Thursday, February 21, 2008

Psych 101: OCD

Obsessive-Compulsive Disorder causes a lot of discomfort for people. In the DSM-IV obsessions are described as "persistent ideas, thoughts, impulses, or images that are experienced as intrusive and inappropriate and that cause marked anxiety and distress." The person experiences these obsessions as being not under their control, though is aware that they have created them (not like "hearing" voices). Common obsessions are about being contaminated by germs, repeated doubts (for example, having left a door unlocked), a need to have things in a particular order (people refer to a milder form of this as being "anal"), aggressive impulses (eg. hurting someone), and disturbing sexual images. People suffering from OCD try to neutralize the persistent thoughts with compulsive behaviors. For example, the concern about germs may trigger compulsive hand washing. "Compulsions are repetitive behaviors or mental acts (e.g. praying, counting, repeating words silently) the goal of which is to prevent or reduce anxiety or distress." These compulsions feel like things that you HAVE to do. Go back and check the door over and over to make sure it's locked before you can go out; or checking the stove repeatedly long after you should be in bed because you're obsessing about the house burning down; or spending hours washing your hands (obsessing about germs); being in a meeting and counting the ceiling tiles (or the dots on the speaker's tie).

There are a lot of theories about how we get OCD. I don't think people are born with it. They may be prone to it (ie. the "in-the-genes" theory), but mostly people learn it. We're effected by the influences of the care taking people close to us as children, as well as by traumatizing events. And we typically get a lot of practice with the thinking and behavior patterns. I've discussed my theory about habits before (see my blog posting of 9/14/07, on Anger Management).

To treat people with OCD is interesting for me, and enjoyable to see the client's progress, to see the reduction in suffering. It requires a lot of work. My primary goal is to teach the person to interrupt the chain of events (including thoughts and feelings) that trigger the obsessions and/or compulsions, and retrain the part of the brain that's responsible to respond differently. Dr. Jeffery Schwartz and Sharon Begley in The Mind and The Brain: Neuroplasticity and the Power of Mental Force, explain the "plasticity" (changeability) of the brain. I train the client in self-hypnosis, in order for them to learn to replace the anxiety with relaxation. And a lot of practice, first in their head (imagining the situations), then "in vivo" (in real life). We also discuss the early childhood family dynamics that helped lay the foundation for developing this illness . So there are definitely solutions to the conditions of our lives that distress us. It is up to you to find those answers, and with it (hopefully) the happiness that you deserve.

Thursday, February 14, 2008


When I was growing up my mother had certain meals that she cooked on Saturday for me, my 3 brothers, and my Dad. Both of my parents worked during the week, so there were not a lot of "special meals" during the week (My older brothers were good at making the hotdogs and baked beans, or heating things up).Tuna Noodle Casserole was one of the Saturday 'specials' that I really liked. There was also chile con carne and rice, and something I called Spaghetti Pizza (Baked spaghetti). When my father had to work on Saturdays, about once a month, he would bring home a couple of pizzas for dinner. New York Pizza is really the best in the world. Sadly, for now, I haven't been able to eat it or other white carbs much lately. When we go to NYC I do allow myself to go to Koronet Pizza shop (110th St and Broadway), to eat a slice they sell that is 3 times the size of a normal slice. I'm looking forward to our trip up in June.

Anyway, I call it 'My' Tuna Noodle Casserole because I made some changes in the recipe to accomodate my changed diet. Mom would use egg noodles (white pasta), and butter (or probably margarine) which is not really necessary for me. We had not had this dish in a long time, and tried it again recently. Really liked it. You should try it. Make changes if you want. You can make it "Your" Tuna Noodle Casserole.


Ingredients (serves 4 people)
1. 2 cups of cooked whole wheat noodles (or other whole wheat pasta)
2. 1 can of Cream of Mushroom Soup (they make this with reduced salt)
3. 1/2 cup milk
4. 2 6 oz. cans of tuna (I prefer tuna in water, drained, or rinsed if it's in oil)
5. (optional) bread crumbs, and 1 tablespoon of melted butter
6. (also optional) I like spices, so add your favorite ones, for example oregano, garlic, pepper, a little worcestershire sauce
1. Preheat the oven to 400 degrees
2. Mix soup, milk, tuna and spices (if using them) in a bowl
3. Put cooked noodles in a 1 1/2 quart casserole dish
4. Stir the soup mixture into the casserole dish with the noodles
5. Bake at 400 degrees for 20 mins. or until hot.
6. (optional) mix bread crumbs with butter, and sprinkle on top. Bake for 5 more min.
It's easier to make than it looks, and is good to eat after reheating a few days later. Enjoy!