An individual suffering from obsessive compulsive disorder (OCD) is very often consumed with unwanted and senseless intrusive thoughts. These negative thoughts can create a ritual of overwhelming repetitive actions known as compulsions. The negative thoughts will send messages to do things that a person does not really want to do, and they find themselves hijacked into doing exactly what the messages tell them to do.
Despite knowing that the relief from “listening to” these thoughts is only temporary, people with the disorder still listen and obey. The thought process keeps repeating itself like a chain of commands to make sure that the repetitive behavior continues. What is interesting is that the brain thinks that by this rumination it’s helping the individual resolve their issues. The fact remains that listening to these thoughts only reinforces the brain’s strengthening circuits supporting those actions, making it harder for the person to resist them in the future. It is natural to surrender to these negative thoughts to avoid the enduring pain. Yet in time, this loss of control becomes a habit of impulsive urges that often leads to shame and depression.
To treat this disorder, it’s best to explore the neuroscience involved. We have two pathways in the brain that can produce anxiety, called the cortex and the amygdala. The frontal lobes located behind the eyes are divided into halves, the left prefrontal lobe and the right prefrontal lobe, often referred to as the neocortex.
The neocortex is the internal thought-processing pathway that provides one with the ability to understand and interpret situations. The neocortex’s job is to try to make sense of the information that a person takes in. It is more of a conscious pathway that will use logic, analysis and reasoning to plan ways of responding to any sort of anxiety. In addition, the neocortex has two major functions—determining safety and danger—so that it can orchestrate a proper reaction. If the left neocortex is disabled and not capable of evaluating safety or danger, as with OCD, the brain will no longer feel safe, will become preoccupied with a thought and unable to stop thinking it. Obsessive thoughts tend to focus on contamination, danger, violence or orderliness. The compulsions often involve cleaning, checking, counting or touching.
In the case of Kayla, a young college student, every morning for hours she could not stop brushing her hair. A few months ago, I received a distress call from Kayla’s mother. It was time for Kayla to start college, but not like this. When she first arrived at my office, she was feeling despair and hopelessness. Kayla made it clear that the information she found online was that OCD could not be cured, but with medication it could be managed. It is interesting to note that she was taking four different drugs at the time, including one for depression.
The fact remains that her online information was not entirely correct. Depending on the intensity of the symptoms, OCD can be managed without medication, and in some cases almost eradicated. The OCD brain will not stop unless you find ways to intercept and distract the messages.
Using hypnosis is one of many tools that uses the subconscious to intercept and distract those unhealthy messages. After only four sessions of hypnosis, Kayla was down to three drugs and feeling hopeful. In the months that followed she was down to two, and then down to one. The combination of hypnotherapy and cognitive restructuring (replacing negative thoughts with healthier, coping thoughts) allowed her to retrain her brain to respond less impulsively to external triggers. The good news is that with self-hypnosis she is now doing well, and three times a day she tells her amygdala, “I am calm, relaxed and in control.”
The amygdala is the alarm bell of the brain; it is on the lookout for any indication of harm or danger. The emotional response most often used is fight, flight or freeze. Because the amygdala responds to thoughts just as to events, it often creates a distorted perception, as in negative self-talk and catastrophes. On a good note, It also provides a surge of adrenaline to the rest of the body so that you can respond in case of an emergency. Please note, as might be expected, the neocortex makes mistakes. For example, by sending a misguided message to call Hatzalah because a person is in cardiac arrest, when it’s more likely a panic attack, the amygdala will respond with worrisome, intense anguish and more impulsive fear than the situation requires.
Most medical doctors treat OCD with medication to calm the amygdala. Kayla was informed by her doctor that her condition could not be cured, but with medication it could be managed. The fact remains that the medication’s side effects were worse than the OCD itself.
I find that how someone communicates with their OCD can greatly reduce their anxiety, and possibly stop the OCD in its tracks. It starts with what we call cognitive fusion. I use both cognitive behavioral therapy and hypnotherapy to assist with awareness to differentiate between a patient’s frontal cognitive thoughts and the induced amygdala emotions. The clinician needs to provide hypnotic resources and support to create optimism about the patient’s recovery.
Moishe Herskowitz, M.S., LCSW, CH, is a licensed clinical social worker, a renowned hypnotherapist and instructor. Herskowitz holds his certification from the National Guild of Hypnotherapy. In addition, he specializes in anxiety, OCD and weight loss. He can be reached at 718.404.2344, mherskowitz.com, www.howwecommunicate.info, and [email protected].
