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“The Brain that Changes Itself” is an informative book about neuropsychology but specifically i have focused on Chapter six that discusses Obsessive-Compulsive Disorder. This mental illness is incurable and the people that suffer from this disease have a lot to overcome but with the help of Norman Doidge and Dr. Schwartz people with OCD can calm their anxieties down with the treatment that Dr.Schwartz has developed. Plasticity-based treatment has helped not only with OCD but people who have regular day worries to relabel their thoughts to teach their brains that they can fight their obsessions and compulsions so that they can learn to live a better happier life with OCD.
Keywords: Obsessive-Compulsive Disorder, Therapy, Plasticity, Treatment
Obsessive-Compulsive Disorder is one of the most tormenting mental health diseases that plague so many people. This mental health illness makes patients who suffer have uncontrollable thoughts that then create behaviors that cause patients to desire to repeat those behaviors or compulsions constantly. The people who suffer from OCD are the people that get affected the most from the worries that constantly run through their minds. Norman Doidge, author of “The Brain That Changes Itself” explores OCD and how it can affect patients and discovery of new treatments for OCD. This condition worsens over time because people who suffer from OCD focus solely on their worries. Often times there is a deeper significance that can be emotional when a patient with OCD has their first attack. Many obsessions often have things in common to one another such as fear of being tainted with germs, needing things to be kept tidy and put together, violent thoughts about self-harm or torture others, etc.
The same theme is applied when it comes with compulsions. Some patients create imaginary rules and protocols to follow the obsessive behavior because they feel it helps control their anxiety when obsessive thoughts occur. Although everyone sometimes has worries or doubts it is completely different for patients with obsessive-compulsive disorder because they spend so much time going over these thoughts throughout their day, they do not get any sort of relief from taking part in the behaviors because they only feel slight relief. The compulsions are usually superfluous and most of the time are not related to the problem they are intending to fix. Some patients with the obsessive-compulsive disorder also have tic disorder. These tic’s come through out of the blue and involves repetitive movements such as eye blinking and other movements with the eye, shoulder shrugging, and head jerking.
There are also vocal tics that include repetitive throat clearing, sniffing, or grunting sounds. There are a few causes for OCD including biology, which would be due to changes in your body’s natural chemistry or brain functions. Genetics could be a portion but the specific genes have not been identified yet. Mr.Doidge discusses in the chapter the treatments that Dr.Jeffrey Schwartz has initiated. It is an effective plasticity-based treatment that helps patients with OCD, people who suffer from strong everyday worries, helps us when we get mentally “sticky”, and helps us overcome bad habits.
Dr.Schwartz created a new psychotherapy treatment by studying the brain scans of patients with OCD and those without it. He also took brain scans on patients before therapy sessions began and after therapy was finished and found that the brain normalizes when treatment. This demonstrated how talking communication-based therapy could change the brain. Normally when a person does something wrong three things happen in the following order. First, we get the “mistake feeling” following after that we get anxiety and feel the need to correct our mistake. Finally, once the wrong is corrected we “turn the page” or move on from the situation. The brains of patients that have OCD do not move on even when the mistake they made is corrected. There are three parts of the brain that are involved in obsessions.
Once the mistake made is detected our orbital frontal lobe (part of the frontal lobe) is signaled. Once the mistake feeling arises the orbital frontal cortex sends signals to the cingulate gyrus located in the deepest part of the cortex. The “automatic gear shift” that helps us to move on is the caudate nucleus that is located deep in the center of the brain which allows our thoughts to flow smoothly from one to the other but the patient's caudate nucleus is extremely “sticky” which causes the lock in their brain. Brain scans reveal that all three parts of OCD brains are hyperactive. The treatment that Dr.Schwartz developed has two major components. The first is the person going through an attack needs to reidentify what is happening to him/her so they or realize they are having an OCD episode. Dr.Schwartz is coaching patients to recognize the difference between the general form of OCD and that of an obsession (i.e. the dangerous germs, fear of loved ones being harmed, etc).
The second component is response prevention which is suppressing the patient from acting on his/her compulsion. By changing the focus of the patient they are learning not to get drawn into the obsession but to work around it. The more you partake in the acts OCD is urging you to do the more you want to do it but, once you start learning to control your obsessions the less you will want to act on them. According to “BMC Psychiatry” although treatment guidelines recommend both pharmacological and psychological treatments, research has shown that people prefer psychological therapies rather than medication. Even with the existence of effective treatments, many patients are stopped by a few issues such as lack of trained practitioners, and the cost of these treatments.
The therapy generally lasts twelve to sixteen sessions beginning with an entire assessment of the patient and ends with a series of therapy techniques that are carefully planned through partnership between the therapist and the client that gets implemented during therapy sessions and while the patient is doing their day to day activities. The BMJ journals also say that cognitive-behavioral therapy put together with medication is the best treatment option. They also discuss EPR (exposure and response prevention therapy) which involves a controlled exposure to situations that cause mild levels of anxiety. Over time exposure to obsessional triggers helps the patient to slowly get used to them, leading to a reduction in anxiety. The International OCD Foundation discusses deep brain stimulation that has been used since the 1980s.
Statistics for treatment using deep brain stimulation show that for twenty-six patients with treatment-resistant OCD described in the Greenberg manuscript, 61.5% were considered responders to deep brain stimulation. They have concluded that with the treatment in neurosurgery for the obsessive-compulsive disorder has progressed very much over the years there is still continuing research that is needed to optimize deep brain stimulation treatment and to better understand how deep brain stimulation functions. Obsessive-compulsive disorder along with all mental health issues are a huge problem that are not taken seriously, in fact, many people are often belittled and made fun of for being mentally ill. There is no cure for OCD but there are many things that sufferers of this illness can do to help themselves for the future to come.
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