The Brain That Changes Itself – Dr. Norman Doidge Chapter 6 “Brain Lock Unlocked – Using Plasticity to Stop Worries, Obsessions, Compulsions, and Bad Habits”

In this chapter, Doidge introduces us to the work of Jeffrey M. Schwartz:

OCD – obsessive, compulsive disorder plagues individuals in many ways. For example:

  • Terrified at what has happened or will happen to themselves or their loved ones.
  • Reacting to an emotional trigger – hearing of a traumatic experience of another, reading about a chemical in the food supply, or seeing a gruesome image.
  • Suffering obsessions like fears of contracting a serious, terminal illness, or by being contaminated by germs or radiation, or demanding that something be kept in a perfect order that you only know about.
  • Obsession – a thud while driving had to be a person you ran over – you go back and check it numerous times.
  • Washing over and over because of perceived contamination.
  • A mother who fears she will hurt her own baby may wrap a butcher knife up in a towel and lock it in a “safe” place. P. 164-168

Treatment for OCDvery difficult: Medication and behavioral therapy are only partially effective for some people.  Jeffrey M. Schwartz developed “an effective, plasticity-based treatment. Other ways this treatment can help: nasty habits (nail biting, hair pulling, shopping, gambling, eating, jealousy, substance abuse, compulsive sexual behavior). Schwartz has compared the brain scans of typical individuals and those with OCD. By doing before and after scans, he documents effectiveness of his treatment.  For most of us when we make a mistake, we are aware of the mistake, worry about it and then correct it. Once we correct it we can move on while the individual with OCD cannot move on…  The orbital frontal cortex (just behind our eyes) is where we detect mistakes. The cingulate gyrus (deepest part of cortex) triggers anxiety. Then our “automatic gearshift” (caudate nucleus – deep in the center of the brain) allows us to move on unless it “sticks” or we experience “brain lock.” P. 169-170

Causes of “brain lock” vary – may be genetic, may be infections that swell the caudate. “Learning may also play a role in its development.” P. 170 Schwartz wondered if those with OCD could “manually” shift the gear – by “paying constant, effortful attention and actively focusing on something besides the worry, such as a new pleasurable activity.” In the process they would be growing a new brain circuit. “With this treatment we don’t so much ‘break’ the bad habits as replace the bad behaviors with better ones.” P. 170

Schwartz’ therapy has two basic steps:

  1. Recognize the problem and relabel it – not a germ problem, but OCD.
  2. Replace thoughts with a positive.  “Schwartz has found it essential to understand that it is not what you feel while applying the technique that counts, it is what you do.” P. 173

In chapter 3, “Redesigning the Brain” Doidge gave us two key laws of plasticity:

  1. “Neurons that fire together wire together.”
  2. “Neurons that fire apart wire apart.” P. 174

The more one is able to avoid acting on the compulsion, the weaker the bad connection becomes.

Typical medication: Anafranil or a Prozac-type drug complements the therapy.

I would recommend working with a naturopath along with the two steps Schwartz developed before using the traditional medication. Further, working with a neurodevelopmentalist will help you to get to the underlying causes.

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