Areas › Worry and anxiety › Obsessions and compulsions
It can help to give the parts of your brain jobs. The front of your head is the manager, the memory system is the librarian, and the alarm is a security guard who is good at his work and far too keen on it.
The point is not accuracy, it is having language you can reach for quickly. Saying the guard is overreacting again gets you further than trying to describe a feeling, and it puts the reaction slightly outside you, where you can look at it. Young people tend to take to it, and it gives a family a shared shorthand for the week between sessions.
Obsessive thoughts and compulsions respond well to a specific kind of therapy. What is here is for understanding them, not for treating them by yourself.
Qur’an and Sunnah
Man was truly created anxious (Quran 70:19). The alarm is part of how a person is made, so an alarm set too sensitively is a fault of tuning rather than of character.
Translation: M.A.S. Abdel Haleem, The Qur'an, Oxford University Press, 2004.
What the research says
In a study scanning patients before and after four weeks of intensive exposure-based therapy, brain metabolism shifted alongside their symptoms, showing that behavioural work changes brain function and not only what people report. That is a fair basis for talking about these systems as changeable rather than fixed. The guards and librarians are a teaching device, not anything those images show.
Saxena S, Gorbis E, O'Neill J, Baker SK, Mandelkern MA, Maidment KM, Chang S, Salamon N, Brody AL, Schwartz JM, London ED. (2009). Rapid effects of brief intensive cognitive-behavioral therapy on brain glucose metabolism in obsessive-compulsive disorder.. Molecular psychiatry doi
Strength of evidence: one line of research. A single study, or a theoretical account.
Why it works
Naming the part that is firing turns a state you are stuck inside into something you can point at.
This one is still a draft. It is waiting on a scholar and a clinician to read it before it is published.
Near this one
If this has been going on for years, medication is often part of what helps, and it usually needs a longer run at it than people expect. Starting low and building up slowly is the normal way of doing it.
Offer choices rather than instructions. With a problem that runs on control, being told what to do gives that control somewhere to dig in.
The thing your obsession keeps circling is usually something you care about a great deal. Contamination worry sits on top of wanting people safe, and harm worry sits on top of never wanting to hurt anyone.