The graph above shows why OCD does not lessen or resolve, on its own. The compulsive behavior (or thoughts) do serve a purpose – they lessen the anxiety. When anxiety is reduced in this way, the compulsion grows stronger. That is because it has been reinforced.
Using compulsive behaviors to reduce anxiety is not healthy. It ends up creating more problems than it solves. Even so, because it effectively leads to a sense of relief, this solution (using compulsions) is reinforced. Anything that is reinforced is more likely to occur in the future.
One unhealthy result of using compulsions to get rid of fear is that the unrealistic thought that gave rise to anxiety is never pushed back upon. It is never put to the test.
It is similar to what would happen if a little child, who is fearful of jumping into the family swimming pool and being caught by her father, remained on standing next to the pool. Imagine if that young child made such a fuss that her parents gave up and told her to go play on the swings.
She would be relieved. Making a fuss and tantrums would be reinforced. Learning that it was safe to jump into her father’s arms would never happen. Her fear of being dropped, allowed to flounder in the pool, would remain intact.
Similar to the ‘repeater’ who fears that his wife will die unless he perfectly arranges and rearranges items on his desk, he feels relief once the compulsive ritual is completed. But the unrealistic fear that drove him to enact this compulsion has not been confronted.
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.’