The Science Of Worrying

06/19/2012 09:07 am ET | Updated Aug 19, 2012

There you are: a view of the waves, bottle of wine just corked. The week is finally over. You're taking in the light dancing on the water when...

"What's that, honey?" you say.

"God, do you ever listen to me?" your girlfriend says, clanking her fork on her plate a bit too hard.

Apparently, you were enjoying the light on the water a little too much.

"I, um, was listening. I just missed that. What did you say?"

"Were you thinking about work again?"

"You're overreacting. I've said before, it's because --"

"It's not because my father has hearing problems. You just don't care what I'm talking about."

"Of course I care. I resent that you don't think I care."

This is an excerpt from a discussion I used to have with my ex every month or so. An hour later we would have been rehashing versions of roughly the same quotes. Both children of therapists, we prided ourselves on never letting a crappy emotion pass between us without finding catharsis -- and that was one of our problems. Our long discussions always purported to be working through our psychological issues (and they often did), but for some reason, this particular conversation about listening was like quicksand. The more we struggled, the deeper we sank.

I wish I knew then what I know now. I'm no psychologist, but in doing the research for my upcoming book The Fear Project, interviewing neuroscientists, psychologists, and various other experts about how fear and memory work, I think I got a hint of what might have been going on in our brains during these quicksand arguments. The gist is that we all, from time-to-time, have OCD.

Sure, I know that's not actually true and I don't mean to make light of a serious disorder. But hear me out.

OCD is a sad condition. Patients -- as exhibited so well in Leonardo DiCaprio's portrayal of Howard Hughes in The Aviator -- often spend years spinning webs of dread that are completely fabricated. They think that they're covered in germs and find themselves scrubbing themselves for hours. They think they've left the door unlocked so they go back and check the lock hundreds of times before leaving the house. Oftentimes, part of them knows intellectually that they're not covered in germs or that the door is actually locked (just as my ex knew that I did, in fact, care what she was saying and I knew that I could do a better job listening), but they can't let go of the worry, the feeling that something is wrong. They also can't let go of needing to fix something. Like my ex and I, they're attached to finding catharsis inside the content of their worries. They want to find the answer to why they're suffering.

OCD has proven to be extremely difficult to treat, but recent neuroplacticity work by Jeffrey M. Schwartz, a psychiatry professor at UCLA, has made definitive progress. His trick is simple: switching from the content of worry and focusing simply on something else -- something good.

As Dr. Norman Doidge explains in his wonderful book The Brain That Changes Itself (where I learned about Schwartz), what is happening in OCD is this: That feeling that you've made a mistake is usually detected by a part of the brain called the orbital frontal cortex, behind the eyes, which sends a message to the cingulate gyrus, an older part of the brain deep in the cortex, which tells our heart and gut to feel dread and worry. Usually, we're able to get through this by either correcting a mistake (locking the door and leaving, for example) if that's possible, or refocusing on something else. The part of the brain that allows us to flow to the next thought is called the caudate nucleus and functions a bit like a mental gearshift.

Brain scans of OCD sufferers show that all three of these brain regions are hyperactive. The gearshift is jammed, keeping them stuck in an endless loop of worry. So what Schwartz has done is create a therapy that, like meditation, gives the sufferers distance from their own thoughts. During an OCD attack, patients are encouraged to acknowledge that there is a problem but distinguish that the problem is not the situation they're worried about (germs, the door, whatever); the problem is an OCD attack. Once it's acknowledged that the problem is OCD, Schwartz encourages patients to refocus on a positive and pleasurable action or thought that is completely different from the worry: going for walk, playing tennis, playing music, gardening. This is different from the old-school positive therapy technique where the patient might say, in the case of germs, "I'm clean and healthy" over and again. That's a positive affirmation -- like me saying, "I do care what you're saying, honey" -- but it tends to keep the brain stuck where the quicksand is. Changing the subject matter allows the brain to get unstuck, and amazingly, as OCD patients undergo this therapy, you can actually watch their brains return to normal, the caudate nucleus "shifting" just as it should.

When it comes to emotions, by all means talk about them. Be open, honest. But I think with these quicksand issues -- these dead horses we've been beating for years, whether with a partner or inside ourselves -- we're something like patients with OCD. I would have been better off just saying, "You know what? I wasn't listening. I was focused on that beautiful light over there. Let's go for a walk after dinner. I'm so glad to be here with you and sorry for spacing out." Or something like that. Instead, I reacted defensively, and planted us back in the quicksand.

For fans of processing and psychology or, say, Buddhism (I'm a fan of both), changing the subject might sound like a wimp-out, like escaping. In these traditions, we're taught to be with an icky feeling, investigate it, see what's there, even if -- in the case of Zen -- the answer is ultimately that all emotions are fundamentally illusory. I'm all for sitting with an issue. But changing the subject to something positive in these quicksand patterns is not escaping. It's wisdom. In these issues, we're attached to wanting a catharsis that can't be found inside the content. Instead, we should try pulling ourselves out of the quicksand and walking away -- ideally someplace sunny.

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