One of the things I love about living in Oxford is all of the great museums around. The closest museum to my house is called the Pitt Rivers Museum, and it has the most unbelievable collection of, for lack of a better word, stuff I’ve ever seen. One section that always interests me is called Amulets and Charms, and it contains thousands of artifacts that someone at some point in history believed had magical powers. The exhibit always reminds me of how deeply we desire to feel a sense of control over our lives and environment.

The desire to feel in control is part of the human psyche, and has wide ranging impacts.  For example, many people who suffer from depression feel that they do not have enough control over their lives. In contrast, many people suffering from anxiety problems try too hard to control every aspect of their life. In this blog I’m going to take a quick look at some research I have been involved in.

 

Control and anxiety

Does knocking wood help?

Superstition is an example of one way we can increase our feeling of control. For example, if you knock on wood after saying something you hope doesn’t happen, the superstitious belief is that the act of knocking of wood will magically influence the outcome of a future event in the real world.  Regardless of whether or not you actually believe in magic, if you conduct this ritual enough times it can lead to a pattern of learned behavior. If the undesired event does not occur, you may feel like you have contributed to the outcome, even if it was completely outside of your control. Therefore, you get a small reward for knocking on the wood, which reinforces the behavior. In the long run, this can create the illusion that you are responsible for things you have no control over. In some cases this can help maintain a form of anxiety known as obsessive compulsive disorder.

Superstition and obsessive compulsive symptoms

As mentioned above, over time superstitious behavior can lead to people believing that they can impact the outcomes of events which they actually have no control over. As a result, some people develop a strong sense of responsibility. For example, someone may have the obsessive and intrusive thought “if  I don’t knock on wood, something bad will happen and it will all be my fault”. This thought is an example of magical thinking, since magic is needed to explain a causal relationship between knocking on wood and an unrelated future event.

Several studies have observed a correlation between magical thinking and obsessive compulsive thoughts. Given this relationship, my PhD supervisor Ross Menzies and his colleague Dr Danielle Einstein had a new idea. Would it be possible to treat obsessive compulsive disorder by targeting magical thinking? The idea is as follows: if someone truly understands that there is no way that knocking on wood will impact a future event, they may be less likely to engage in the compulsive behavior. We took a look at this idea, and our early results indicate that there is some promise to this approach.

 

References

Danielle A. Einstein, Ross G. Menzies, Tamsen St Clare, Juliette Drobny and Fjola Dogg Helgadottir (2011). The treatment of magical ideation in two individuals with obsessive compulsive disorder.  The Cognitive Behaviour Therapist, 4, 16-29 

Fjóla Dögg Helgadóttir, Ross G. Menzies and Danielle A. Einstein. (2012). Magical thinking and obsessive–compulsive symptoms in Australia and Iceland: A cross-cultural comparison. Journal of Obsessive-Compulsive and Related Disorders, 1. 216-219

Coming up: Paper at the World Congress of Behavioral and Cognitive Therapies WCBCT 2013, July, Peru, Lima. Title: Superstitious behaviour in Iceland during and after the global financial crisis simulates the aetiology of obsessive-compulsive disorder. More…

 

fdh

 

Fjola  Helgadottir, PhD, MClinPsych, is a clinical psychologist, a senior research clinician at the University of Oxford, and is a co-creator of AI-Therapy.com, an online CBT treatment program for overcoming social anxiety

 

There is a well known 2011 study that looks at the brains of London taxi drivers. The map of London is complex, and taxi drivers are required to memorize the complete layout and pass a difficult exam before being given their taxi license. The study found that the hippocampus region of the brain, which plays an important role in memory, actually grows (in a physical sense) while the prospective drivers are studying for the exam. This is an interesting result since it clearly shows that our actions can make real, measurable changes to our brains.

 

Can you change your brain with therapy?

In short, yes.

Some people view psychological treatments as “softer” than using medication, since drugs can directly target neurochemical aspects of the brain. However, this view is unjustified, since there is mounting evidence that therapy can make very real structural changes to the brain. A great example is CBT.

Cognitive behavior therapy (CBT) is an evidence-based approach to tackling mental health problems, such as anxiety or depression. CBT has been subject to countless clinical trials, and has even been shown to be more effective than medication in some long-term studies. CBT works by targeting the thoughts and behaviours that are maintaining the problem (more information about CBT, and how it can be administered online, can be found here). For example, consider someone who has social anxiety and would like to ask their boss for a raise or promotion. This would be extremely stressful situation for them, and they would likely put it off indefinitely. CBT treatment would examine the thoughts that are leading to this avoidance, and would challenge them through a series of exercises. In much the same way that physical exercise changes the body, these mental exercises can make changes to the structure of your brain!

 

How does CBT change the brain?

The fact that CBT changes the brain is not a particularly new result. However, neuroscience journals tend to announce findings with headlines like “The neurobiological role of the dorsolateral prefrontal cortex in…”. The details are complex, but the general idea is understandable in surprisingly basic terms.

The brain is divided into different regions or modules, each of which is specialized to perform a certain type of task. For example, the visual cortex is the region of the brain that processes the sensory input from the eyes. There are some brain structures that deal with emotions such as stress and fear, and collectively these are sometimes known as the “emotional brain”. These are very “old” areas of the brain, in the sense that we share them with our distant ancestors. When a socially anxious person is nervous when thinking about asking for a raise, it is the emotional brain that is becoming active.

There are higher order brain structures that deal with planning, logic and reasoning. These are sometimes known as the “logical brain”. These brain areas, such as the prefrontal cortex, are “newer” in the sense that they are much larger in primates than in other species. There are two key points:

  • The logical brain is able to override the emotional brain. For example, our socially anxious person can take a rational look at the situation, and realize that he or she is exaggerating the potential risks. He or she might come to the conclusion “the worst case scenario is that the boss says no – that’s not the end of the world!” This thought will help them calm down, and build the confidence to actually ask for the raise.
  • Every time the logical brain overrides the emotional brain, the logical brain “muscle” becomes stronger and stronger. In other words, through CBT training the brain actually reinforces the neural pathways, so it becomes easier and easier to deal with future stressful situations.

This is good news: by changing our thinking and behaviour using CBT, we are making positive, long term, hard coded changes to our brains!

 

 

softonline

 

fdh

 

Fjola  Helgadottir, PhD, MClinPsych, is a clinical psychologist, a senior research clinician at the University of Oxford, and is a co-creator of AI-Therapy.com, an online CBT treatment program for overcoming social anxiety