Having lived through OCD and come out the other side, I completely understand why the solution was considered bad.
Sure, this solves the particular obsession. But the issue is that OCD is never satisfied. You develop rituals like this and they work for a while, giving your brain that little dopamine boost every time you look at the hairdryer in your car. But that dose diminishes over time, and soon taking the hairdryer with you isn’t enough. You need to do something more to feel okay about the obsession. This is why OCD sufferers find themselves doing something over and over.
Sustainable solutions address the anxiety (most often meds) or build up the person’s tolerance for uncertainty (exposure response prevention). It was only a combination of these approaches that helped me overcome my illness.
It's critical to find any intervention that works for a debilitating problem. If the hairdryer person lost their job because of it, they may not be able to continue ANY treatment and that might be the end of them.
The first goals in DBT therapy are to stop behaviors that may interfere with therapy or kill the patient. Seems like a good approach to me.
On a related note, I knew someone who had some very self-destructive ways of dealing with her stressful life and associated problems. She held down a good professional job at <big company> and most people didn't know about her issues. She found a psychologist that she liked (and I didn't) and after somewhere between 1 and 2 years she ended up dead. You've got to stop self-destructive life-interfering problems any way you can.
When a person might be bleeding to death, the first step is to stop the bleeding even if by tourniquet. You can do surgery to fix things later, but not if the patient is dead. Priorities are a thing.
She’d seen countless psychiatrists, psychologists, and counselors, she’d done all sorts of therapy, she’d taken every medication in the book, and none of them had helped.
Sounds like everything else had been given a fair shake to me.
> And approximately half the psychiatrists at my hospital thought this was absolutely scandalous, and This Is Not How One Treats Obsessive Compulsive Disorder
Well, you can call it a stopgap. As long as they're not saying "cured! It's over for you now." I think it is great. Why does the patient have to live through the debilitating symptom while the causes are worked on? Perhaps a part of the treatment then is getting the patient to leave the dryer at home on weekends, maybe initially curled up on the coffee table, then in the bathroom, etc. while they go to the grocery store or for a jog. It could be a very good first step.
I have a compulsive problem that developed due to an anxious situation I was in. I was taking a nap on the couch, I smelled burning and assumed it was someone in my neighborhood grilling, which was common. I woke up to an apartment filled with smoke, my place was on fire. It was small, I was able to get out the front door (which is where the fire was) and call the fire department, they came and put it out, minimal damage, no loss of life. But still, since then, if I smelled wood burning, even though I know it's probably someone grilling or with a fire in the fireplace I go outside and look around just to be sure. It is irrational and I know while I'm doing it. What helped me was living in a place where some neighbor or other burns wood almost daily. I still get a tinge of "but what if that's not what it is this time" every time I smell it, but I don't compulsively check anymore.
Also for a lot of people these mental illnesses cannot be cured, only managed. I'd think finding simple solutions to reduce compulsive anxiety are more sustainable than long term drug use.
When monitored, sure. The approach I would guess an OCD specialist would use (I’m not one, so this is only a guess) is to have the patient dry their hair, leave the bathroom, and wait as long as they can bear without checking to make sure they turned it off. Then, some time later, have them do it again, and try to wait longer. Repeat until they can go to work without worrying. Letting them take the hairdryer with them until they can do without it seems like a good addition to ensure they can get through the rest of the day.
Also having OCD, I can see how this would be helpful though. You can fall into a stable position where you're doing enough to keep the OCD at bay (taking the hairdryer with you) without it being something that interferes with your life. I don't think it's an _ideal_ long-term solution, as the OCD can latch onto something else, but as a starting point for ERP (leaving the hairdryer at home on shorter trips) or if other solutions have been tried and failed, I can see it being useful.
Did you consider that the OCD could get worse due to the negative effects of the OCD, e.g., bad performance in the job or problems with the patient's relationships to friends and family? If such a feedback loop exists, breaking it can be part of the cure, no?
Breaking the cycle is important, no doubt. The issue I take is the quote makes it seem like all they had to do was carry the hair dryer with them. There’s so much more that needs to be done.
Don’t let the perfect be the enemy of the good. It may not be the final solution but it improves the life of the person.
I would have more sympathy with the other doctors if they actually had a solution for OCD but they don’t. So somebody who has no fix for the problem is criticizing someone who fixes a part of the problem.
Sure, this solves the particular obsession. But the issue is that OCD is never satisfied. You develop rituals like this and they work for a while, giving your brain that little dopamine boost every time you look at the hairdryer in your car. But that dose diminishes over time, and soon taking the hairdryer with you isn’t enough. You need to do something more to feel okay about the obsession. This is why OCD sufferers find themselves doing something over and over.
Sustainable solutions address the anxiety (most often meds) or build up the person’s tolerance for uncertainty (exposure response prevention). It was only a combination of these approaches that helped me overcome my illness.