The key ideas

Brain Lock

Jeffrey M. Schwartz, Beverly Beyette, 1996

Someone knows the door is locked but returns to check it again and again. Psychiatrist Jeffrey Schwartz explains why, in OCD, the mind understands one thing while a feeling demands another. He proposes his four-step method, which his group’s findings suggest may even be associated with changes in brain function.

Who it is for

For people dealing with obsessive thoughts and rituals, and their loved ones. The book helps explain the author’s method but does not replace treatment.

It’s not me, it’s my OCD.

About the book

Someone leaves home, locks the door, and pulls the handle. Then they return to check again. And again. They know perfectly well the door is locked. But the feeling that something is wrong does not go away.

Jeffrey Schwartz is a psychiatrist at the University of California, Los Angeles. He spent many years working with people who have obsessive-compulsive disorder, or OCD. In this book, he describes a four-step method his patients can use themselves and explains what, in his model, happens in the brain when a thought gets “stuck.”

An important point from the start: this book explains the author’s method; it does not replace treatment. It helps explain obsessive thoughts but does not diagnose you or your loved ones.

Idea 1. Knowing, but feeling otherwise

One of OCD’s strangest features, in Schwartz’s description, is the gap between knowing and feeling. Someone washes their hands for the tenth time and understands they are clean. Yet a signal continues inside: “Something is wrong; do it again.”

These thoughts are called obsessions. An action someone performs to silence the anxiety also has a name: a compulsion. The problem is that a ritual brings only brief relief. Then the signal returns, often stronger.

Schwartz asks the question holding the whole book together: if people themselves see that the thought makes no sense, why can they not simply stop?

You are already on the subway, but “Is the iron definitely off?” keeps looping in your head. Memory says it is off, but certainty does not come.

In the author’s account, an obsessive thought is hard to defeat with arguments because the problem may not be a lack of arguments at all. The alarm signal may follow its own course even when reason disagrees.

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About the author

Jeffrey Schwartz is an American psychiatrist and researcher at the University of California, Los Angeles (UCLA), who has studied OCD and the brain’s capacity to change. Beverly Beyette is a journalist and the book’s coauthor.

All books by this author: Jeffrey M. Schwartz, Beverly Beyette

Terms from the book

  • Compulsion
  • OCD: Obsessive-compulsive disorder: a condition involving distressing obsessive thoughts and urges to perform repetitive actions. Only a physician can make the diagnosis.
  • Orbital cortex: A region in the front of the brain above the eyes. In Schwartz’s model, increased activity there may be associated with a feeling that “something is wrong.”
  • Caudate nucleus: A structure deep in the brain. In the author’s model, it helps switch between thoughts; the “stuck gearbox” image is Schwartz’s metaphor rather than a medical term.
  • Fifteen-minute rule: The author’s advice: before performing a ritual, switch to another activity and wait, preferably at least fifteen minutes. A technique within Schwartz’s method rather than a universal treatment.
  • Impartial spectator: An image from philosopher Adam Smith that Schwartz uses: the part of us that can view our thoughts and feelings from outside without obeying them.

All terms

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