The Pathological Brain

In the previous post  I cited Norman Doidge who walked us through what happens in a normal brain when presented with a problem. Doidge has contrasted how the normal brain compares to the brain of a person who suffers from obsessive compulsive disorder (OCD):

“…the brain of the obsessive-compulsive does not move on or ‘turn the page.’ Even though he has corrected his spelling mistake, washed the germs off his hands, or apologized for forgetting his friend’s birthday, he continues to obsess. His automatic gearshift does not work, and the mistake feeling and its pursuant anxiety build in intensity.

We know that Doidge is correct because of brain scans that have been performed on people who struggle with obsessions. Repeat brain scans have also been performed on the same patients after successful therapy and shown that the brains had normalized.

The three parts of the brain described above are still involved but while a normal person’s caudate will be able to switch gears once the mistake has been corrected, for someone who obsesses the caudate does not do its proper work. Quoting again from Doidge:

“Because the caudate doesn’t ‘shift the gear’ automatically, the orbital frontal cortex and the cingulate continue to fire off their signals, increasing the mistake feeling and the anxiety. Because the person has already corrected the mistake, these are, of course, false alarms. The malfunctioning caudate is probably overactive because it is stuck and is still being inundated with signals from the orbital frontal cortex.

Understanding these neurological dynamics are central in certain therapies designed to help OCD sufferers. That will be the subject of our next post.

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