Can’t Just Stop | Sharon Begley

Summary of: Can’t Just Stop: An Investigation of Compulsions
By: Sharon Begley

Introduction

Delve into the complex world of compulsions with ‘Can’t Just Stop: An Investigation of Compulsions’ by Sharon Begley. This book examines the increasing prevalence of anxiety in modern society and the resultant compulsive behaviors people develop as coping mechanisms. From mild compulsions such as repeatedly checking for messages to extreme OCD driven behaviors, you’ll explore the interplay between addiction, compulsive behavior, and impulsive behavior in individuals. Through this exploration, you’ll learn how people cope with anxiety, the neuroscience behind compulsions, and how these behaviors and treatments have evolved over the years.

The Reality of Compulsions

The prevalence of anxiety in the US leads people to adopt mechanisms for coping such as compulsions. These behaviors create the illusion of control and ease anxiety enough to allow daily functioning. Compulsions stem from a need so desperate that it feels like a vessel filling with steam. Mild compulsions like checking phones and perfecting towel hanging can escalate anxiety levels when not performed and are prevalent. Extreme compulsions come from the same source as other coping mechanisms and require help and compassion. Meanwhile, some people find compulsions adaptive and useful for efficiency and happiness.

Redefining Addiction, Compulsion, and Impulsivity

The American Psychiatric Association’s Diagnostic and Statistical Manual (DSM) has revised definitions of addiction over the years. Addiction is characterized by pleasure, tolerance, and withdrawal. Meanwhile, compulsive behavior doesn’t bring pleasure, but not doing it causes anxiety. Impulsive behavior, on the other hand, is driven by immediate gratification. Understanding these distinct qualities can help identify and treat behavioral issues effectively. Kleptomania is an example of impulse control problem while gambling meets the criteria for a behavioral addiction. The DSM revisions address the commonality of brain circuitry associated with substance abuse, chocolate craving, and compulsive behavior.

Understanding OCD

OCD is a mental disorder that affects individuals from mild to extreme levels. For people with OCD, performing a compulsion-driven behavior reduces intense distress and anxiety. The compulsion feels external, and due to this, suppressing the behavior calls on them to perform a new form of compulsive behavior. OCD happens in the frontal cortex and striatum, the “worry circuitry” of the brain, where individuals cling to compulsions as a lifeline. People with OCD often have “just-right” compulsions that bring temporary relief from anxiety. They perceive the thought of not performing a compulsion-driven behavior as the cause of a horrible situation. It is challenging to diagnose since it has atypical symptoms that clinical psychologists don’t recognize.

Understanding Conscientiousness

Conscientiousness is a crucial aspect of one’s personality, reflecting an individual’s ability to follow rules, be orderly and opinionated while also being achievement-oriented. However, when conscientiousness is taken to the extreme, it can lead to obsessive-compulsive personality disorder (OCPD). Unlike OCD, people with OCPD carry out activities in a way they believe is sensible and easy to rationalize, often leading to rigid standards being applied to themselves or those around them. Anxiety is the root cause for this condition, making the world seem a safer place when activities are performed in a particular way.

New Hope for OCD

OCD patients can find relief through Exposure-and-response prevention (ERP) therapy and mindfulness-based cognitive therapy. ERP therapy challenges the patient to resist compulsive behavior during anxiety-triggering situations, reconditioning the brain to wait instead of giving in. A 16-week ERP program that is difficult for 50% of patients can result in recovery for 60-80% of those who complete it. Meanwhile, mindfulness-based cognitive therapy teaches patients to observe their thoughts objectively and disregard obsessive, deceptive thoughts for optimal brain function. This therapy proves effective in treating OCD in 55% of cases, providing new hope for sufferers.

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