Free Brain Lock: Free Yourself From Obsessive-Compulsive Behavior by Jeffrey M. Schwartz, Beverly Beyette

says, “was that I thought I had to fix my problem myself. I had false pride. I did not want anyone to see my shame.”
At UCLA, we taught Karen the Four Steps, which she keeps pasted on her bathroom mirror and consciously invokes whenever she spots a tempting yard sale or an attractive item poking from a trash can. When Karen Relabels an obsession and says to herself, “Let it go!” she means letting go of both the obsessive thought and the fleeting wish to hang onto another piece of junk. “If I make the right choice,” she says, “I get to feel good about myself. I get to be that much closer to a rubbish-free, hassle-free environment. I get to be healthy. I get to have friends. I get to have a life!” One technique she uses is to get angry at all that stuff and how it’s wrecked her life. “I don’t just toss things into garbage cans. I throw them in with a vengeance, as if to kill them, as if our lives depended on it, and—in a deep sense—they do.”
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    BLAME IT ON YOUR GENES?
    In telling her story, Karen mentions that she grew up in a rigidly perfectionist household with an eccentric father who would rant constantly against waste. She wonders if this experience mandated the content of her OCD, which is possible, especially since as yet there is no biological explanation as to why one person washes, while another hoards.
    Other patients also reflect on their childhoods and their genetic legacies in attempting to find answers to why they developed OCD. Certainly, genetics does seem to play a role. Again and again,patients have told me of mothers or sisters or grandparents who certainly had OCD tendencies long before the disease was given a label. Formal studies show the same thing: OCD tends to run in families. Frequently, parents of people with OCD were rigid and inflexible and became very uncomfortable if things weren’t done in a certain way. For example, at five on the dot each day, Howard Hughes’s grandparents went out on the porch of their summer house. As a child, Howard had to be there precisely at five, or there was hell to pay. One can think of this kind of rigidity as low-grade OCD. These traits can be highly advantageous if you are, say, a surgeon or an accountant, but they can become pathological if they are amplified. Thus, it’s not surprising to see that a precursor of an OCD biochemical imbalance is this much less disruptive habit-based brain function.
    Childhood-onset illnesses have also been linked to OCD. Dr. Susan Swedo’s group at the National Institutes of Health has established a link between OCD and Sydenham’s chorea, a variant of rheumatic fever that involves an autoimmune attack on the brain. Her work implicated Sydenham’s chorea in both the onset and exacerbation of OCD. The fact that there is a strong relationship between Tourette’s syndrome, a motor tic disease, and OCD is also intriguing. The link between childhood psychological experiences, especially traumatic ones, and classic OCD is less clear, but some of my patients are convinced there is one.
    Michael, a stenographer, feels strongly that his OCD stems from growing up in a household with a father who would dwell for days on minutiae and a mother he describes as an “anal-retentive” compulsive cleaner. He recalled: “My mother tended to be very overpossessive. But, though she smothered me, she didn’t nourish me in other ways. Which is the same thing my OCD does. You know, you have all this potential that is smothered. I remember other kids taking piano lessons, whatever, but she never allowed me to do those things. She just did the smothering. With OCD, you might have the potential, but it smothers you and does not allow you to get it out.”
    Michael describes himself as having a “Dr. Jekyll and Mr. Hyde brain,” with a good side and a bad side—the OCD side. He has had counting and touching compulsions, compulsions about “good”numbers and “bad” numbers, and compulsions to repeat sentences