Ocd Thoughts Quotes

Thoughts are only thoughts. They are not you. You do belong to yourself, even when your thoughts don't.

Carrying all of these thoughts is downright heavy.

People who live with OCD drag a metal sea anchor around. Obsession is a break, a source of drag, not a badge of creativity, a mark of genius or an inconvenient side effect of some greater function.

OCD focuses on the negative. I didn't think to myself, My praying will save my grandma. Instead, I thought, If I don't pray, my grandma will die for sure.

The return of the voices would end in a migraine that made my whole body throb. I could do nothing except lie in a blacked-out room waiting for the voices to get infected by the pains in my head and clear off. Knowing I was different with my OCD, anorexia and the voices that no one else seemed to hear made me feel isolated, disconnected. I took everything too seriously. I analysed things to death. I turned every word, and the intonation of every word over in my mind trying to decide exactly what it meant, whether there was a subtext or an implied criticism. I tried to recall the expressions on people’s faces, how those expressions changed, what they meant, whether what they said and the look on their faces matched and were therefore genuine or whether it was a sham, the kind word touched by irony or sarcasm, the smile that means pity. When people looked at me closely could they see the little girl in my head, being abused in those pornographic clips projected behind my eyes? That is what I would often be thinking and such thoughts ate away at the façade of self-confidence I was constantly raising and repairing. (describing dissociative identity disorder/mpd symptoms)

It would've been the perfect time to tell her. To tell anyone. To say, 'I'm drowning and I need someone, anyone, to be my life raft.' To say, 'I thought it had gone, and it hasn't and I'm so scared by what that means.' To say, 'I just want to be normal, why won't my head let me be normal?

how very, very tired I am with this hidden battle for my own thoughts, the burden of counting, the work it takes to hide it.

In job interviews they’d ask me, What’s your greatest weakness? and I’d explain that I’ll probably spend a good portion of the workday terrorized by thoughts I’m forced to think, possessed by a nameless and formless demon, so if that’s going to be an issue, you might not want to hire me.

The real problem with his type of OCD--chronic fear of hurting other people--was that you thought so much about not running over children, not sideswiping pedestrians, not poisoning strangers with germs on your hands--essentially not killing a world full of strangers--that you ended up hurting the people you loved most. He saw that now.

Statistics say that a range of mental disorders affects more than one in four Americans in any given year. That means millions of Americans are totally batshit. but having perused the various tests available that they use to determine whether you're manic depressive. OCD, schizo-affective, schizophrenic, or whatever, I'm surprised the number is that low. So I have gone through a bunch of the available tests, and I've taken questions from each of them, and assembled my own psychological evaluation screening which I thought I'd share with you. So, here are some of the things that they ask to determine if you're mentally disordered 1. In the last week, have you been feeling irritable? 2. In the last week, have you gained a little weight? 3. In the last week, have you felt like not talking to people? 4. Do you no longer get as much pleasure doing certain things as you used to? 5. In the last week, have you felt fatigued? 6. Do you think about sex a lot? If you don't say yes to any of these questions either you're lying, or you don't speak English, or you're illiterate, in which case, I have the distinct impression that I may have lost you a few chapters ago.

An average person can have four thousand thoughts a day, and not all of them are useful or rational.

The baby was warm against my chest. I knew I was broken too. I wasn't like other people. I was scared and weird and anxious and sad lots of the time, and I didn't know why. My parents thought I was abnormal, I was pretty sure. They said I wasn't, but you don't get sent to a therapist if you're normal. Sometimes we really aren't supposed to be the way we are. It's not good for us. And people don't like it. You've got to change. You've got to try harder and do deep breathing and maybe one day take pills and learn tricks so you can pretend to be more like other people. Normal people. But maybe Vanessa was right, and all those other people were broken too in their own ways. Maybe we all spent too much time pretending we weren't.

People who live with OCD drag a mental sea anchor around. Obsession is a brake, a source of drag, not a badge of creativity, a mark of genius or an inconvenient side effect of some greater function.

Mind over matter represents the triumph of will over physical hindrance. Our thoughts are our weapon against the world.

My compulsive thoughts aren't even thoughts, they're absolute certainties and obeying them isn't a choice.

I try Dr. Pat's breathing exercises but they're not working because my entire mind is focused on keeping myself glued to the couch. I don't want to move any closer to the bathroom just in case. But I hate myself for the thought. I know it's not right or normal. I know I'm not simply some cute quirky girl like Beck says, and every moment I can't get off the couch is a moment that makes me one level crazier. That heavy, pre-crying feeling floods my sinuses and I drop my head from the weight of it. Cover my face with my hands long enough to get out a cry or two. Because there is nothing, nothing worse than not being able to undo the crazy thoughts. I ask them to leave, but they won't. I try to ignore them, but the only thing that works is giving in to them. Torture: knowing something makes no sense, doing it anyway.

Because facts are information we can learn from to adjust or inform our behavior in the future. Thoughts, on the other hand, hold the same weight as dreams. They’re in our brain, so they seem real, but they’re not. They’re quite literally figments of our imagination.

I really didn’t want to see a horror flick, even a stupid one. I didn’t need any more fodder for my already gory imagination.

I realized that I was okay with myself. I was quirky and withdrawn and loud, but I liked that. I smiled at strangers without thinking they were going to attack me and drag me into their cars. I went to doctors’ offices and touched magazines that had been touched by sick people.

I am better. I don't know whether it's for good, or if one day something might make me abnormal again. But that's the funny thing about living. If you do it properly, you don't know how the next sentence will begin.

I can’t believe he’s going along with this.” She flops on her bed, then wrinkles her forehead and stares at the mattress. “Did you make my bed?” “Yes,” I say sheepishly, but she doesn’t seem pissed. I’d already warned her that my OCD might rear its incredibly tidy head every now and then, and so far she hasn’t batted an eye when it happens. The only items on her don’t-touch-or-I’ll-fuck-you-up list are her shoes and her iTunes music library. “Wait, but you didn’t fold my laundry?” She mock gasps. “What the hell, Grace? I thought we were friends.” I stick out my tongue. “I’m not your maid. Fold your own damn laundry.” Daisy’s eyes gleam. “So you’re telling me you can look at that basket overflowing with fresh-from-the-dryer clothes—” she gestures to the basket in question “—and you aren’t the teensiest bit tempted to fold them? All those shirts…forming wrinkles as we speak. Lonely socks…longing for their pairs—” “Let’s fold your laundry,” I blurt out. A gale of laughter overtakes her small body. “That’s what I thought.

She tells me that over time doing these lists will make us perfect, but it’s little consolation. Every day feels like an unrelenting slog of words generated, letters compiled, actions reviewed—with nothing to show for it but exhaustion and despair.

My room’s a mess. I scurry around, scooping up piles of clothes and stuffing them into the laundry hamper. “I thought people with OCD were supposed to be neat,” she says. “Popular misconception,” I say as I kick all the textbooks strewn across the floor into a haphazard pile.

Sometimes my thoughts were hard to digest. Sometimes my brain would get stuck on a concept that troubled me and would create endless rabbit holes in my head. It seemed like the more I tried to find an answer, the more complicated it would become. And sometimes unsettling images would randomly flash into my head. I didn’t want to describe what they were. I knew the images weren’t true, but they often made me feel uneasy.

It's a thousand tiny impulses, building on one another. First you decide it's a good idea to check the oatmeal bin for bugs. Next you're going through all the canisters, and before you know it, you're wearing a hazmat suit and examining the frosted flakes for ground-up glass. Each action further enforces the obsessive-compulsive circuit. When the disease is full-blown, sufferers are firmly entrenched in the neural loops that make them repeat thoughts and actions over and over. In other words, your brain keeps getting back in line for the same carnival ride it didn't enjoy in the first place. You lose your sunglasses, you throw up on your shirt, and two minutes later you're back on the Whizzer. Wheeee.

Someone asked me recently, what it is like to live with OCD. I paused for a while and said, imagine watching your sibling getting run over by a truck in front of your eyes, not once, not twice, but repeatedly like in a looped video, or your child getting beaten up at school, or your partner getting abused by strangers on the street - and the only way you can stop that event from happening is to keep on repeating the task that you were carrying out when the vision first appeared in your mind, until some other less emotionally agonizing thought breaks the loop of that particular vision and replaces it - and though you know, it's just a thought and not the destiny of the people you love, you feel it excruciatingly necessary to keep repeating the task until the thought passes, so that nothing bad happens to your loved ones - and that's what it is like inside the head of a person with OCD, every moment of their life.

Some people with OCD are compelled to pick up pieces of broken glass from the street. They worry that, if they don’t, then someone else might cut themselves on the glass. If the person with OCD fails to prevent that happening, they think, well I may as well have walked up to the stranger and deliberately hurt them. So they take

One day, I just decided to see how long I could go without eating. I never thought I was fat; if anything, my lack of boobs and scrawny legs told me that I was actually too skinny, but being extra-OCD about food soon became my thing. It gave me something to think about all day and it was a secret that I could obsess over without anyone else knowing.

I’d love to return my brain to factory settings.

Reassurance, like offence, is taken not given.

I have existed for twenty-one years. I didn’t live them all, but from now on I am hoping to.

But she hasn’t done us a favour, because it is Classic FM, and they are playing fucking Vivaldi.

Don’t attach significance to it. If it loses its power to be scary, it won’t hurt you anymore.

I suppose I should be thankful that if I have to go mad, at least I get to do it in a fashionable, aristocratic way.

I couldn’t escape the spiral of my thoughts, and I felt like they were coming from the outside.

[I]f he had to guess, he would say that the reason he doesn't want to loan the book out, to Ethan or anyone else, is because of the part of his personality that is one gigantic record-keeping system, a complex sifting and filing scheme that dictates what goes here and what goes there, turning his life into so many marks on a tablet. His mind would busy itself with the book's whereabouts every second it was away. He knows it would.

By [anticipatory anxiety] I mean that the patient reacts to an event with a fearful expectation of its recurrence. However, fear tends to make happen precisely that which one fears, and so does anticipatory anxiety. Thus a vicious circle is established. A symptom evokes a phobia and the phobia provokes the symptom. The recurrence of the symptom then reinforces the phobia. The patient is caught in a cocoon. […] [Obsessive-compulsives] fear the potential effects or the potential cause of the strange thoughts. The phobic pattern of flight from fear is paralleled by the obsessive-compulsive pattern. Obsessive-compulsive neurotics also display fear. But theirs is not 'fear of fear' but rather fear of themselves, and their response is to fight against obsessions and compulsions. But the more the patients fight, the stronger their symptoms become. In other words, alongside the circle formation built up by anticipatory anxiety in phobic cases, there is another feedback mechanism which we encounter in the obsessive-compulsive neurotic. Pressure induces counter-pressure, and counter-pressure, in turn, increases pressure. If one succeeds in making the patient stop fighting his obsessions and compulsions -- and this may well be accomplished by paradoxical intention -- these symptoms soon diminish and finally atrophy.

These choices are part of the butterfly effect of my life, whether I like it or not. If I make the wrong decision, it will affect the rest of my day. It sounds crazy, but I know from experience the complete and utter devastation caused by one misplaced judgement.

If I'd been the author, I would've stopped thinking about my microbiome. I would've told Daisy how much I liked her idea for Mychal's art project, and I would've told her that I did remember Davis Pickett, that I remembered being eleven and carrying a vague but constant fear. I would've told her that I remembered once at camp lying next to Davis on the edge of a dock, our legs dangling over, our backs against the rough-hewn planks of wood, staring together up at a cloudless summer sky. I wouldv'e told her that Davis and I never talked much, or even looked at each other, but it didn't mater, because we were looking at the same sky together, which is maybe more intimate than eye contact anyway. Anybody can look at you. It's quite rare to find someone who sees the same world you see.

Years later, a different therapist asked her exactly what she was afraid of. Varya was initially stumped, not because she didn’t know what she was afraid of but because it was harder to think of what she wasn’t. “So give me some examples,” said the therapist, and that night Varya made a list. Cancer. Climate change. Being the victim of a car crash. Being the cause of a car crash. (There was a period when the thought of killing a bicyclist while making a right turn caused Vaya to follow any bicyclist for blocks, checking again and again to make sure she hadn’t.) Gunmen, Plane crashes – sudden doom! People wearing Band-Aids. AIDS ¬¬- really, all types of viruses and bacteria and disease. Infecting someone else. Dirty surfaces, soiled linens, bodily secretions. Drugstores and pharmacies. Ticks and bedbugs and lice. Chemicals. The homeless. Crowds. Uncertainty and risk and open-ended endings. Responsibility and guilt. She is even afraid of her own mind. She is afraid of its power, of what it does to her.

Beliefs about overimportance of thoughts and thought control are more frequent in highly religious people and mediate the observed association between religiosity and OCD. Thought-action fusion overlaps with magical thinking and is associated with religiosity, paranormal beliefs, and positive schizotypy. most likely, thought-action fusion plays a significant role in the etiology of autogenous obsessions.

…sometimes my thoughts were hard to digest. Sometimes my brain would get stuck on a concept that troubled me and would create endless rabbit holes in my head. It seemed like the more I tried to find an answer, the more complicated it would become. And sometimes unsettling images would randomly flash into my head. I didn’t want to describe what they were. I knew the images weren’t true, but they often made me feel uneasy.

No way," I tell her. "Once was enough for me." And I mean it, though it has nothing to do with Paul and his blue eyes, and everything to do with how very, very tired I am with this hidden battle for my own thoughts, the burden of counting, the work it takes to hide it. The Djinn hates it when I'm adrift in the world, trying to live my life; he prefers me anchored to my home, where I can feed his need for numbers without fear of discovery.

Having OCD, and tending to see things as either black or white and in perfectionistic terms, as well as being overconscientious, he was extremely hard on himself and insisted that he somehow be guaranteed that he would not one day snap and act on his thoughts. At one point, Frank told me that he was now concerned that he was feeling too little anxiety, which made him think that perhaps he was a sociopath without a conscience after all and would end up like Jeffrey Dahmer!

He explained that many if not most people have thoughts like hers, but the OCD brain takes intrusive thoughts seriously. He said OCD sufferers often believe they are responsible for things they can’t control, which is probably why she thought she alone controlled her cat’s destiny. Even if she rationally knew this couldn’t be true (because if it were, why not tell people what a good job she was doing, keeping the stupid ungrateful cat alive by laboriously reciting those tables), it felt true.

Most people say "I'd do anything for my child," but the Harm OCD sufferer has to do more than just show up for the job. You have to show up to this amazing beautiful being even knowing that it aggravates your disorder. You have to do exposure to the darkest, most terrifying corners of the mind. You have to cope with extreme love, often reminding you of extreme fear. You have to tolerate the uncertainty that your child may have a short or painful life in order to maximize the possibility that she has a happy one. To love your children is to be vulnerable to them and to see their vulnerability. You have to risk being harmed and you have to risk harming in order to be close to anyone. OCD can make you think you're too crazy to deserve this closeness with a child. But you're not crazy. You got this.

I sure do like this sculpture.” Jolene smiled at the newcomer. “Well, hello, Lou.” The Devil sent her a narrow-eyed look. “Hello, vile woman.” “You buttoned up your shirt wrong,” Jolene told him. “What?” he squeaked, peeking down at the shirt. Realizing she was kidding, he flattened his lips. “See, vile.” Jolene rolled her eyes. “Let it go, Lou.” Sensing there was more to this than the shirt comment, Harper asked, “Let what go? What did you do, Grams?” Jolene tipped her chin at Lou. “He was in a bad mood, so thought I’d take him to a nice, calming atmosphere to cheer him up. Only there is no cheering him up.” Harper wasn’t buying that innocent act for a single second. “Where did you take him?” “To a poetry recital.” Lou’s face hardened. “The words hardly ever rhymed! How is that poetry?” And it clearly drove his OCD streak crazy.

So what came first, do you reckon, the horrible thoughts forcing you to carry out rituals like a junkie, or the need to make people laugh? Or maybe they’re two sides of the same coin. The vivid imagination causing thoughts which make you want to cry is the same imagination that can find humour in situations other people would call ‘mundane’…” “It’s occurred to me, yes.” “Oh, it’s more than occurred to you, Nicky boy. You’re an intelligent man who has an affliction which affects your mind, so you’ve definitely thought about it. A lot, I bet. I’d like to tell you something Nicky, but I want to make sure I’ve got your full attention. Do I?” “Yes,” I replied in spite of myself. He leaned even closer, as if we were either co-conspirators in some scheme or lovers about to kiss. “We’re all victims. All of us. Victims of our own minds...

I began the process of cutting up my random fabrics into strips. Of course, I chose easy things first, items that didn't' hurt me very much to cut up: torn sheets. A flannel nightgown so tattered it could never be worn again, one of Steve's worn-out t-shirts, couch upholstery. The resulting balls of fabric yarn that I wound together after cutting astounded me. They were gorgeous--each one prettier than the last, which made me braver. I took some photographs. And I heaved a sigh. Things in me were changing, I could feel it...so many months focusing on Stuff, Stuff, STUFF had made me bolder. What's the worst that could happen? I thought to myself. It reminded me of the day I finally, after ten years of kicking and screaming, took that first half pill [for OCD]. To someone else it might be no big deal, but to me? It felt like jumping out of an airplane without a parachute.

Addiction, OCD, and mood disorders like depression and anxiety share a central feature: a narrow self-focus and intrusive rumination. For addiction, that rumination is cyclical, quieted only temporarily by the object of the given addiction—whether it is a substance or a behavior—and then it is set in motion again as soon as the object fades from focus. For OCD and eating disorders, that rumination manifests in uncontrollable compulsive behavior. For depression, it manifests as a sense of failing, catastrophization, and guilt. Hendricks sees this short-circuiting of rumination as the most significant potential benefit of psychedelics. “You think of somebody who’s addicted to a drug, and they’re almost spinning their wheels, thinking about how am I going to get it next? And if you can have an experience in which you’re suddenly thinking outside of yourself, you break from these self-nagging thoughts. Suddenly, you’re not even thinking about your desire, your craving, for that

At the same time, the deeper I get with my OCD and treatment, the more I realize that it is also a part of me. It is the part of me I try so hard to repress, the part of me I don't believe is worthy of love, the part of me I judge in other people. It has to be fought, but to some extent, it also has to be placated. I also have to say, I'm not as smart as I thought I was, I'm not as in control, I better not judge these people because whoo-ee look at me. It can't simply be exorcised. It illuminates the brittleness and arrogance of my own precious assumptions about myself: that I am smart, that I am in control because I am smart, that I can do everything just so, that I can do it better. But it also attacks the parts of myself I want to keep: the gritty traveler, the artist who bucks conventions, the bold experimenter. Fine, it says, my thoughts are random, my thoughts are constructed, my thoughts are only thoughts, but then so are yours: all of it is a fantasy, dark and light.

Obsessive-compulsive personality disorder (OCPD) is unhelpfully named, since it is not particularly closely related to the better known obsessive-compulsive disorder (OCD). It does not tend to co-occur with obsessive-compulsive disorder, or even run in the same families. Obsessive-compulsive disorder is an anxiety disorder, in which the sufferer feels compelled to repeat particular thoughts or actions, such as checking or hand-washing. As an anxious condition, it belongs to the same family as depression and generalized anxiety disorder, and thus is related to high Neuroticism and responds to some extent to serotonergic antidepressant medications. Some people have even seen obsessive-compulsive disorder as a low Conscientiousness problem, since the affected individual cannot inhibit the checking or washing response in rather the same manner as the alcoholic cannot inhibit his desire to drink. Whether this is the right characterization or not, it is clear that OCPD is a very different type of problem.16 What, then, does OCPD entail? Psychiatrists define it as ‘a pervasive pattern of preoccupation with orderliness, perfectionism, and mental and interpersonal control, at the expense of flexibility, openness and efficiency, beginning by early adulthood and present in a variety of contexts’.

The world has a way of balancing—for every time something good happens, something bad has to happen and vice versa. With the thought of my date with Blaine, I mentally prepare myself for the blow of something bad that I’m sure is headed my way.

I tidy up the loose ends for a couple of minutes and then nod, signalling that I am done. I say done — I’m never really done when I only have two minutes, but I am done enough to attempt to engage in a conversation for a small window of time. Bursting point has been delayed.

In the absence of effort the OCD pathology drives the brain’s circuitry, and compulsive behaviors result. But mental effort, I believe, generates a directed mental force that produces real physical effects: the brain changes that follow cognitive-behavioral therapy for OCD. The heroic mental effort required underlines the power of active mental processes like attention and will to redirect thoughts and actions in a way that is detectable on brain scans. Let me be clear about where mental effort enters the picture. The OCD patient is faced with two competing systems of brain circuitry. One underlies the passively experienced, pathological intrusions into consciousness. The other encodes information like the fact that the intrusions originate in faulty basal ganglia circuits. At first the pathological circuitry dominates, so the OCD patient succumbs to the insistent obsessions and carries out the compulsions. With practice, however, the conscious choice to exert effort to resist the pathological messages, and attend instead to the healthy ones, activates functional circuitry. Over the course of several weeks, that regular activation produces systematic changes in the very neural systems that generate those pathological messages—namely, a quieting of the OCD circuit. Again quoting James, “Volitional effort is effort of attention…. Effort of attention is thus the essential phenomenon of will.

At bottom, though, the failure to face nonlocality reflects an unease with the implication that the stark divide between mind and world sanctioned by classical physics—in which what is investigated and observed has a reality independent of the mind that observes or investigates—does not accord with what we now know. Almost all scientists, whether trained in the eighteenth century or the twenty-first and whether they articulate it or not, believe that the observer stands apart from the observed, and the act of observation (short of knocking over the apparatus, of course) has no effect on the system being observed. This attitude usually works just fine. But it becomes a problem when the observing system is the same as the system being observed—when, that is, the mind is observing the brain. Nonlocality suggests that nature may not separate ethereal mind from substantive stuff as completely as classical materialist physics assumed. It is here, when the mind contemplates itself and also the brain (as when an OCD patient recognizes compulsions as arising from a brain glitch), that these issues come to a head. In the case of a human being who is observing his own thoughts, the fiction of the dynamic separation of mind and matter needs to be reexamined.

I’d love to learn everything all over again, but learn it right this time. I’d love to return my brain to factory settings.

The will, it was becoming clear, has the power to change the brain—in OCD, in stroke, in Tourette’s, and now in depression—by activating adaptive circuitry. That a mental process alters circuits involved in these disorders offers dramatic examples of how the ways someone thinks about thoughts can effect plastic changes in the brain. Jordan Grafman, chief of cognitive neuroscience at the National Institute of Neurological Disorders and Stroke, calls this top-down plasticity, because it originates in the brain’s higher-order functions. “Bottom-up” plasticity, in contrast, is induced by changes in sensory stimuli such as the loss of input after amputation. Merzenich’s and Tallal’s work shows the power of this bottom-up plasticity to resculpt the brain. The OCD work hints at the power of top-down plasticity, the power of the mind to alter brain circuitry.

Revaluing is a deep form of Relabeling. Anyone whose grasp of reality is reasonably intact can learn to blame OCD symptoms on a medical condition. But such Relabeling is superficial, leading to no diminution of symptoms or improved ability to cope. This is why classical cognitive therapy (which aims primarily to correct cognitive distortions) seldom helps OCD patients. Revaluing went deeper. Like Relabeling, Reattributing, and Refocusing, Revaluing was intended to enhance patients’ use of mindful awareness, the foundation of Theravada Buddhist philosophy. I therefore began teaching Revaluing by reference to what Buddhist philosophy calls wise (as opposed to unwise) attention. Wise attention means seeing matters as they really are or, literally, “in accordance with the truth.” In the case of OCD, wise attention means quickly recognizing the disturbing thoughts as senseless, as false, as errant brain signals not even worth the gray matter they rode in on, let alone worth acting on. By refusing to take the symptoms at face value, patients come to view them “as toxic waste from my brain,” as the man with chapped hands put it.

It was clear to Stapp, at least in principle, that Quantum Zeno might allow repeated acts of attention—which are, after all, observations by the mind of one strand of thought among the many competing for prominence in the brain—to affect quantum aspects of the brain. “I saw that if the mind puts to nature, in rapid succession, the same repeated question, ‘shall I attend to this idea?’ then the brain would tend to keep attention focused on that idea,” Stapp says. “This is precisely the Quantum Zeno Effect. The mere mental act of rapidly attending would influence the brain’s activity in the way Jeff was suggesting.” The power of the mind’s questioning (“Shall I pay attention to this idea?”) to strengthen one idea rather than another so decisively that the privileged idea silences all the others and emerges as the one we focus on—well, this seemed to be an attractive mechanism that would not only account for my results with OCD patients but also fit with everyone’s experience that focusing attention helps prevent the mind from wandering. Recall that Mike Merzenich had found that only attended stimuli have the power to alter the cortical map, expanding the region that processes the stimuli an animal focuses on. And recall Alvaro Pascual-Leone’s finding that the effort of directed attention alone can produce cortical changes comparable to those generated by physical practice at the piano. It seemed at least possible that it was my OCD patients’ efforts at attention, in the step we called Refocusing, that caused the brain changes we detected on PET scans.

Quantum theory “allows for mind—pure conscious experience—to interact with the ‘physical’ aspect of nature…. [I] t is [therefore] completely in line with contemporary science to hold our thoughts to be causally efficacious,” Stapp argued. He ended his JCS paper with a discussion of my OCD therapy, calling it “in line with the quantum-mechanical understanding of mind-brain dynamics.” According to that understanding, mental events influence brain activity through effort and intentions that in turn affect attention. “The presumption about the mind-brain that is the basis of Schwartz’s successful clinical treatment,” Stapp concluded, “is that willful redirection of attention is efficacious. His success constitute[ s] prima facie evidence” that “will is efficacious.

Why and how does this person switch gears, activating circuits in the dorsal prefrontal cortex connecting to adaptive basal ganglia circuits, rather than the OCD circuits connecting the orbital frontal cortex to the anterior cingulate and caudate? (See Figure 4.) At the instant of activation, both circuits—one encoding your walk to the garden to prune roses, the other a rush to the sink to wash—are ready to go. Yet something in the mind is choosing one brain circuit over another. Something is causing one circuit to become activated and one to remain quiescent. What is that something? William James posed the question this way: “We reach the heart of our inquiry into volition when we ask, by what process is it that the thought of any given action comes to prevail stably in the mind?

Compulsions show up in three major ways: physical compulsions, mental compulsions, and avoidance.

Humans are obsessed with ceremony. In some cases, this fixation can even become pathological. Obsessive-Compulsive-Disorder (OCD) is a condition characterized by intrusive thoughts and fears and the urge to perform highly ritualized actions in order to alleviate those worries. These actions have some of the core attributes of cultural rituals: they are characterized by rigidity, repetition and redundancy, and they have no obvious purpose. Nonetheless, those who suffer from OCD feel the compulsion to perform them and become intensely anxious if they are unable to do so.

the intrusive thoughts in OCD (such as What if I suffocate my baby?) are considered ego dystonic: they go completely against the person’s values, action, and true desires. It’s unlikely, for example, that a murderous person would even be in therapy discussing their murderous thoughts, because they wouldn’t register the thoughts as unwanted or intrusive, and they certainly would not receive an OCD diagnosis.

There’s me, finally seen as I should be, twisted into something as monstrous as I feel.

DO YOU THINK I WANT TO LIVE LIKE THIS? Do you think that I wake up in the morning and say, ‘You know what would be really fun, let’s spend hours and hours locked in my head, let’s not leave my room, and hey, while we’re at it, let’s cut out all the people who care, because there really is nothing better, no, I cannot think of anything I would like to do more, than to reject the perfect, happy life I could have, and choose instead to live stuck on repeat in my own private hell’?

What I experience is so unlike the OCD people have on TV. Have they got it right?

When I spend uninterrupted time with other people, a dam builds in my head. It can hold the words back for a while, but at some point they’ll surge free and overflow, and there will be chaos.

takes a lot of energy to be a good person all the time and never show a trace of annoyance, and there are times, like just now, when my mask slips.

Dr Finch has explained ‘cognitive dissonance’: where a person holds two contrary beliefs, such as ‘I know I have not taken out my needles’ and ‘My needles might be in with the clothes.

The idea is to help patients more clearly assess the contents of their thought stream, teaching them to note and correct the conceptual errors termed "cognitive distortions" that characterize psychopathological thinking. Somone in the grips of such thinking would, for instance, regard a half-full glass not merely as half-empty but also fatally flawed, forever useless, constitutionally incapable of ever being full, and fit only to be discarded. By the mid-1980s, cognitive therapy was being used more and more in combination with behavioral therapy for OCD, and it seemed naturally compatible with a mindfulness-based perspective. If I could show that a cognitive-behavioral approach, infused with mindful awareness, could be marshaled against the disease, and if successful therapy were accompanied by changes in brain activity, then it would represent a significant step toward demonstrating the causal efficacy of mental activity on neural circuits.

The discovery that modified speech can drive neuroplasticity in the mature brain is just the most dramatic example (so far) of how sensory stimuli can rewire neuronal circuits. In fact, soon after Merzenich and Tallal published their results, other scientists began collecting data showing that, as in my own studies of OCD patients, brain changes do not require changes in either the quantity or the quality of sensory input. To the contrary: the brain could change even if all patients did was use mindfulness to respond to their thoughts differently. Applied mindfulness could change neuronal circuitry.

Freud, who spoke German, used the term zwangsneurose (obsessional neurosis). The word zwang was translated as ‘obsession’ in London, but ‘compulsion’ in New York. Faced with confusion, scientists introduced the hybrid term ‘obsessive-compulsive’, a label subsequently given to millions of people, as a compromise.

I tried to point out that it's not a gimmick to teach patients suffering with OCD that their intrusive thoughts and urges are caused by brain imbalances, and that we now know they can physically alter those imbalances through mindfulness and self-directed behavioral therapy techniques.

The Quantum Zeno Effect "fit beautifully with what Jeff was trying to do," recalls Henry Stapp. It was clear to Stapp, at least in principle, that Quantum Zeno might allow repeated acts of attention-which are, after all, observations by the mind of one strand of thought among the many competing for prominence in the brain-to affect quantum aspects of the brain. "I saw that if the mind puts to nature, in rapid succession, the same repeated question, 'shall I attend to this idea?' then the brain would tend to keep attention focused on that idea," Stapp says. "This is precisely the Quantum Zeno Effect. The mere mental act of rapidly attending would influence the brain's activity in the way Jeff was suggesting." The power of the mind's questioning ("Shall I pay attention to this idea?") to strengthen one idea rather than another so decisively that the privileged idea silences all the others and emerges as the one we focus on-well, this seemed to be an attractive mechanism that would not only account for my results with OCD patients but also fit with everyone's experience that focusing attention helps prevent the mind from wandering.

I built an idea in my head of the hero I wanted to be, a grab bag of traits from heroes, villains, and side characters. I did not have book role models, I had book blueprints. But there remained a huge gap between the person I wanted to be and the person who I was. This was because no matter how many book blueprints I had, as much as I wanted to make myself the hero of my own life, it didn’t matter as long as I kept telling the story wrong. Nowadays, as a storyteller, I know what the problem was. I had all the elements I needed to tell a good story. But I was telling it the wrong way, so I could never get to the ending I wanted. If you tell yourself you’re a winner, you know what kind of story you’re telling, and you will march toward that... Likewise, if you tell yourself you’re a loser, you’ve made that your story, and you will march toward that instead. The same setbacks could happen in the loser’s story as in the winner’s story, but the self-defined loser would let them be proof that they were never going to be anything. Here’s the story I was telling myself back when I was little edible child waiting to be carried away by hawks and making OCD rituals for herself: once upon a time, there was a girl who was afraid of everything. When I was 16, I realized that I knew what this story looked like and how it ended, and it wasn’t the life I wanted for myself. If I wanted my ending to look different, I needed to change the kind of story I was telling about myself. I needed to shape my events into a different genre: once upon a time, there was a woman who was afraid of nothing. At age 16, I legally changed my name from my birthname — Heidi — to one I thought sounded like the hero I wanted to be: Maggie. And I vowed that I would never be afraid of anything ever again. Did it work? No, of course not. Not right away. But it became a mission statement, my hero’s journey.

Mental health problems don’t define who you are. They are something you experience. You walk in the rain and you feel the rain, but, importantly, YOU ARE NOT THE RAIN.

TOILET: We came out the toilet, and Ellie was waiting outside the door to use it. We’d only done a pee, but suddenly we felt like we had done a huge shit and it was all over the whole toilet, the walls and the floor. We needed to go back and check. We couldn’t do that because that would look weird. We froze. Ellie raised an eyebrow. Did this whole interaction look odd? Was there actually shit everywhere?

Dean laughs. “He’s so cute! He’s walking between us like a little child!” I start to worry fervently that Dean might think I’ve trained Rocky to walk like this to convince him how nice it would be if we had children of our own, even though we’ve only met twice. I add MANIPULATIVE DOG OWNER to BITCH.

Do you think that I wake up in the morning and say, ‘You know what would be really fun, let’s spend hours and hours locked in my head, let’s not leave my room, and hey, while we’re at it, let’s cut out all the people who care, because there really is nothing better, no, I cannot think of anything I would like to do more,

10:00 p.m.: the only person in the whole building who hasn’t gone bonkers kills themself. The other patients cheer . . .

CAUDATE NUCLEUS. That’s the part of the brain that’s not filtering out the OCD thoughts properly.

Let’s all agree to not hurt our partners for no real reason. We only need to share the content of our thoughts if something good can come from it.

I can actually follow the plot of TV programs now, and I no longer use books as masks—I read them like a normal person, just like you have read this. Which assumes you are normal; maybe you’re not. Maybe none of us are. Maybe none of us would want to be anyway. But, for the sake of argument, let’s call me normal now. I am better. I don’t know whether it’s for good, or if one day something might make me abnormal again. But that’s the funny thing about living. If you do it properly, you don’t know how the next sentence will begin.

I feel so terrible.” “Why?” “For not noticing.” “You couldn’t have. I live my life trying to come across as normal. All my energy seems to go into making sure no one does notice anything at all. If you knew, that would have meant I’d failed.

I’d swelled up a storm that only I could see. Here’s to the strong ones. Here’s to the ones who never give up.

I am relieved to discover that I can still feel sadness.

I will miss Frankie. She was constant and unavoidable in a way even my routines couldn’t destroy. She fizzed with life and a lust for fun. She stretched her hand out to a version of myself I thought I’d lost forever, held me tight, and then, when I least expected it, pulled me back from the brink.

There must be a way of dealing with worries that doesn’t involve checking with everyone whether you have done something wrong. What could it be?

For as long as I could remember, I wasn't me, I was me.

Two of us sat side by side in my head, woven together, inseparable. She didn't even have a name; she was just She. Really, it was hard to say where She ended and I began. But food was not shared with her. She did not play tag and never required a seat. She was, by her very essence, nothing like these imaginary friends. She was just there. One was not proud of her, in the same way as one is not proud of a liver, and there was no need to show her off, nor tell anyone She existed.

Parts of the brain that are related to OCD symptoms include areas of the frontal lobes in the cortex, the basal ganglia, and connections between the frontal lobes and the amygdala (Fullana et al. 2017;

You’re not insane,” he says again. “Then what’s wrong with me?” I ask. “Why do I have these . . . these thoughts?” The word doesn’t feel like enough; it’s too airy, and implies I am capable of telling them apart from reality. “Is it fear?” Felicity asks. “Though I suppose fear is elicited by an immediate threat, and it sounds as though often there isn’t one. Except those created inside your mind. So it’s fear looking for a source? Does that sound right?” I press my fists against my forehead. “It feels like someone is shouting at me all the time, all these lies that I know are lies but I’m so terrified of what will happen if I don’t listen, and then it just gets louder and louder so that I can’t hear anything else over it all and I can’t make them stop.” I look up at Monty. “Does everyone feel this way?

Throughout life we tend to believe our thoughts much more than the signals of the body.

I knew I could get help and, more importantly, get better. Because suddenly I wasn’t bad, it was bad. It was no longer me, it was something else. I wasn’t schizophrenic, or psychotic, or any of the other things I thought I was. I had Obsessive Compulsive Disorder, or OCD. In that unforgettable moment, I took back some of my power – chunks of it flooding into my psyche, called in from afar, returning home to me.

the OCD approach was weirdly liberating. I could acknowledge these fears, then wave the wand of “maybe, maybe not,” the gold standard treatment for OCD. Those words robbed my thoughts of their power and value. I could live by what I did know and value. I could wait to move forward until the mirage eased. I could take care of myself and watch the anxiety fade away.

Other common obsessions are a fear of hurting others (this is usually known as harm OCD), which might manifest themselves as intrusive thoughts depicting violence inflicted on oneself or others; or perhaps, the fear of running someone over while driving and not having noticed it; or the worry that one might commit a criminal act against somebody who is vulnerable, such as sexual assault of a minor, or abusing, or stealing from an elderly person, etc. Compulsions vary depending on the individual.

Ginny told me that, like Dr. Wisner's patients, her problem was not so much that she had an urge to kill her grandchildren, but rather a fear that she might somehow lose control of her senses. She put it this way: "The fear is not that in my current state I could do these things, but that I might slip into a state where I could do it. Right now, when I am thinking about it, I know it won't happen. But still it festers, it festers and lingers, and it keeps beating on you and beating on - like it's the villain, the enemy, the monster, the demon - it's a faceless devil." With my encouragement, Ginny told her husband about the thoughts. She was relieved that his reaction was "he just couldn't even believe what he was hearing - he knew I'd never do these things, they were just bad thoughts." When I asked Ginny why she thought he has so much faith in her, she replied, "Because he sees me with people daily. He said he fell in love with me because I am kind. For example, he reminded me of a time when we were together in a cabin, and I noticed a bee trapped behind a screen and I told him I didn't want the bee to die, so he spent the first hour of our first weekend together undoing the screen to free the bee. He asked me, does that sound like someone who would kill her grandchildren? He also reminded me that I am soft and warm and very loving, and he would never worry about me doing the awful things I was thinking of." Needless to say, Ginny was relieved by her husband's reaction, since she had feared he would think she was crazy.

When my first child was born, I thought it quite hilarious that within seconds of her arrival, she was placed before me on a tray and a doctor put a sharp pair of scissors in my hand. It was to cut the umbilical cord. I had an advantage over potential Harm OCD with my children, which is that I always knew full well that I would have intrusive violent thoughts about them. Because I always assumed I'd have thoughts of cutting, smothering, strangling, microwaving them, and so on, I never responded to any individual thought of that nature like it was particularly interesting. If anything, I welcomed such thoughts as useful reminders of why I became a therapist.