How distrust of the past shapes obsessive-compulsive disorder

OCD sufferers cannot trust past experiences, making the future even harder to manage.

woman washing hands with bar of soap

In this photo illustration a woman washes her hands on February 26, 2020 in Berlin, Germany.

Photo Illustration by Florian Gaertner/Getty Images
  • Obsessive-compulsive disorder makes it hard to predict good future outcomes.
  • A new study at The Hebrew University of Jerusalem found that OCD sufferers often do not trust their past experiences.
  • Researchers hope to develop therapeutic means for improving goal-directed behaviors in sufferers.

Insomnia is not fun for anyone, but one particular man suffered from an unimaginable problem. Every night, while lying in bed, he listened for police sirens. His existential distress: dying from battery acid spilled in a car crash. When the sirens rang, he put on a special pair of running shoes, drove to the scene, and waited for the police to leave.

Next, as psychoanalyst Norman Doidge describes, "he would scrub the asphalt with a brush for hours, then skulk home and throw out the shoes he had worn." The man's expensive habit was due to obsessive-compulsive disorder (OCD), a disease in which sufferers feel that imminent harm is present to themselves or those they love. OCD grows worse with age, restructuring parts of the brain. The worries, often viewed as bizarre by outsiders, cripple the patient.

The concerns of OCD patients revolve around danger: not shutting off an oven; being dirty, leading to excessive hand washing; living in a germ-filled environment, which can cause compulsive cleaning. We are all built from habits that serve an evolutionary purpose: dependable patterns allow us to apply our cognitive resources elsewhere. Those with OCD become "stuck" in habits that dominate their existence. Thus far, most treatments have proven ineffective.

Pinpointing an exact cause of OCD can be difficult. As Doidge writes, one particularly afflicted college student put a gun in his mouth and pulled the trigger. Miraculously, he survived, giving himself a lobotomy in the process. Upon recovering, his OCD was cured. He soon returned to college. The damage to his frontal lobes fixed his suffering, so it appears such obsessive checking and worrying is a human trait.

Not that we should ever contemplate such an extreme path. A new study, published in PLOS Computational Biology by researchers at The Hebrew University of Jerusalem, adds to the literature by speculating that OCD sufferers place less trust in their past, creating a negative feedback loop as they age.

There's a parallel with anxiety disorder. When sufferers experience a panic attack in a certain location, they imprint that environment as a place that causes attacks. When they return, the environment—more accurately, their nervous system responding to the environment—triggers a panic response. Likewise, those with OCD create a mental image of distrust from past habits. When triggered, symptoms of their disorder manifest. They leave the house, walk into the hallway or front yard, and are triggered to check that the lights are off—again, and again, and again.

For this study, lead author Isaac Fradkin and his colleagues studied 58 people with varying degrees of obsessive-compulsive symptoms. The subjects were asked to judge past experiences with recent observations. The more symptoms they expressed, the more likely they were to distrust their past. This caused them to believe that new environments are unpredictable, and therefore should be avoided or distrusted. They were actually more surprised by predictable outcomes than unpredictable ones.

man sitting on a sofa

Brandon Petulla sits on the sofa at home in New York on October 28, 2017. Obsessive-compulsive disorder (OCD) turned a young photographers life into a living hell - by convincing him he had sold his soul to the devil.

Photo: Ruaridh Connellan / Barcroft Media via Getty Images

The researchers used mathematical models to reach their conclusions—the worse the disorder, the more likely subjects were to be shocked by mundane outcomes. They might not thrive in uncertainty, but they appear to expect it. As Fradkin puts it,

"Our findings highlight a novel framework for understanding the cognitive and computational process that gives rise to obsessive compulsive symptoms. The results also stand in stark contrast with the common preconception of OCD as being characterized by inflexible behavior, distinguished by overreliance on past experience."

This research should also help support the growing literature that shows how important environment is to disease. Environmental triggers bear influence across the spectrum of mental health disorders. Humans are not separate from nature; we are an integral part of it. Modern medicine has a tendency to isolate the neurochemistry of disorders from the environment that it appears in, which only explains the what, not the why. Therapeutic courses needs both.

As the authors conclude, "excessive transition uncertainty," the inability to predict future outcomes, "is expected to affect not only reliance on the past, but also goal-directed behavior." We all predict based on past experiences, but when you distrust the past, it becomes impossible to trust the future. This is the feedback loop OCD sufferers live inside of. Finding a way out remains the challenge therapists and patients face.

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Stay in touch with Derek on Twitter and Facebook. His next book is "Hero's Dose: The Case For Psychedelics in Ritual and Therapy."

A landslide is imminent and so is its tsunami

An open letter predicts that a massive wall of rock is about to plunge into Barry Arm Fjord in Alaska.

Image source: Christian Zimmerman/USGS/Big Think
Surprising Science
  • A remote area visited by tourists and cruises, and home to fishing villages, is about to be visited by a devastating tsunami.
  • A wall of rock exposed by a receding glacier is about crash into the waters below.
  • Glaciers hold such areas together — and when they're gone, bad stuff can be left behind.

The Barry Glacier gives its name to Alaska's Barry Arm Fjord, and a new open letter forecasts trouble ahead.

Thanks to global warming, the glacier has been retreating, so far removing two-thirds of its support for a steep mile-long slope, or scarp, containing perhaps 500 million cubic meters of material. (Think the Hoover Dam times several hundred.) The slope has been moving slowly since 1957, but scientists say it's become an avalanche waiting to happen, maybe within the next year, and likely within 20. When it does come crashing down into the fjord, it could set in motion a frightening tsunami overwhelming the fjord's normally peaceful waters .

"It could happen anytime, but the risk just goes way up as this glacier recedes," says hydrologist Anna Liljedahl of Woods Hole, one of the signatories to the letter.

The Barry Arm Fjord

Camping on the fjord's Black Sand Beach

Image source: Matt Zimmerman

The Barry Arm Fjord is a stretch of water between the Harriman Fjord and the Port Wills Fjord, located at the northwest corner of the well-known Prince William Sound. It's a beautiful area, home to a few hundred people supporting the local fishing industry, and it's also a popular destination for tourists — its Black Sand Beach is one of Alaska's most scenic — and cruise ships.

Not Alaska’s first watery rodeo, but likely the biggest

Image source: whrc.org

There have been at least two similar events in the state's recent history, though not on such a massive scale. On July 9, 1958, an earthquake nearby caused 40 million cubic yards of rock to suddenly slide 2,000 feet down into Lituya Bay, producing a tsunami whose peak waves reportedly reached 1,720 feet in height. By the time the wall of water reached the mouth of the bay, it was still 75 feet high. At Taan Fjord in 2015, a landslide caused a tsunami that crested at 600 feet. Both of these events thankfully occurred in sparsely populated areas, so few fatalities occurred.

The Barry Arm event will be larger than either of these by far.

"This is an enormous slope — the mass that could fail weighs over a billion tonnes," said geologist Dave Petley, speaking to Earther. "The internal structure of that rock mass, which will determine whether it collapses, is very complex. At the moment we don't know enough about it to be able to forecast its future behavior."

Outside of Alaska, on the west coast of Greenland, a landslide-produced tsunami towered 300 feet high, obliterating a fishing village in its path.

What the letter predicts for Barry Arm Fjord

Moving slowly at first...

Image source: whrc.org

"The effects would be especially severe near where the landslide enters the water at the head of Barry Arm. Additionally, areas of shallow water, or low-lying land near the shore, would be in danger even further from the source. A minor failure may not produce significant impacts beyond the inner parts of the fiord, while a complete failure could be destructive throughout Barry Arm, Harriman Fiord, and parts of Port Wells. Our initial results show complex impacts further from the landslide than Barry Arm, with over 30 foot waves in some distant bays, including Whittier."

The discovery of the impeding landslide began with an observation by the sister of geologist Hig Higman of Ground Truth, an organization in Seldovia, Alaska. Artist Valisa Higman was vacationing in the area and sent her brother some photos of worrying fractures she noticed in the slope, taken while she was on a boat cruising the fjord.

Higman confirmed his sister's hunch via available satellite imagery and, digging deeper, found that between 2009 and 2015 the slope had moved 600 feet downhill, leaving a prominent scar.

Ohio State's Chunli Dai unearthed a connection between the movement and the receding of the Barry Glacier. Comparison of the Barry Arm slope with other similar areas, combined with computer modeling of the possible resulting tsunamis, led to the publication of the group's letter.

While the full group of signatories from 14 organizations and institutions has only been working on the situation for a month, the implications were immediately clear. The signers include experts from Ohio State University, the University of Southern California, and the Anchorage and Fairbanks campuses of the University of Alaska.

Once informed of the open letter's contents, the Alaska's Department of Natural Resources immediately released a warning that "an increasingly likely landslide could generate a wave with devastating effects on fishermen and recreationalists."

How do you prepare for something like this?

Image source: whrc.org

The obvious question is what can be done to prepare for the landslide and tsunami? For one thing, there's more to understand about the upcoming event, and the researchers lay out their plan in the letter:

"To inform and refine hazard mitigation efforts, we would like to pursue several lines of investigation: Detect changes in the slope that might forewarn of a landslide, better understand what could trigger a landslide, and refine tsunami model projections. By mapping the landslide and nearby terrain, both above and below sea level, we can more accurately determine the basic physical dimensions of the landslide. This can be paired with GPS and seismic measurements made over time to see how the slope responds to changes in the glacier and to events like rainstorms and earthquakes. Field and satellite data can support near-real time hazard monitoring, while computer models of landslide and tsunami scenarios can help identify specific places that are most at risk."

In the letter, the authors reached out to those living in and visiting the area, asking, "What specific questions are most important to you?" and "What could be done to reduce the danger to people who want to visit or work in Barry Arm?" They also invited locals to let them know about any changes, including even small rock-falls and landslides.

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