January 13, 2015 @ 12:32 pm
Yesterday I heard this great interview on Obsessive Compulsive Disorder (OCD) on NPR. It’s become common, especially among young people, to use the label to describe healthy, high-performing individuals who display higher-than-average anxiety -- about their grades, for instance. I teach at Governor’s School, and I taught Early College high school students last fall, and they use the phrase commonly. It’s true that every single one of us has weird, irrational fears. According to the interview, there’s apparently even a developmental progression of highly unlikely things, from being abandoned as a small child to being completely ostracized and alone as a teenager to sexual perversions to fears of disease and bizarre ways of dying as adults. Most of us ignore these irrational thoughts, and they go away.
However, some people have more obsessive thoughts, or they last longer (variation). Some portion of those people reinforce those thoughts by dwelling on them, reactivating them in a positive feedback loop, increasing their anxiety level (selection). All of us have an anxiety threshold beyond which we freak out and behave irrationally. That threshold varies between people, so that some of us reach it sooner, with less provocation. I would guess that people who have lower anxiety thresholds are more likely to develop clinical OCD, but I haven’t seen any real research on that. There is a scale to measure where you are on the spectrum.
I took it, and got a 4 out of 40. It’s subjective, because the questions ask things like how much it disturbs you, not how many times per day the thoughts occur, but it's enough to get a rough idea. There's a cute bar graph at this link.
One of the ways to reduce anxiety is to do something calming, to perform a behavior, which may or may not have any rational connection to the stimulus. The important thing is that the behavior immediately reduces the anxiety level. At first the connection might be completely accidental, but in neuroscience, that doesn’t much matter. Simple repetition strengthens the connection, like Pavlov’s experiments, where he paired meat powder with a bell to “teach” his dogs to salivate when the bell was rung alone. The same mechanism could produce compulsive behaviors. The essentially loopy nature of behavior in general can even lead to people doing their compulsions to try and prevent the obsessive thoughts, rather than waiting for the obsessive thought to occur on its own, thereby actually triggering the obsessive thought.
Anyway, it was a great interview, and in particular the author said
you get trapped in this loop where you're desperate for certainty, and you can never get it. You're always checking.
This struck me when I heard it. It struck me again as I was walking home from Panera this morning, when I saw a soggy, discarded tract lying on the sidewalk:
That You Will
Go To Heaven
When You Die?
It’s actually that demand for certainty that bothers me, and in my anecdotal experience, I see it about equally often in hard-core atheists and in religious people. Likewise, a quick Google Scholar search showed no evidence that religion fosters OCD, though there is a form of OCD that centers around religious and moral issues called scrupulosity. Maybe they aren’t looking closely enough, at the proper magnification. Maybe it’s not religion in general, but looking at that tract, and remembering my own fundamentalist upbringing, I have to imagine that at the very least there are particular churches, particular spiritual leaders, who act as amplifiers, increasing the existing tendency towards OCD in their followers as part of a feedback loop. Or selecting for those vulnerable followers, for those people who are especially looking for certainty, who would pick up that tract and go to that church to find out more, rather than saying “Huh, that’s interesting,” and recycling it like me.Share | Comments