my first encounter with
obsessive-compulsive disorder was
Nicolas Cage's character in the movie
matchstick men who apparently had a
combination of OCD and Tourette's
syndrome the jerking motions and vocal
outbursts were due to the Tourette's and
the obsessive cleaning and things like
locking the door multiple times was due
to the OCD though we only see these
behaviors when he forgets his medication
and otherwise he's a smooth and
successful conman now I personally don't
have OCD and frankly the term seems to
be used lightly too often a lot of
people don't realize how serious OCD can
be lightheartedly saying I'm so OCD
because you like to keep your desk
really tidy is almost like saying I'm so
leukemia because your nose is runny what
I'm interested in is how the brain of
somebody with OCD works so I can figure
out how to deal with a much less dire
but very annoying behavior of mine some
mornings I'll be five minutes away from
my apartment and will suddenly think
wait did I lock the door I know I just
have to rush back and check or it will
bother me for at least the next hour
this happens maybe three times a week
and every single time I go back to check
the door was indeed locked
luckily going back and checking like
this is enough and I can get on with my
day after that but I was curious what
happens in my brain that makes me do
this and how is it different from
someone who has for example the
compulsion to lock and relock the door
50 times just so they feel comfortable
well there are three parts of the brain
that come into play here a part of the
frontal lobe called the orbital cortex
is responsible for detecting when you
think you've done something correctly
and when you think you've made a mistake
et roles a behavioral psychologist at
Oxford University found that the cells
in rhesus monkeys orbital cortex would
fire when the monkey performed a task
properly and was expecting some juice as
a reward
however when the monkeys perform the
task properly as they were instructed
but got salt water instead the orbital
cortex lit up much more intensely and
stayed lit up longer the conclusion was
at the orbital cortex as your brains
error detection system in general the
strong firing of the orbital cortex
gives you a feeling
of something is wrong after the orbital
cortex fires it sends a signal to
another area called the cingulate gyrus
which will make you feel uneasy until
you do something to correct the mistake
then once the mistake is corrected a
third area called the caudate nucleus
activates and acts like an automatic
gearshift allowing you to switch gears
forget about it and get on with other
activities in my case I thought
something was wrong and felt anxious
until I went back and checked on the
door then my gear shift and I got on
with my date brain scans of OCD patients
show that all three of these brain areas
are hyperactive this means the something
is wrong feeling and the anxiety that
comes with it are abnormally strong so
even with incredibly trivial
imperfections in something like say the
fibers on a carpet the OCD afflicted
person feels that a terrible mistake has
been made and the consequences will be
absolutely horrible this is why OCD can
result in such irrational obsessions
like if I don't vacuum the carpet five
times my parents will die as Norman
Doidge explains in the brain that
changes itself what happens in people
with OCD is that their gearshifter the
caudate nucleus becomes extremely sticky
this means that even if the person does
something to correct the mistake of
their brain is detecting that feeling
doesn't go away their brain can't shift
to the next gear and they stay very
anxious most people who have OCD are
actually aware of the fact that their
worries and behaviors are completely
illogical but since the orbital cortex
and the cingulate gyrus are stuck in the
on position they are strongly compelled
to repeatedly attempt to correct the
imaginary mistake UCL a research
psychiatrist Jeffery Schwartz calls this
situation brain lock and in his book
titled brain lock he describes a very
effective behavioral therapy for OCD to
understand it let's look at hand washing
a common OCD obsession in the behavioral
therapy when an OCD patient has the urge
to wash their hands again even though
they're already clean there are two
first mindfully acknowledge that the
urge to do this is simply a result of a
fall
the circuit in their brain and that
nothing bad will actually happen if they
don't wash their hands again they then
have to manually shift their gear by
right away doing some other constructive
activity for as long as they can the
urge to give in to a compulsion is
usually overwhelming so dr. Schwartz
recommends to start by waiting at least
15 minutes before giving into it and
then expand that time day by day with
consistent practice this manual gear
shifting becomes an automatic habit to
wear when the urge to do some compulsive
behavior arises their immediate reaction
is to first identify the compulsion as
simply the result of brain lock and then
move on to another activity brain scans
of OCD patients who use this behavioural
therapy show that after a while the
problem causing hyperactive caudate
nucleus in the brain had actually become
less active compared to before therapy
as dr. Schwartz says we can now say we
have scientifically demonstrated that by
changing your behavior you can change
your brain I didn't realize it at first
but this was essentially the strategy I
used back when I was quitting sugar
whenever I got an urge to go buy some
sweet garbage from the convenience store
I stood up set a timer for 20 minutes
and started reading something sometimes
I would give in and buy the snack after
the 20 minutes were up but I just made
sure to increase the time on the timer
each day pretty soon I was setting the
timer for an hour and after a while the
immediate message in my head transformed
from I want sugar time to get some
snacks - I want sugar time to stand up
and read alright so back to my door
double-checking issue as someone with a
properly functioning caudate nucleus
what's the solution to keep me from
wasting my time as Norman Doidge
explains we often check and recheck
things without really concentrating so
he suggests to perform the first check
with the utmost care if you're moving so
fast during your morning routine without
paying attention and being distracted by
something like an audiobook the problem
solved circuit doesn't get processed
when locking the door the first time and
the gear in the brain doesn't turn by
simply taking a moment to slow down and
be aware of what I'm doing
I check the coffee maker and head out
the door and now I no longer get the
urge to go back and check again later
getting my last 15 or 20 minutes a week
back is nice but more importantly for me
it's nice to no longer be asking what
the hell is wrong with me