2013 Winter EAP PATHWAYS Newsletter - draft.pub

The Newsletter of the BOCES Employee Assistance Program Winter 2014
Understanding and Overcoming Obsessive-Compulsive Disorder—(OCD)
Written by William Futtersak, Ph.D.
You might be surprised to learn that not everyone with
Obsessive-Compulsive Disorder (OCD) is like Monk, the
fastidious police detective played on TV by Tony Shalhoub,
who is as much consumed with cleanliness and order
as he is with solving crime. In reality, OCD is more
than just a fear of germs and an overriding attention to
orderliness. It may also involve worries related to health
and safety, fears of embarrassment in social situations,
fears of being less than perfect in school or at work, and
even fears of causing harm to other people (usually loved
ones). Additionally, most people with OCD do not suffer
from a disorder that is so all-encompassing as to render
them reclusive or compelled to wear protective gear such
as surgical masks. The fact is, most people who suffer
from OCD manage to keep their disorder secret while trying
to maintain a relatively normal life.
OCD is a neurologically based disorder, affecting both children
and adults, that leads otherwise healthy individuals
to worry about specific concerns in an intensely exaggerated
manner. The concerns of the individual with OCD
may be real on some level, but so disproportionate to reality
as to be well beyond what is practical or constructive.
An individual with OCD suffers obsessions, which are
repetitive thoughts or worries, as well as compulsions,
which are ritualistic actions or behaviors intended to reduce
anxiety. Some compulsions are easy to explain,
such as repetitive hand washing to reduce obsessions
about germs, or the ritualistic checking of doors and windows
to ensure family safety. Other compulsions may be
less easily understood, like the repetition of a “lucky”
word or phrase or the tapping of a table or wall to make
an uncomfortable obsession, like a guilty thought, disappear.
For the person with OCD, these seemingly odd
compulsions become “accidentally” associated with the
reduction of anxiety and then get repeated as long as
they continue to ward off stress.
One of the hallmarks of OCD is that the person with this
disorder knows that the worried thoughts they hold are
irrational and that the compulsions or rituals they are performing
are mostly unnecessary. However, that knowledge
alone does not mean that they can stop their OCD
worrying or ritualistic behavior.
The truth is, obsessions and compulsions are only as
strong as we make them. Our brain does not really “think”
for itself, but rather it processes information according to
what we feed it. If we ignore an alarm signal from the environment,
say a freckle that seems to have suddenly appeared
on our arm, a “dust bunny” under the sofa, or a
misspoken word we said in conversation, it fails to take
hold in our brain and we ultimately deem it unimportant.
However, if we attend to an alarm signal over and over
again, as with an obsession, it assumes an even greater
place within the hierarchy of concerns that exist within
our brains. Now that freckle becomes a howling, buzzing
alarm that can only be turned off if we have it medically
examined, the “dust bunny” becomes an unrelenting focus
of our scrutiny and a target for daily vacuuming, and
the misspoken word we may have dropped into our conversation
becomes a source of catastrophic shame and
embarrassment. To put it simply, the more often and
more intensely we worry about something, the more our
brain believes that particular worry is important. Conversely,
the more we ignore something, the easier it is
for our brain to let go of it. Thus, minor worries can become
especially important to us if we attend to them
enough, and real problems can be denied if we practice
sufficient avoidance.
In the case of OCD, the problem is worrying repeatedly
and intensely about things that, in reality, pose no real
threat. For example, we may obsess that we have left the
door unlocked, when we have, in fact, locked it. Our
brains come to think these things matter based simply
upon the number of times we have “thought” about them
and the intensity in which we have c onsidered t hem.
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Intense, repetitive worrying only triggers additional cycles
of OCD attention and worry. To reduce OCD, we must
break these cycles of attention, worry, and ritualistic behavior.
Traditionally, the treatment for OCD has involved talk
therapy designed to help individuals gain insight into the
subconscious motivations beneath their obsessive behaviors
and/or behavioral therapy approaches designed
to help the individual dispute the reasonableness of OCD
behavior. Often, family members try to alleviate the
worries of OCD sufferers through constant offerings of
reassurance and even by forcibly trying to “block” loved
ones from engaging in their compulsions.
Jeffrey Schwartz, M.D., a neuroscientist, has demonstrated
in his research why these types of interventions
are generally not very helpful. By providing attention to
the part of the brain that is obsessing, even in the context
of trying to understand the worry, trying to dispute
it, or trying to forcibly block it, only adds fuel to the obsessional
thinking. Dr. Schwartz has developed the following
four-step method to re-wire the brain and significantly
reduce the impact of obsessional thinking. It has
already shown great promise in the treatment of OCD.
STEP ONE: RE-LABEL: In this first step, individuals with
OCD learn to re-label their obsessive worries and compulsive
urges. Rather than seeing them as legitimate
alarm signals that must be attended to, OCD sufferers
learn to re-label their worries as simple misfires of the
brain. As a result, obsessive worry moves from the allimportant
fear center of the brain to the part of the
brain that handles “false alarms” from the environment
of any type. Analogous to a telemarketer’s phone call at
dinnertime, the OCD worry is reduced to the level of a
nuisance, meant to be ignored rather than attended to.
STEP TWO: RE-ATTRIBUTE: As Dr. Schwartz has described,
obsessions are a creation of one’s own brain.
In this second step, OCD sufferers use this knowledge to
remind themselves of the true origin of their obsessive
worries. Instead of attributing their worries to real
world threats, OCD sufferers learn to diminish their fears
by more accurately attributing them to their own previous
patterns of obsessive thinking.
STEP THREE: RE-VALUE: Based upon the insights gained
during Steps 1 and 2, OCD sufferers can now more
clearly see their worries as wasted energy expended on
false threats. Knowing their obsessive worries have no
real value, individuals with OCD can ignore, reject, or
even make light of their own worries. In re-wIring the
brain, Schwartz has found that it is much more effective
for OCD sufferers to conclude for themselves that their
obsessions have no real value rather than to rely upon
the frequent reassurances of others.
STEP FOUR: RE-FOCUS: Finally, having relabeled obsessive
worrying as a misfiring of one’s own brain with no
true value, the OCD sufferer can now refocus upon
more constructive endeavors. Refocusing upon more
positive concerns such as family relations, social interactions,
leisure activities, etc. helps break the cycle of repetitive
worry and reduces the importance of these worries
in one’s own brain.
According to Dr. Schwartz, repetitive practice of the 4-
Steps--rather than repetition of obsessions and compulsions—ultimately
leads to a rewiring of the brain and
eventually frees an individual from the invisible bonds of
OCD.
If you or your family member(s) need assistance with
this issue, or if you would like information regarding
how to contact Dr. Futtersak, contact your EAP at (631)
289-0480. WE ARE HERE FOR YOU!
1741D North Ocean Avenue, Medford, NY 11763 (631) 289-0480
35 Crooked Hill Road, Suite 103, Commack, NY 11725 (631) 858-9177
188 W. Montauk Hwy, Ste. E1, Hampton Bays, NY 11946 (631) 728-2008
Eastern Suffolk BOCES does not discriminate against any employee, student, applicant for employment, or candidate for enrollment on the basis of gender, race,
color, religion or creed, age, weight, national origin, marital status, disability, sexual orientation, military or veteran status, domestic violence victim status, genetic
predisposition or carrier status, or any other classification protected by Federal, State, or local law. Inquiries regarding the implementation of applicable laws
should be directed to either of the Eastern Suffolk BOCES Civil Rights Compliance Officers: the Assistant Superintendent for Human Resources, 201 Sunrise
Highway, Patchogue, NY 11772, 631-687-3029, ComplianceOfficers@esboces.org; or the Deputy Superintendent for Educational Services, 201 Sunrise Highway,
Patchogue, NY 11772, 631-687-3056, ComplianceOfficers@esboces.org.