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How Understanding the 'Mind' and the 'Brain' Can Help Us Treat OCD

Nothing is more confusing or painful than when your own brain takes over your thoughts, attacks your self-worth, questions your abilities, overpowers you with cravings or attempts to dictate your actions.

Once thought to be a rare mental illness now known to be a more common, approximately two to three million adults in the United States have obsessive compulsive disorder (OCD). It affects men, women and children. It can start at any age although most commonly in childhood, adolescence or early adulthood. If left untreated the disorder can escalate in severity.

So, it’s important to understand the cause and treatment of OCD to improve our mental health

There are two components of obsessive compulsive disorder that are important to understand:

1. Obsessions are unwelcome thoughts, images, urges, worries or doubts that repeatedly appear in your mind. They can make you feel anxious and feel difficult to manage or eliminate.

2. Compulsions are repetitive activities you do to reduce the anxiety caused by the obsession. As Prof. Paul Salkovskis says, OCD is your false friend. It promises you again and again that if you keep doing these rituals, you will be safe. But the reality is that the more you do this, the more complicated your illness become.

Why you need to stop listening to these Deceptive Brain Messages (intrusive thoughts)?

First thing to understand is that you are not your brain. There is a big difference between the brain and the mind.

Let me give you a concrete example that will help you understand it more clearly. To do that, we are going to do a thought experiment inspired by Daniel Kahneman‘s book – “Thinking Fast and Alow.” We’ll call the brain “system one” and the mind “system two.”

To observe your brain in automatic mode, glance at the image below:

angry woman

As you see the image, you quickly notice the woman’s shirt is white, and you knew she is angry. You sensed this woman is about to say some unkind words, probably in a loud and strident voice. A premonition of what she was going to do next came to mind automatically and effortlessly. You did not intend to assess her mood or to anticipate what she might do. It just happened to you. It just happened automatically by “system one” (brain).

Now look at the following problem.

17 * 24 = ?

You knew immediately this is a multiplication problem and probably knew you could solve it with paper and pencil, if not without. Without spending some time on the problem, a precise solution did not come to mind and you felt that you could choose whether or not to engage in the computation. In this instance, you need the help of your “system two” (mind).

System one operates automatically and quickly, with little or no effort and no sense of voluntary control. 

System two allocates attention to the effortful mental activities that demand it, including complex computation.

When we think of ourselves, we identify with system two (mind), the conscious reasoning, the self that has beliefs, make choices and decides what to think about and what to do. System two believes he is in the driver’s seat, but most of the time sadly that’s not the case.

System one (brain) thinks emotionally, often looks for the quick payoff over the long-term payoff. But system two thinks rationally, it has the ability to think long-term, to plan, to think beyond the moment.

But there is a big problem. The problem is, you can’t turn off system one and system two is not as efficient as system one. That’s where the real problems arise.

Deceptive brain messages (DBM) can’t always be avoided because system two has no clue about the deceptive brain messages. Even when cues to DBM are available, errors can be prevented only by the enhanced monitoring and effortful activity of system two. The reason our brain works this way is to minimize the efforts and optimizes performance. Do you think about how to brush your teeth every morning? No, it’s just happening automatically. It would be a disaster if we have to do it every day.

But when DBM arises, your heart starts to beat faster, you start sweating and due to these false emotional sensations, your brain’s fight or flight mode gets activated which shut down your system two and you start acting in a habitual way (in the case of OCD, compulsions) to get rid of these emotional sensations.

Now that we know this, it’s easier to understand the steps for treating OCD, as I learned from Dr. Jeffrey M. Schwartz.

1. Re-label.

Identify your deceptive brain messages and the uncomfortable sensation: call them what they really are.

The main purpose of this step is to understand your DBM’s when they arise so that you can apply the rest of the solution. The best way to do it to use mindfulness. Mindfulness is about awareness – being fully knowledgeable that something is happening right now, at this very moment. A helpful exercise for developing mindfulness is to find a private place just for yourself and then concentrating on your breath. Let these DBM come and go, don’t act on them or try to change them or fight with them. The aim at this stage is to gain awareness of the process, not the content of the intrusive thoughts.

2. Re-frame.

To stop giving too much importance to these messages, say why these thoughts, urges and impulses keep bothering you. If you are feeling a compulsion to check your email again and again, just say I’m having the urge to check email again because I don’t want to miss out on something important and it also decreases my anxiety. Tell yourself that it’s not me, it’s just my brain or it’s just my OCD or pick up any of the thinking errors described hereLots of the time our brain filters out important information, misinterprets and creates false conclusions about any people or situations and also about ourselves.

3. Refocus.

The best way to refocus is directing your attention towards an activity of a mental process that is productive, even while intrusive thoughts are present and bothering you. We need to refocus because our attentions get diverted easily by these intrusive thoughts and we start to overthink a situation, again getting caught up in the cycle of DBM.

By refocusing, we decrease the power of these messages and rewire our brain in a healthy way. However, I don’t mean you should try to change these thoughts. Some helpful refocus activities you can do — walking, running, playing basketball, tennis, reading/writing, learning a new skill, sports, spend time with someone or your pet etc.

4. Re-value.

This step helps you to see these intrusive thoughts for what they are. These thoughts or urges have no value in your life. They are something to dismiss, not focus on.

Ask yourself:

  • Would another person respond in a similar way to how I actually responded?
  • What advice will your wise advocate (someone who loves you and supports you without any judgment) give you if you share your experience with him/her? Because, lots of the time we caught up by these thoughts so much that we can’t able to see the bigger picture. Seeing these thoughts from someone else eyes help us to see the reality rather than believing these intrusive thoughts.

And if you are still not sure if it is a DBM or not, just ask yourself, is this thought, urge or impulses, etc. aligned with my true goals and intentions in life (i.e. your true self)? If the answer is no then it’s probably a DBM, not a reality.

Don’t believe in everything, you think or feel. 

Author’s note: If you feels like that you have OCD or some symptoms of it then you must need to see a professional doctor for help.

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