In EPPP Prep, and in analyzing the neurological processes involved in unhealthy emotions and pathologies, it is always tempting to start thinking we are determined by our brains. But one of the fascinating things about the science of neuro-plasticity is that it shows that there is a reciprocity between how our brains operate and the choices we make. Nowhere is this more true than when it comes to treating OCD. And understanding this will prove helpful in your EPPP prep.
Once scientists began to understand what is happening in the brain of someone suffering from OCD (see our post ‘The Pathological Brain’), therapists were able to develop techniques to help OCD sufferers form new circuits and no longer be ruled by their dysfunctional brains. I’ll let Norman Doidge explain how this works, as he channels the ground-breaking discoveries of Jeffrey Schwartz, author of Brain Lock: Free Yourself from Obsessive-Compulsive Behavior:
“Schwartz set out to develop a treatment that would change the OCD circuit by unlocking the link between the orbital cortex and the cingulate and normalizing the functioning of the caudate. Schwartz wondered whether patients could shift the caudate ‘manually’ by paying constant, effortful attention and actively focusing on something besides the worry, such as a new, pleasurable activity. This approach makes plastic sense because it ‘grows’ a new brain circuit that gives pleasure and triggers dopamine release which, as we have seen, rewards the new activity and consolidates and grows new neuronal connections. This new circuit can eventually compete with the older one, and according to use it or lose it, the pathological networks will weaken. With this treatment we don’t so much ‘break’ bad habits as replace bad behaviors with better ones.”
Focusing on a pleasurable activity at times when a person normally feels anxiety is a way to associate something that was formerly negative with something positive, and because of the principle that neurons that fire together wire together, this can actually help to create new neuro-pathways in the brain. Doidge continued:
“The OCD patient should also remind himself that the reason the attack doesn’t go away immediately is the faulty circuit. Some patients may find it helpful, in the midst of an attack, to look at the pictures of the abnormal OCD brain scan in Schwartz’s book Brain Lock, and compare it with the more normal brain scans that Schwartz’s patients developed with treatment, to remind themselves it is possible to change circuits…. Schwartz assures his patients that though their ‘manual transmission’ is sticky, with hard work it can be shifted using their cerebral cortex, one effortful thought or action at a time.
“…two key laws of plasticity also underlie this treatment. The first is that Neurons that fire together wire together. By doing something pleasurable in place of the compulsion, patients form a new circuit that is gradually reinforced instead of the compulsion. The second law is that Neurons that fire part wire apart. By not acting on their compulsions, patients weaken the link between the compulsion and the idea it will easy that anxiety. This delinking is crucial because, as we’ve seen, while acting on a compulsion eases anxiety in the short term, it worsens OCD in the long term.”
“Unlearning and weakening connections between neurons is just as plastic a process, and just as important, as learning and strengthening them.”