Buddhist Recovery Network book review
“Brain Lock: Free yourself from Obsessive Compulsive Behaviour”
Jeffrey M. Schwartz, M.D. & Beverly Beyette
A Four-Step Self-Treatment Method to Change Your Brain Chemistry
Regan Books, HarperCollins, 1996.
Paperback. 219 pages.
School/perspective: Cognitive-Behavioural Therapy
Note:This title is included on this website because: there is an overlap between sufferers of OCD and alcoholism (which is clear from some of the stories in this book); it introduces Buddhist mindfulness practice to dealing with our obsessions and compulsions; it provides an important, contrasting perspective to books on compulsions like Mary O’Malley’s. Obsessive-Compulsive Disorder (OCD) has entered popular culture through films like The Aviator, which brought to the screen some of Howard Hughes’ bizarre rituals. Its most popular manifestations are a repeated, irrational urge to check things, or wash your hands.
- Part I: The Four Steps
- 1. Step 1: Relabel “It’s not me – it’s my OCD”
- 2. Step 2: Reattribute “Unlocking Your Brain”
- 3. Step 3: Refocus “Wishing Won’t Make It So”
- 4. Step 4: Revalue “Lessons Learned from OCD”
- Part II: Applying the Four Steps to Your Life
- 5. The Four Steps and Personal Freedom
- 6. OCD as a Family Disorder
- 7. The Four Steps and Other Disorders
Overeating, Substance Abuse, Pathological Gambling, Compulsive Sexual Behaviour
- 8. The Four Steps and Traditional Approaches to Behavior Therapy
- 9. OCD and Medication
- 10. University of Hamburg Obsession-Compulsion Inventory Screening Form
- 11. An OCD Patient’s Diary of Four-Step Self-Treatment
- Part III: Self-Treatment Manual for the Four-Step Method
“In learning to Relabel, it is not enough to shrug and say, “It’s not me – it’s my OCD” in an automaton-like manner. Mindful awareness is essential. Mindful awareness differs from simple, superficial awareness in that it requires you to consciously recognize and make a mental note of that unpleasant feeling, Relabeling it as an OCD symptom caused by a false message from the brain. As the feeling sweeps over you, you must say to yourself, “I don’t think or feel that my hands are dirty; rather, I’m having an obsession that my hands are dirty. I don’t feel the need to check that lock; rather, I’m having a compulsive urge to check that lock.” This will not make the urge go away, but it will set the stage for actively resisting the OCD thoughts and urges...”
“In Relabeling, you bring into play the Impartial Spectator, a concept that Adam Smith used as the central feature of his book The Theory of Moral Sentiments. He defined the Impartial Spectator as the capacity to stand outside yourself and watch yourself in action, which is essentially the same mental action as the ancient Buddhist concept of mindful awareness. People with OCD use the Impartial Spectator when they step back and say to themselves, “This is just my brain sending me a false message. If I change my behaviour, I’ll actually be changing how my brain works.” It is inspirational to watch people with OCD shift from a superficial understanding of their disorder to a deep mindfulness that allows them to overcome their fears and anxieties, to mentally organize their responses, to shift gears, and to change their behaviour. This process is the basis for overcoming OCD.” (pp. 10 - 11)
“From childhood, Jeremy had been overwhelmed by touching and checking compulsions that he performed without fail, fearing that a family member would die “and God would damn me to hell for it.” Home became a “torture chamber” of rituals. By his teens, Jeremy was seeking escape in alcohol and drugs. As a young adult, he kicked his drinking habit with the help of Alcoholics Anonymous, but he began to obsess that something he had eaten contained alcohol. It could be a Rice-a-Roni or something equally nonsensical. Logic played no role here...” (p. 15)
© 1996 Jeffrey M. Schwartz
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I suffer from OCD to a mild extent. Brain Lock recounts research undertaken at the UCLA School of Medicine which led to the development of a Four-Step Self-Treatment Method. Their explanation for OCD is that it’s not a psychological problem but a neurological problem, a ‘biochemical imbalance in the brain that may be genetically inherited’. This ties in with The Craving Brain, and the analysis there of addiction. The book encourages us to make a fundamental distinction between our ‘Impartial Observer’, our ability to stand outside and observe ourselves, and our brain. We need to stand apart from our brain, which is faulty. This is where the Buddhist practice of ‘mindful awareness’ is introduced (see the first excerpt above). Its treatment of ‘mindfulness’ while describing an aspect of it, doesn’t really explore it or convey its full depth from a Buddhist perspective. The book’s slogans give an idea of the approach being advocated: “It’s not me, it’s my OCD”, “Blame it on the brain”, “It’s not how you feel, but what you do that counts”, “Don’t be polemical, it’s just a chemical.” There is insufficient space here to analyse the Four Steps, but they are to ‘Relabel’, ‘Reattribute’, ‘Refocus’ and ‘Revalue’. Although the book nods in the direction of Buddhism and AA, it takes a strongly ‘self-development’ perspective on recovery, rather than a ‘self-surrender’ perspective. Thus it aims to increase our willpower to fight OCD, and equates ‘spiritual’ with our ‘will’ (eg p 124 “A genuine spiritual (willful) process has taken place…”).
In contrast to Mary O’Malley’s very ‘self-surrender’ take, Jeffrey Schwartz is almost applying the George Bush and Donald Rumsfeld approach to treatment. OCD is our enemy and must be wilfully killed. The fact that this approach does work for many people in battling OCD (including me) shows that different approaches work better for different conditions and different people. The book does have many things in common with the other books on the list. This includes the importance of ‘leaning into the pain’, and ‘the only way out is through’. We need to proactively expose ourselves in a managed way to the discomfort. He points out that OCD does differ from substance abuse, (for a start people who have OCD hate it and want to stop it) so he doesn’t hold out his Four Steps as a cure-all for all impulse control issues. He does acknowledge the self-surrender approach, by describing someone who attends an OCD Twelve Step group saying that ‘letting go’ in this context means letting go of both the urge, and the compulsive act that you feel compelled to perform. To sum up, although I had read some of this research before, I did find the book valuable. It reminded me of the extent to which OCD had infiltrated my life. I have a checking compulsion which I have managed down to a very controlled level. But there are other aspects (such as hair pulling, or creating inventories) where one can still see the hand of OCD. So it increases self-awareness. It has also re-energised me, and made me less accommodating of the residual level of OCD which I was ‘managing’. Every time I give in and check something I know is irrational, I guarantee its recurrence.
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