I have a friend whom I shall call Brian who suffers from obsessive-checking syndrome. He will stare at a water tap or an electrical switch for minutes on end and then break away, only to return and repeat the exercise. He will slam his front door and then press it once, twice, three, four times and then break away, only to return and repeat the exercise. He will do circuits of his parked car, pulling on the door handles whilst angling his head to look and make sure the interior lights are off, and then break away… Yeah, yeah, you get the idea.
To someone witnessing this behavior – and Brian’s neighbors have sometimes wryly commented on the floor-show – it appears ludicrous, comical and potty. Anyone might check something once, twice or even three times just to make sure, but after that it’s axiomatic that the situation is in an okay state. When I watch Brian I have to suppress a chuckle, and I remain perpetually amused and a little awestruck as I shake my head in pity, even though I've seen the show hundreds of times before. The trouble is, I suffer from obsessive-checking syndrome myself – though not nearly so badly as Brian. No, no, not as bad as that, no way! And anyhow, it’s different when it’s you doing it.
Why do you keep on checking when you can see, obviously, that the tap or switch is off or the door is locked?
Yes, you know the tap is off. You don’t doubt that the tap is off. What you doubt is that you've properly perceived that the tap is off. And in consequence, if there is a possibility that your perception may be faulty, then there is also a possibility that the tap may not be off after all. That is why you constantly check – not to check that the tap is off, but to convince yourself that your senses are working correctly. And as you’re using your senses to monitor your senses, an element of double bind and infinite regression is inevitable. You just have to continue until you can make that leap of faith and be convinced and truncate the checking. Once you do reach that point you know you can remember the fact later for support, if and when doubts start to recur when you’re away from base. For some it’s harder than for others.
But why go through all that palaver? Why don’t you just accept the tap is off and leave it at that?
Well, if that were possible there wouldn't be a problem – there wouldn't be such a thing as OCD and we wouldn't be having this conversation. The same is true for depression – if you could just ‘snap out of it’ or ‘pull yourself together’, every depressive would do that and depression would become a forgotten illness in about two seconds flat. But of course it doesn't work like that.
In 1935 quantum physicist Erwin Schrödinger devised his famous Schrödinger’s Cat thought experiment to underline the flaws in the quantum Copenhagen interpretation, which says that a particle exists in multiple states simultaneously until it is observed. By creating the conditions whereby a cat in a sealed box will be either killed or not killed as a result of the decay or otherwise of a radioactive particle, he revealed the nonsense of the idea. If until it’s observed the particle will have both decayed and not decayed, then before the box is opened the cat will be both dead and alive, but clearly it will be one or the other regardless of observation.
Schrödinger said that his experiment prevented the naïve acceptance of such a ‘blurred model’ of representing reality as the Copenhagen interpretation suggests. And it occurs to me that in the mind of an OCD sufferer a similarly blurred model exists, a quasi-quantum paradox where a tap can be simultaneously off and not off, and in this case observation is not an automatic remedy!
So what is the remedy? OCD is thought to be primarily genetic and neurologically based, therefore it’s something to be controlled rather than eradicated, and traditional talking-based psychotherapy is considered largely ineffective in its treatment. Medication, usually SSRIs, are used to reduce attendant anxiety when that’s a big problem, but cognitive behavioral therapy or CBT – in particular the ‘exposure and response prevention’ technique – is what’s most recommended. This involves confronting your fears by indulging in the very feared thing – such as an Adrian Monk-style germaphobe having to touch a dirty toilet bowl – with the aim of desensitizing the subject, which hopefully leads to a reduction in anxiety and a more normal response.
Therefore the cognitive route is the right one, and cognitively speaking all us obsessives should adopt it when dealing with our problems. But we all have different vulnerabilities and pressure points, and one of the big underlying bugbears of OCD is the rejection of common sense. Like Schrödinger, we need to design thought experiments in a bespoke manner, to expose the fallacies of our needs to ritualise. Schrödinger’s task lay in surmounting the fact that the states of subatomic particles are difficult, if not impossible, to concretely imagine; therefore one can perhaps all too easily accept that they may have science-fiction-like properties. But the states of life and death in a cat are so palpable that no such difficulty occurs, so by making the latter contingent on the former a working cognitive bridge is formed.
Along such lines, I devised a practice where I held my mobile phone underneath taps and watched as it failed to get wet and damaged. This acted as an amplifier and also as a second line of verification to simply perceiving the tap’s state, and afterwards the phone’s continued state of dryness helped to ramify my conviction that the tap couldn't have been on or dripping. It worked so well that I don’t have to do it anymore, except on occasions of exceptional stress. Such techniques aren't perfect or an automatic cure, but they do help in reaching the point where that leap of faith can be made, after just three or four checks perhaps, like with normal people…almost.
As for Brian, when I talked to him recently about his holidays, he told me that he hasn't spent a night away from his house in over five years because of fears of night-time burglary. The fact that a burglary could occur in the daytime, or that he has the best locks known to man on his doors and windows, or that he doesn't have anything really worth stealing anyway, naturally doesn't cut any ice. For some people the cat will always be both dead and alive.