Beating Obsessions and Compulsions

By Maryse IsmaSpecial to CSMS MagazineObsessions and compulsions can literally ruin someone’s life. It can trigger a constant irritation that, if remains untreated, can provoke many drawbacks in the life of an individual. “You’re not sure you turned off the stove, so you go home to check. After you leave again, you’re still unsure. What if the house burned down? So you check again. And again. This is classic obsessive-compulsive behavior. Dread arising from intrusive thoughts (obsessions) leads to repetitive behavior (compulsions),” said Dr. Schwartz, the author of Brain lock: Free yourself from obsessive-compulsive behavior.            My cousin, who is a psychiatrist, took great pain telling me last week that one of his patients washes his hands more than 50 times a day. Even though he always knows that his hands are clean, he just cannot overcome the feeling they are dirty. So, he would scrub them until they are cracked and raw.            This person is not alone. Five million Americans suffer from obsessive-compulsive disorder (OCD), whose symptoms make their daily life exceedingly difficult. Experts agree that numerous more have minor obsessions and compulsions they would like to get rid of.For example, getting up to check and recheck a lock, rereading the same passage to make sure you got every word and having unspeakable thoughts of violence that you can’t get out of your mind are all signs of OCD.            When that happens, there are always reasons for concerns. But all is not lost. Researchers have made great strides in pinpointing the cause of the maddening symptoms and developing a therapy that really helps.What causes OCD? Researchers believe that it is caused by a glitch in the brain, a biochemical imbalance in the caudate nucleus—a region of the brain whose function is to control another part of the brain called the orbital cortex.            Ordinarily, the orbital cortex serves as a sort of “error-detection system.” When the caudate nucleus malfunctions, the orbital cortex is left stuck in the “on” position. This “brain-lock” conditions creates a “something-is-amiss” feeling that won’t go away.            According to Dr. Jeffrey M. Schwartz, associate research professor psychiatry at UCLA school of Medicine, there is a four-step program that can control OCD within a matter of weeks.Step 1: Relabel Since obsessions and compulsions won’t go away of their own accord, your step is to relabel them by making mental notes.            If you feel compelled to count all the blue cars you pass on the highway, for example, tell yourself, “I don’t need to count the blue cars. I’m having a compulsive urge to do so.”            This inner dialogue brings you back to reality. By observing your brain—neither giving in the compulsion nor pretending it doesn’t exist—you bolster your “Impartial Spectator.” That’s the innermost part of your personality…and what will allow you to conquer OCD.Step 2: Reattribute The next step answers the question, “Why won’t these terrifying thoughts, urges and behavior go away?” Reattribute these symptoms to their cause—a biochemical imbalance in the brain.            Think of OCD anxiety as a mental alarm system—with a hair-trigger. The siren may wail incessantly, but that doesn’t mean you must pay attention to it.            Remember: Silently reflect on the phrase, “It’s not me, it’s OCD.” Doing so stresses the distinction between your thoughts and fears…and your urges and anxieties, you can choose not to act on them.Step 3: RefocusEach time your obsession or compulsion resurfaces, refocus your attention on pleasurable, constructive activity—taking a walk… gardening…doing needlepoint…listening to music…playing a computer game.            Your goal is to pursue the activity for at least 15 minutes. At first, however, you may be able to go no longer than five minutes.            The longer you refrain from acting on a compulsive urge, the weaker it becomes. Even if you ultimately give in, you still come out ahead. You’re learning to tolerate psychological discomfort…and building up your power to say “no.” This is profoundly empowering.Step 4: Revalue The more diligently you practice relabeling, reattributing and refocusing, the more fully you’ll recognize your obsessions and compulsions for what they are—worthless distractions having no value whatsoever.            The process will gradually become automatic. Without even thinking, you’ll be able to devalue the thoughts and urges and fend them off until they fade.            So, if you suffer from these symptoms, try these steps. It should work. It worked for many others before. Why shouldn’t it work for you, too? Also see Some tips about Craniosacral TherapyCan Physicians Protect You From Superbugs?Note: Maryse Isma is a clinical social worker and board member of the Center for Strategic and Multicultural Studies (CSMS). She lives and works in Saint Augustine, Florida.