I've read most of Scott's blog posts and he rarely mentions OCD and when he does it tends to be "this is what I think people with OCD experience" and not "this is what my patients have told me" which leads me to believe that he is not an expert in OCD.
I have OCD and it's ruined my life in ways that are hard to articulate. Which is why I can point out two good reasons why what's being described might not be a good idea. First, giving into compulsions just legitimizes them and reinforces the patterns that are central to OCD and can ultimately make things worse. Secondly, OCD has a habit of changing how it manifests. Sure, maybe the woman is no longer bothered by the hairdryer, but what happens when it becomes changes to worrying if the oven is on? She'll be right back where she started.
I doubt that the anecdote actually happened as described. It's way too contrived, simplistic and borders on "Psychiatrists hate her! Cure your OCD with this one simple trick!". Realistically, OCD is incredibly insidious and if it were that simple to cure then nobody would have OCD. What's described is, at best, a short-term fix and half the psychiatrists likely knew that such things rarely stick.
I've had the same thing happen to me more times than I can count. I think I found the silver bullet, a way to permanently defeat my obsessive thoughts. If I'm lucky then it'll last a week before my OCD comes back in full force. But the truth is that you cannot directly fight OCD, it's like squeezing dough. When you clamp down in one spot, it just squirts out somewhere else. There's a quote that I think describes it perfectly "To hate me is to give me breath, to fight me is to give me strength". Fighting OCD or giving into its demands is just falling into its traps. You only truly win when you reach a point where you don't respond to it.
OCD is like a fire... you have trash can burning, and you have to treat the problem properly... so, water? Do I have a container to bring it? A glass is too small.. bottle to slow to empty... what about an extinguisher? Dust or CO2? Where are they? Can I use them= Damp towel? Baking soda?
If the can burning is in a garage, and you're able to move it to the middle of the asphalt (non-flammable) driveway, you still haven't put out the fire, but you've solved one half of the problem and given yourself a lot more time to think and find something that helps.
Driving back home 10 times per day, means that she might lose her job, become homeless and not be able to afford proper care... having a hair dryer in her purse (or wherever), means she can live a pretty much normal life, while slowly working on her problems (eg. start with leaving the hairdryer at the psychs receptionist, and start from there).
"To hate me is to give me breath, to fight me is to give me strength"
I've been listening to the self-esteem meditations on headspace and this is the same thing that they are recommending. I am amazed at how effective it has been.
That's strange. My impression came from his article about the Chamber of Guf where he talks about pure OCD, but it sounds like he's only read about it and never actually met someone with it.
I wonder if the disconnect is in taking the story in an idealistic way vs a practical way. Like sure, if you had someone for whom that works utterly when nothing else works then yeah, do that. But I don't think that's a realistic scenario.
I think it is clearly framed as a last resort rather than standard treatment:
> Here’s someone who was totally untreatable by the normal methods, with a debilitating condition, and a drop-dead simple intervention that nobody else had thought of gave her her life back.
I've suffered from symptoms of OCD on and off, and, personally, I totally believe this anecdote and think it's a great parable.
I think the world is probably split into pro- and anti-hair dryerism, both among people who do and don't have OCD.
>First, giving into compulsions just legitimizes them and reinforces the patterns that are central to OCD and can ultimately make things worse.
Of course, but that's the whole crux of this story: "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." It's paved over for conciseness, but I think it's implied that what you said is definitely not news to the patient.
Of course the first, second, third, and fifteenth thing you should and must try is what you say. I'm sure Scott would agree. This was a Hail Mary when every attempt to do that so far failed.
To give another example: I think ECT is terrible. But if nothing else has remotely helped someone with severe depression over a very long period of time and they hate every waking moment and are close to suicide? Throw that brain in a Tesla coil, I say. Another facet of hair dryerism would be stances on body identity integrity disorder. I won't write at length, but I think anyone can guess my position on it.
>Secondly, OCD has a habit of changing how it manifests.
Yes, this was my first thought, but I think that's also part of this parable, too. It likely will manifest in other ways for the patient, but this is a simple hack that actually helped resolve one immediate issue that was causing her a lot of difficulties at that time.
Some of the other issues will probably cause less severe of a life impact. There's a decent chance some won't, since it could be something thing like an oven, but the point is that this was one method to immediately address one pressing problem that was heavily affecting her life. Obviously you wouldn't just say "okay, you're fine now" and tell her to never come back; this would just be a stopgap while the patient is further treated.
On the topic of OCD, one thing that surprisingly helped me a lot and continues to help me came from what I believe was a random reddit or perhaps HN comment I happened to stumble across a few years ago. It was a short sentence from someone quoting their psychiatrist - essentially a suggestion of a different way of mentally framing things. It actually was "one weird trick" that really did immediately work in my case.
I think it was the precise phrasing of it that helped me, so I don't want to try to roughly paraphrase it from memory, but it definitely made it clear that while OCD is certainly a neurological problem, psychological techniques can help guide your neurology, like the proverbial elephant rider prodding the elephant a bit in one direction or another. Hopefully something like that, or perhaps something entirely different, will help this patient so they don't need to take their hairdryer with them anymore.
Despite my initial comment, I'm pro-hairdryer. If it works when nothing else does, then do it. I'm even pro-hairdryer in the sense that it could be used as a stop gap until the patient learns more effective ways to manage their OCD.
I think what bothers me about is that Scott doesn't mention that there are legitimate drawbacks to the solution in the story. It's a nice "thinking outside of the box" story but to use it as an excuse to be smug and very much "I'm better than the rest of these psychiatrists who don't actually want to help you" is distasteful.
I didn't see it as a way to be smug or seem better. It seemed like his colleagues were split in half, as he said, and he happened to be on one side, and both sides felt like the other side was being ridiculous.
I think what you wrote perfectly describes the correct approach to mental health _in general_. Not just OCD, but also many other mental disorders like anxiety, and just emotions in general. Trying to ignore or repress our thoughts and emotions just serve to "give [them] strength". It's a life lesson I wish a lot more people knew.
[NOTE: This thought got me going on a random train of thought below, not really directed at the person or comment I'm replying to above. Sorry for the slight tangent...]
I've recently started taking on a unique viewpoint of my own psychology. It's more of an interesting way to think of one's mind than an actual theory on the mechanisms of the brain. But basically I started thinking of my mind in terms of the classic conscious/subconscious split, but thinking of the subconscious as less like a ... primitive/instinctive part of myself and more like a separate system with its own thoughts and desires. Kind of like how we imagine the body to be conceptually a separate entity from our minds. Though they're quite intertwined, its easy to imagine that we could transplant our mind into a different body and still be ourselves. I imagine that I could transplant my consciousness into a different brain and still be _me_, but with a different subconscious. That sounds strange, because we're so used to the idea of the subconscious being a part of our us, but hopefully it makes more sense momentarily.
The point of viewing the subconscious like this is then one can say that, like the body, if you don't take care of your subconscious's needs and desires, if you don't give it space to be heard, it will lash out. Trying to repress one's emotions, anxieties, OCDness, etc, you're making your subconscious unhealthy in the same way that you can make your body unhealthy by not eating healthy, not working out, or ignoring pain. Emotions are the way our subconscious tells us its in pain or in need.
More importantly, this allows a subjective _detachment_ from one's emotions and anxieties. To view them objectively. Whereas it's really easy to feel anxious and then believe that that anxiety is _part_ of yourself. That you, yourself, are anxious. But viewing the subconscious as a separate system that must be managed like the body allows one to feel anxiety and acknowledge that it isn't _you_, yourself, that are anxious. It's your brain that's anxious. And it's a signal that you need to do X, Y, and Z to take care of your brain. Much like one would rest when your body is telling you it's hurt.
Again, this is more of a way of viewing the brain, rather than a psychological theory with any basis in reality. It's definitely very derivative of archaic psychology theories like Freud's theories and bicameralism. But I find it helpful none the less. The most important component, and something I think a lot of people with mental disorders have trouble grasping, is that this idea that one's identity is not tied to their disorder. I'm lucky in that I've experienced what my brain is like without anxiety and found out that I'm still the exact same person, just minus anxiety. I know prior to that experience I probably would have said that _I'm_ an anxious person, as if it were some fundamental part of my personality. So that experience has better enabled me to make clearer divisions between self and the flaws of the substrate my conscious mind is running on.
N.B. I'm just sharing a (hopefully) interesting viewpoint. This isn't "do this one weird trick and you won't have a mental disorder anymore!" kind of thing. Anyone who suspects a mental disorder, no matter how small, should seek guidance from a medical professional. Seriously. There's no shame in any of it, and treatments are better today than they've ever been. My little pet theory above is, again, just something I found interesting in the way I view my own psychology.
What you're describing lines up well with recent research[1] on multi-agent models of mind. You might be interested in internal double crux[2] and internal family systems[3] more generally. These are techniques for managing mental health very similar that which you describe, and they build primarily upon the idea that the mind is best treated as a collaboration among multiple subagents.
I have OCD and it's ruined my life in ways that are hard to articulate. Which is why I can point out two good reasons why what's being described might not be a good idea. First, giving into compulsions just legitimizes them and reinforces the patterns that are central to OCD and can ultimately make things worse. Secondly, OCD has a habit of changing how it manifests. Sure, maybe the woman is no longer bothered by the hairdryer, but what happens when it becomes changes to worrying if the oven is on? She'll be right back where she started.
I doubt that the anecdote actually happened as described. It's way too contrived, simplistic and borders on "Psychiatrists hate her! Cure your OCD with this one simple trick!". Realistically, OCD is incredibly insidious and if it were that simple to cure then nobody would have OCD. What's described is, at best, a short-term fix and half the psychiatrists likely knew that such things rarely stick.
I've had the same thing happen to me more times than I can count. I think I found the silver bullet, a way to permanently defeat my obsessive thoughts. If I'm lucky then it'll last a week before my OCD comes back in full force. But the truth is that you cannot directly fight OCD, it's like squeezing dough. When you clamp down in one spot, it just squirts out somewhere else. There's a quote that I think describes it perfectly "To hate me is to give me breath, to fight me is to give me strength". Fighting OCD or giving into its demands is just falling into its traps. You only truly win when you reach a point where you don't respond to it.