Sufferers think if they don ’ t do what their brain tells them , something adverse will happen

BRAIN NOTES

BY TONY PEREIRA

Tony Pereira is an Independent Consultant and Founder of SuperTrouper365

CAUSES OF OCD

THE actual causes of OCD are not known . However , the available literature points to several possible reasons , such as :

• Genetics : People with a history of OCD in the family are more likely to develop this condition . It is not clear how it is passed down .

• Life events : People who have experienced a traumatic event may also develop this condition . According to a

2020 study quoted in VeryWell Health , an online health publication , over 60 per cent of individuals who suffer from OCD experienced some trauma . This could be bullying at school , for example .

• Chemical imbalances : In some cases , people with lower levels of serotonin suffer from OCD . Serotonin is a neurotransmitter which helps maintain our mood and overall state of mind . When serotonin

I remember telling him that the canteen was relatively clean , but he would say that he had to wash his hands . His hands looked very dry from the constant washing . Apart from that habit , he was perfectly normal .

In his excellent book , The Brain That Changes Itself , Norman Doidge explains what happens to an individual who is suffering from Obsessive Compulsive Disorder ( OCD ). People who suffer from OCD think if they do not do something the brain is telling them to do , something adverse will happen .

Let ’ s call my Malaysian friend “ Brian ”. He used to get a thought that if he did not wash his hands , he would contract some infection . When the brain sent him that signal , he would have to wash his hands . If he did not , he could not focus . It used to be a terrible problem if he was in a lecture and got that thought . Being in the UK , he did not have any family support . So , he suffered immensely .

I started researching this topic when I recalled Brian ’ s terrible experience . This is what I found out about OCD . It affects three parts of an individual ’ s brain . Firstly , the orbital frontal cortex ( OBC ). This part of the brain is just behind our eyes . People who suffer from OCD have an overactive OBC .

The OBC fires a signal to the cingulate gyrus , another part of the brain responsible for processing emotions and behaviour . It signals that something adverse will occur if no action is taken ( in Brian ’ s case , the washing of hands ).

IMPULSIVE BEHAVIOUR

So Brian immediately looked to carry out this action . In everyday situations , another part of the brain , the caudate nucleus , will let our thoughts flow freely from one part of the brain to another . The caudate nucleus sits within the basil ganglia and is associated with , amongst other things , regulating impulsive behaviours .

With individuals suffering from OCD , this part of the brain does not function as expected . The thoughts do not freely flow as they should , so the individual is sent a signal to perform this compulsive behaviour even though it does not make sense .

Dr Jeffrey Schwartz , a worldrenowned expert in neuroplasticity , calls this condition “ brain lock ”. The thoughts in the brain are locked and cannot move on until the signal from the cingulate gyrus is actioned .

Typical treatment to deal with OCD includes cognitive behaviour therapy and medication . Dr Schwartz has developed a form of cognitive behaviour therapy to help individuals who suffer from OCD . The treatment is called the 3Rs .

The first step , he says , is to relabel the condition . It involves acknowledging that the individual has OCD . Rather than fighting the feeling of the presence of germs , Brian should say to himself : “ I don ’ t have any germs on me - this is my OCD talking . My brain is locked . I am not facing any

levels are low , we find it difficult to focus and our mood drops . One way of producing more serotonin is to move more and exercise . One activity to reduce OCD is to ensure that the individual develops a habit of exercising regularly . Footnote : OCD is a severe illness . If you suspect that you suffer from this illness or you know of a loved one who is suffering from this , contact a doctor immediately . life-threatening infection .”

It may take time before this part of the treatment is effective . Remember , the brain ’ s amygdala will always respond with one of three options - fight , flee , or freeze . Here , Brian needs to override this response . If that fails , try again the next time . And the next time .

The second step is to reframe the condition . The individual is asked to write statements such as “ My hands are not dirty .” This step is sometimes called response prevention , i . e ., trying to get Brian not to respond as the brain wants him to . It is also difficult to accomplish , and it may take several attempts before Brian can carry out this step effectively .

DIFFERENT ACTIVITY

The final step is to get Brian to refocus , i . e ., do something completely different . When Brian believes an attack is about to happen , he should think of a completely different activity , such as playing a musical instrument or walking . If he can thwart the compulsion , it should go away . But those who suffer from OCD will testify that it is not easy to achieve this .

I wrote a previous column about neuroplasticity and how the brain can form new connections . Dr Schwartz ’ s treatment is another form of neuroplasticity . It aims to create new connections that will override the OCD desires .

By getting the individual to focus on another activity that is pleasing to them , dopamine , which has a pleasurable effect , will be released . This will reduce the chance that the individual will resort to the activity demanded of the OCD sufferer . It is projected that over time , the OCD signals will weaken , thus giving relief to the individual suffering from OCD .

This treatment is not easy . Dr Schwartz acknowledges it . I have witnessed a person having an OCD attack , and if they do not carry out the action the brain is asking them to do , they can get into a terrible state . It is unfortunate to watch .

The other option , of course , is medication . Medication “ unlocks ” the part of the brain that gets into this lock position .

More recently , neurosurgeons believe that a technique called gamma knife surgery can also give relief to individuals who suffer from OCD . However , this treatment is reserved for individuals who are suffering f rom an extreme case of OCD . – The HEALTH