Rewiring the Brain to Treat OCD

Source: Discovery magazine

A groundbreaking therapy, relying on mindfulness meditation to treat obsessive compulsive disorder, suggests even adult brains have neuroplasticity

By Steve Volk

Dec 10, 2013 updated 2019

Dr. Jeffrey Schwartz got a phone call at 3 p.m., a script before 5 p.m. and the next afternoon he was there, sitting with Leonardo DiCaprio, exploring the intricacies of one of the most debilitating mental illnesses in medicine. 

DiCaprio was tackling the role of Howard Hughes in The Aviator, a part requiring him to arc — as Hughes did — from genius billionaire to shaggy recluse, caught in the grip of obsessive-compulsive disorder. Schwartz’s books, Brain Lock and The Mind and the Brain, had established him as one of the world’s foremost authorities on the underlying mechanisms and treatment of obsessive-compulsive disorder, a condition that plagues sufferers with unreasonable thoughts and fears, which in turn compel repetitive behavior. 

He would not teach DiCaprio the mannerisms of people with OCD, Schwartz announced on day one. Instead, he would show him “how to become a person with OCD,” so his brain was “like the brain of a person who has the disease.”

The message was ominous, but DiCaprio proved game to try. He quickly pointed Schwartz to a particular segment of the script. “Right here, for three pages, I only have one line,” he said. Show me the blueprints, repeated 46 times, with minor variations.

Schwartz explained that people afflicted with OCD engage in a wide variety of problematic behaviors — compulsive hand washing, door opening, repetitive checking of ovens and doors, even repeating the same word, phrase or sentence. The cause, at a neurological level, is hyperconnectivity between two brain regions, the orbitofrontal cortex and the caudate nucleus, creating a tidal wave of unfounded mortal fear and triggering habitual response as the only way to attain calm. But the worst part is that, despite recognition that all these thoughts and behaviors are irrational, the OCD sufferer feels driven to obey them, nonetheless.

Schwartz walked DiCaprio through the underlying neurology to help him understand that, for Hughes, those four words — show me the blueprints — held a magical power, offering him an escape from his fear. “Those words, he’s repeating them like his life depends on them,” Schwartz advised. “But he also understands that this doesn’t make any sense.”

In the 2004 film that eventually emerged, this scene is perhaps the most painful to watch. DiCaprio, as Hughes, twists the sentence in new directions with each rephrasing, emphasizing different words and employing different cadences. Sometimes he races through the sentence almost under his breath. Other times, he slows down, seeking the right combination of sounds, the right rhythm, to free himself from the fear roiling in his gut. All the while, his face betrays a tortured self-revulsion. 

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