing takes diligence and time but is worth the effort. We are breaking a bad habit by creating a new habit with better feelings.

A good way to get unstuck from thoughts is to be thoroughly captivated by an activity 

To summarize for recovering from the milder to moderate cases of OCD:

1. Relabel what is happen to you as not an 'unforgivable mistake', or the 'dread of not having a tidy house', or an attack of 'germs' but instead an episode of OCD. Doige tells clients to say, for example, "Yes I do have a problem right now. But it is not germs it's the OCD."
2. Realize that this might take diligence and constant effort at first to literally rewire the brain. There is a book by Jeffrey Schwartz called Brain Lock which is on this very subject, the possibility of changing circuits in the brain.
3. Refocus on a positive pleasurable activity the moment she/he becomes aware of the OCD attack. In other words do something, anything, to shift the brain gears away from the groove in the brain.
4. Remember the struggle is to make the feeling go away, not to give in to it. This is like exercising an underdeveloped muscle, it needs time, practice and to strengthen and grow.
5. Some clients will need medication plus all the work with a psychotherapist on top of it. I recommend someone who is familiar with both Schwartz's and Doige's work to save time.
6. Encourage the client, friend or relative to set a deadline. This gives the feeling of training for a race or practicing for a performance which can enhance resolve. Mark the measurable results and cheer yourself on, let go of the set backs with renewed resolve.
7. It might be handy to have a formal cheering section: family, therapist or friends.

Open your windows and
breathe in the air.                                             

Even from a cell
you can see the sky,
the stars.   Rumi

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