We’ve been doing a lot of blog posts recently about the neurological principle that Freud called ‘the law of association by simultaneity’ but which is more easily summarized by Carla Shatz’s catchphrase: neurons that fire together wire together.
We began the series by considering various examples of this phenomenon and explaining what happens in the brain when two things, ideas or experiences become associated with each other. We saw that this understanding of the brain was central to therapies which aim to address conditions such as Agoraphobia and other pathologies. The goal of these treatments is to replace negative neuro-pathways with healthy positive ones.
I’d like to continue this discussion with a few posts exploring how these basic principles of neuroplasticity can be used to help sufferers of Obsessive Compulsive Disorder (OCD), which is one of the key words in your EPPP study materials.
OCD can be very hard to overcome because the sufferer has numerous opportunities to practice, and therefore to reinforces, the obsession. For example, suppose I have a fear of germs that leads me to compulsively wash my hands every time I have contact with another person. Because neurons that fire together wire together, every time the neurons associated with contact of another person fire up in the brain, the neurons associated with anxiety and fear also fire up, and each time this happens they get wired tighter together. The hand-washing becomes a ritual that temporarily neutralizes the anxiety until the next time it occurs.
When you sit your EPPP, you will need to know that the preferred treatment for OCD is a form of cognitive-behavioral therapy known as exposure and response prevention (ERP) therapy. During ERP therapy, individuals are exposed to the distressing stimuli and prevented from engaging in the compulsion or ritual behavior normally used to neutralize their anxiety. As the therapy progresses, individuals become habituated to the formerly distressing stimuli and learn that failing to perform the prescribed ritual will not result in disaster.
Exposure therapy can be effective, but another less known therapy has been pioneered by the American psychiatrist Jeffrey Schwartz. It is based on the understanding of what is happening in the brain of the person who suffers from OCD. Stay tuned for a discussion of this in the next post.