A combination of meditation and the tools of cognitive behavior therapy (CBT) have empowered obsessive compulsive disorder (OCD) patients to treat themselves. IMO a similar treatment model could be developed for depression
This revolutionary therapy was pioneered by Jeffrey Schwartz M.D. at UCLA and described in his book The Mind & the Brain Neuroplasticity and Mental Force.
Rewiring the “Worry Circuit”
An example of how OCD might express itself is a person who is obsessed with germs; for no real world reason, the person is repeatedly overcome with fear and is compelled to perform a ritual such as washing their hands over and over.
People with OCD have certain parts of their brain which are overactive. This is measured by PET (Positron Emission Tomography) scans which monitor blood flow and oxygen supply.
The abnormally active anterior cingulate, nucleus caudate and orbital frontal cortex work along with the thalamus to create a “worry circuit”.
Studies indicate the anterior cingulate contributes to emotional response and our ability to detect threats in our environment; the caudate nucleus appears to help regulate information sent from the thalamus, which deals with emotion, to the orbital frontal cortex which is the seat of decision making and expectation.
When the three parts of the brain are working properly they are regulated by the thalamus. However through hyperactivity the “worry circuit” kicks in. The error detection mechanism locks up and keeps firing repeatedly. This is the OCD brain problem.
With Dr Schwartz’s treatment regime, a person can rewire their own “worry circuit”. The approach is part mindful awareness, learned through mediation; and part cognitive behavior therapy.
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Learning Meditation and Mindful Awareness
The form of meditation used by Dr Schwartz comes out of Buddhist tradition.
Each of us has the capacity for “Bare Attention” a name for mindful awareness coined by German born Buddhist monk, Nyanaponka Thera. The practice is a skill that moves us outside of self identification with our own thoughts and feelings.
He describes “Bare Attention”:
- “The clear and single-minded awareness of what actually happens to us and in us, at the successive moments of perception…. “Bare” because it attends just to the bare facts of a perception as presented either through the five physical senses or through the mind… without reacting to them by deed, speech or by mental comment which may be one of self reference (like, dislike, etc.), judgment or reflection. If during the time, short or long, given the practice of Bare Attention, any such comments arise in one’s mind, they themselves are made objects of Bare Attention, and are neither repudiated nor pursued, but are dismissed after a brief mental note has been made of them.”
The practice of meditation allows a person to tap into a level of consciousness which allows them to stand back with mindful awareness and observe whatever they’re experiencing without getting caught up in it.
With this level of consciousness, self-identification turns into observation. Rather than being dragged into the quicksand of “Where did this thought or feeling come from?” or “What does it mean?” thoughts and feelings become impersonal things simply to be noted.
Thoughts like “my hands are dirty” lose much of their power. The attachment to wired anxiety and dread is reduced. Again, the idea is to make note of them without judgment or fear.
This power strengthens and deepens a person’s ability to change the way they think.
Cognitive Change and Mindful Awareness
Dr Schwartz’s approach enables a person to treat OCD with four cognitive steps; Relabel, Reattribute, Refocus and Revalue
As disturbing thoughts and urges appear, the person rather than seeing them as a product of the real world, relabels them as OCD symptoms emanating from a miswired brain. Relabeling allows the person to understand what is happening.
The next step is reattribution which helps the person to understand why it’s happening. The person has already learned through a PET scan that their brain hyperactive. They can then attribute their experience to their brain’s “worry circuit” stuck in the “on” position.
The person then refocuses to turn off the “worry circuit” and switch to a “pleasure circuit”. The OCD anxiety and dread is still present. “I’m filthy. I have to wash my hands.” However the person willfully directs their attention to something pleasurable such as working in the garden or shooting hoops. A positive experience is substituted for a negative one. With time and experience, Refocusing rewires the “worry circuit” to a “pleasure circuit”
Finally the last step is revaluing which takes Relabeling a step further. Revaluing quickly categorizes OCD symptoms as “ senseless…false…errant brain signals not even worth the gray matter they rode in on.” The signals are seen as “toxic waste”
To summarize (1) Relabeling acknowledges what is happening; (2) Reattribution notes why it’s happening; (3) Refocusing changes the brain’s wiring and (4) Revaluing determines OCD symptoms to be worthless.
Illness and Freedom
As with depression, you can’t simply think your way out of OCD. This is where mindful awareness comes in. It helps you exercise your free will, persistence and perspective. You aren’t wrestling as much with your symptoms but are freer to change the way you think; to self direct the physiology of your brain and how you experience life.
You can read more about innovative anxiety treatments at WellnessoverDepression post:
