- Mental and physical pain are processed in similar regions of the brain.
- Our inability to escape from RUTs relentlessly drives flight-or-fight physiology, and people may become ill.
- There is a sequence to resolve repeated unwanted thoughts–thought diversion, lowering anger, moving into creativity, and dissolving the ego.
Obsessive Compulsive Disorder (OCD) is manifested by extreme anxiety that is driven by repetitive unpleasant thoughts (RUTs). Most people associate it with disruptive compulsive behaviors, such as hand washing, climbing up and down stairs, following a rigid daily regime— the list is endless. However, there is also a form of OCD called “internal OCD,” where a person has an unpleasant thought and “counteracts” it with a pleasant thought. Either form has no endpoint and is considered a diagnosis to be managed and not solved.
That is simply not true.
RUTs are universal
Essentially every human being has some level of RUTs. At what point do they become severe enough to be considered OCD? Why not discard the diagnosis and consider the process on a spectrum of human consciousness? The classic definition of OCD is when the thoughts/behaviors interfere with your capacity to carry out activities necessary to live a functional life.
What about enjoying your life? With internal OCD, there are no outward manifestations, but your quality of life might range from unremarkable to miserable. There also many “acceptable” behaviors such as working hard, overexercising, “passionate pursuit” of a hobby or vocation. All can be just fine, but what is driving them?
In talking to patients carefully over 40 years, I gradually learned that mental pain is a much bigger problem than physical pain. Asked whether they would prefer to get rid of their physical pain with surgery while still having their ongoing anxiety versus resolving their anxiety and living with the physical pain, the majority of people wanted to get rid of the mental pain.
There are also some cousins of OCD. Consider them in the context of behaviors to cope with the unpleasant sensations created by anxiety (threat physiology). They include:
- Hair pulling
- Nail biting
- Eating disorders
- Excessive attention to physical appearance
- Hoarder’s syndrome
- Skin picking
- Extreme convictions regarding religion, politics, or any social issue
- Imposing these “ideals” on others is the next step because control lowers inflammation. The more power the more control.
Any addiction is an attempt to mask anxiety.
Avoiding anxiety (threat physiology) drives most human behavior
Avoiding anxiety is the driving force keeping all living creatures alive. It is the result of stresses and challenges, not the cause. Amongst the many stressors in our lives, the inability to escape from our thoughts is a major one, maybe the worst. Although we cannot control our thoughts, many activities create sense of control. Suppressing RUTs just makes them worse.
“Worrying” seems normal to many people. But is not particularly enjoyable. Why do we spend so much time worrying about so many things, many of which we have no control over? One reason is that it provides a feeling of control. Somehow, worrying enough will help solve the problem. What it does is keep your brain and body fired up, leaving you with less energy to effectively deal with challenges. But suppressing worry is even worse.
Or maybe you have an “anxiety disorder.” Everyone has anxiety, so why call it a disorder and why personalize the intentionally unpleasant sensations that evolved to keep you alive. It is something you have, not who you are.
What about those who don’t have any of these behaviors. Even many well-adjusted people living normal enjoyable lives can experience a level of RUTs that interfere with their quality of life. Actually, when life is relatively calm, the repetitive thought patterns can significantly increase. Pursuing pleasurable activities to distract themselves doesn’t work and is actually highly inflammatory. The data shows that a hedonistic lifestyle creates aggressive inflammatory cells known as “warrior monocytes.” In addition to attacking viruses and bacteria, they also go after your own tissues. Other factors that stimulate their formation include social isolation and chronic stress.1 Your body knows how to effectively deal with acute stress, but it needs a break to rest and regenerate.
Degrees of OCD
Obsessive thought patterns are inherent in human cognitive consciousness. There are degrees of intensity, and they vary day to day depending on the level of stressors and the state of your nervous system—calm or hyperactive. Again, even if your life is relatively calm, they can also be problematic.
OCD, the extreme manifestation of this situation, is considered a diagnosis to be managed, not solvable. However, medicine has not consistently addressed the body’s physiology. When you are in a flight-or-fight state, your brain also becomes inflamed, and such thoughts fly out like clay pigeons at a shooting range, except there are trillions of them. The medical profession has also not acknowledged the seriousness of the effects of less intense RUTs on people’s sense of well-being and health. They still drive threat physiology. They are often referred to as a “monkey mind” or signs of a nervous breakdown. These thinking patterns are a problem, but our inability to escape them is even more problematic.
There are four aspects of solving RUTs. They all happen simultaneously and indefinitely. Eventually, as your brain evolves away from them, you no longer have to work at dealing with them.
The four approaches to RUTs are:
- Diverting, not controlling, them—mindfulness, expressive writing, cognitive behavioral therapy (CBT)
- “Turning down the heat”— When you are trapped by anything, your threat state fires up even more, and you are angry. Anxiety is activated, and anger is hyperactivated threat physiology.
- Nurturing creativity and joy. This is where the real healing occurs as you move away from the spinning circuits.
- Dissolving your ego—We work hard to attain enough self-esteem to feel better about ourselves. However, most of it is based on cognitive distortions that drive RUTs even more. Without an ego to defend, the racing thoughts will abate, often dramatically.
This set of approaches evolved from my own 15-year ordeal with severe “internal OCD.” Not only do I not experience the vivid, almost visual thoughts, I don’t seem to have the random distracting thoughts I had before I became ill. There is also a vast amount of research looking at the mechanisms of why and how they occur,. The challenge is to present it in a manner so you can pursue your own healing journey. No one else can do it for you.
As your brain heals, your body heals. As your body heals, your brain will heal. The reality is that they are just two parts of one unit—you.
Our inability to escape our unpleasant thoughts is inflammatory. Since half of your brain has inflammatory receptors, it also fires up in response to unpleasant thoughts.. The diagnosis of OCD is considered to be relatively uncommon; however, many people suffer from RUTs that interfere with the quality of their life. Obsessive thought patterns are considered to be unsolvable and just subject to management. However, medicine is not generally addressing the underlying physiology. There are four aspects of dealing with OCD that will lower the intensity of the thoughts: thought diversion, lowering anger, moving into the creative part of your brain, and allowing your ego to dissolve. They are solvable.
1. Cole SW, et al. Social regulation of gene expression in human leukocytes. Genome Biology (2007); 8:R189. doi:10.1186/gb-2007-8-9-r189