Breaking Free Of Obsessive Compulsive Disorder (OCD)

Obsessive Compulsive Disorder

In fact, that fear has been strengthened by his having performed the compulsive behavior. His brain has now been through one more training cycle that links relief from a fear of his wife dying, to the performance of a specific compulsion. The neuronal connections associated with these feelings, thoughts, and behaviors have now grown stronger.

When someone relies on compulsions to deal with the anxiety they fail to punch back against the fear. They are simply trying to escape. To win against OCD you have to punch back. You need to face the fear and say “Show me what you got” or better yet, “Go to hell.”

Firing Together, Wiring Together and OCD

There is a saying among neuropsychologists (who are known for pithy sayings, and for their mouthwatering fruit cake recipes). It goes like this “Neurons that fire together wire together.” (REF) That is brain cells that interact to form a thought, a feeling, a behavior, or a combination of those three, begin to form stronger connections with each other over time.

This is common sense, right? We may not have seen this happen, but each of us has experienced it before. It explains why performing complicated skills become easier with repeated practice over time.

When first learning to play a note on the guitar it is difficult to place your fingers in the proper position on the neck of the guitar. You read the note on the page of music, you know what strings need to be pressed in order to make that note, and you clumsily arrange your digits in the proper position. The result, at first, is pretty pathetic.

But after practicing for several days things get along much better. It begins to sound as though you are making music. Your fingers are starting to form notes more naturally.

This is because you have been training neurons to fire together, so now they have begun to wire together (that is, automatically talk with one another). Over time, with practice, the neurons responsible for holding onto the idea of forming a certain note on the guitar, begin to wire up with neurons responsible for placing fingers in the proper position on the neck of the guitar.

Intentional time spent practicing has caused neurons to ‘fire together.’ Now they have become ‘wired together.’

Read: OCD Quiz: How Sensitive Is Your OCD Radar?

How Does This Relate To OCD?

This same thing happens with OCD. That is, the neurons involved in the sequence of events described in the figure above begin to wire together. They form a circuit of sorts.

The nerve cells that are involved with an intrusive thought become more strongly connected to the neurons involved in the fear associated with that thought. This happens because they are frequently activated together (first the thought then the fear).

Of course, the next step in the sequence is where the nerve cells associated with fear go on to activate the neurons controlling the compulsive behavior. After this sequence is repeated many times these cells also become ‘wired together.’

Eventually, the entire sequence becomes a closely integrated web of brain cells capable of operating independently – they become automatized.

The key to beating OCD is finding a way to ‘unwire’ the neurons that maintain this painful pattern. To do this we must disrupt the pattern of neurons firing together (i.e., intrusive thoughts ->  fears -> compulsive behavior -> diminished fear which is rewarding and reinforces this painful pattern).

The longer these patterns become disrupted, and the more frequently they become disrupted, the better.

Disrupted patterns lead to weaker connections between the neurons responsible for each part of the pattern. Weaker connections between neurons mean the amygdala (fear center in the brain) is less activated. A less activated amygdala means less anxiety.

The end result? OCD begins to lose its grip on your life.

OK, that was a lot to take in. If you got lost along the way that’s understandable. Take a few minutes to re-read that material starting with the Pattern Of Anxiety section.

Pay special attention to the infographics – it should make things much more clear. I want you to have a good grasp of these ideas because they are essential for understanding how to kick OCD to the curb. (Yes, that’s right, if you want your life back then you need to see OCD as an enemy – one who gets curb-stomped so you can come out winning).

Driving A Stake Through The Heart Of OCD (And Keeping It There)

Mastering OCD requires that you be able to disconnect neurotic anxiety from unrealistic beliefs. These two things need to be ‘unwired.’

BTW, it is “neurotic” anxiety because it is based on unrealistic beliefs (if the beliefs were realistic then the anxiety would not be neurotic).

One way to try and unwire anxiety from neurotic beliefs is to change the conclusion(s) that attach to these beliefs.

Let’s take a moment and look at this a little more closely.

Imagine you have OCD and one of the things you struggle with each morning before leaving for work is the compulsion to check and recheck that all the windows and doors of your house are locked.

The anxiety that drives this compulsion arises from your belief (or conclusion) that if some entry point remains unlocked, your home will surely be burglarized.

This conclusion, therefore, is an essential element of the pattern of thoughts, feelings/fears, and behaviors that keep you in an emotional prison.

Intrusive Thought: “The windows and doors to my home may not have been locked”

Conclusion: “Someone will break into the house and steal my possessions.”

Emotional Response: Anxiety/apprehension.

Compulsion/Behavioral Response: Double checking locks on windows and doors.

Emotional Response: Decreased anxiety.

Breaking Free Of Obsessive Compulsive Disorder (OCD)
Breaking Free Of Obsessive Compulsive Disorder (OCD)

If the conclusion step in this pattern can be changed to something more realistic, and less threatening, the pattern becomes altered.

Imagine if the conclusion was changed to “I’ve checked the windows and doors already, it should be fine. This anxiety is just my brain playing tricks on me. The hell with that, I’m in control and not giving in to my fears.”

That sort of conclusion, even when it is not yet fully believed, begins to move the needle on how much anxiety controls your life.

Unfortunately, by itself, it is unlikely to move the needle very far. A good start, but just not enough.

Here is why. As a pioneer in psychoanalysis once said, “The patient needs an experience, not an education” (Fromm Reichmann). Intellectually convincing someone that their fear has little basis in reality seldom leads anyone to become fully relaxed and confident.

Think about it for a moment and you’ll understand how frequently this is the case. Let’s take as an example the woman who is terrified of getting on an airplane. She intellectually knows that the chances of the aircraft crashing are astronomically small. So what? She remains petrified.

Put her at the gate of an airline, bag in hand, ready to board and her vision will blur, beads of sweat will appear on her face. Her heart will be racing, palms perspiring and her stomach will be ambivalent about keeping a tight hold on lunch.

It sounds like midnight at a mosh pit. Even so, were you to ask her to recite statistics on airline safety she would still be able to do so. At the end of her statistical soliloquy, she would no doubt exclaim “What’s your point? I feel like I am about to die.”

The problem with those statistics is that they do not apply to her, and not to the plane she is about to board. At least that is how it feels to someone with those fears.

Overcoming this distortion requires a corrective experience. These corrective experiences invariable mean that the person begins to engage in the very thing that he or she is desperately trying to avoid. In this case, the woman needs to get on an airplane and have an uneventful flight. After having this initial success, she would need to get on many more flights in order to thoroughly unwire the OCD connection.

If she did this, we would expect that her fear of flying would soon be mastered. Not absent altogether, but reduced to the point that she was in control.

The bottom line, intellectual arguments may help someone take the first step toward facing his or her fear. Seldom, however, do such arguments fully extinguish the anxiety. For that, you need corrective experiences. End of story.

Read How Sensitive Is Your OCD Radar? Take This Quiz To Find Out!

Corrective Experiences: The Road To Mastery

Punching back against OCD is all about giving yourself corrective experiences. This may be a term that you have not heard of before, so we’ll take a moment to explain what it means.

A corrective experience is simply an interaction in life that causes one to confront distorted perceptions or beliefs. These experiences push back at the lies we sometimes tell ourselves.

They confront the misperceptions that have distorted one’s view of life so as to create a sense of perpetual danger and fear. In doing so, corrective experiences have the power to help us see reality for what it is, thereby encouraging us to respond in ways that are not driven by OCD.

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Forrest Talley Ph.D.

Forrest Talley, Ph.D., is a clinical psychologist with a private practice in Folsom California. Prior to opening this practice, he spent 21 years working at the University of California, Davis, Medical Center. During that time he supervised MFT and SW interns, psychology interns, and medical residents. In addition, he was an Assistant Professor in the Department of Pediatrics at UCDMC. He worked in several capacities at the UCDMC CAARE Center. These include Co-Training Director of the APA approved psychology internship program, the Individual and Group Therapy Manager, primary supervisor for interns and staff, and the main supplier of bagels/cream cheese for all souls at the UCDMC CAARE Center.View Author posts