Psycho- education about OCD

How might Tom explain the physiology of the brain to help his client?
Again, maximizing Lang- hao’s engineering interest in how things work, Tom demonstrated
what appears to be happening ‘mechanically’ in the brain by showing him a diagram of the
brain which he found on the internet. Using this, he explained how the orbito- cortex (behind
the eyebrows) is involved in the initial recognition and response to danger. This picks up threat
signals, detecting if something is ‘right’ or ‘wrong’ in a fast, decisive, black- and- white manner.
This signals to the cingulate gyrus to activate gut- feelings which indicate that something is not
right.
The third part of the brain involved is the caudate nucleus, which is basically like an ‘on–off’
switch: in the ‘on’ position it indicates that action is needed, and in the ‘off’ position it indicates
that action is no longer needed.
Tom pointed out how constant negative introspection, overthinking, worry and anxiety
associated with OCD can overload this mechanism, causing it to malfunction. As a result, the
on–off switch (caudate nucleus) can get stuck in the ‘on’ position, indicating that the threat has
not been dealt with satisfactorily. Threat messages then loop back to the orbito- cortex, which
again activates the cingulate gyrus, keeping up the gut- feeling of threat and the urge to engage
in further (now unnecessary) action. This threat signal loops round and round until the gut-
feeling eventually subsides and things start to ‘feel right’. The switch can then eventually move
to the ‘off’ position again, until next time
(seehttp://www.bbc.co.uk/science/humanbody/mind/articles/disorders/causesofocd.shtml).
Lang- hao showed great interest in the diagram of the brain and appreciated having the
mechanics explained as it demystified things for him, making the problem seem solvable