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Howard Hughes and Obsessive Compulsive Disorder (OCD)


Exploring the role that Obsessive Compulsive Disorder (OCD) had to play in the demise of Howard Hughes.

by Charles Pasternak

The Aviator, the film that won five of this year’s Oscars, tells the story of the first forty years of Howard Hughes’ life. A man obsessed with beautiful women (none of whom made it into a lasting relationship with him), with making movies (none of which turned into classics in the mould of Citizen Kane, Gone with the Wind or Casablanca), and with designing – and flying, to his own near demise – larger and faster aeroplanes (none of which made it into production). Hughes was afflicted with another obsession, now recognised as obsessive compulsive disorder (OCD).

The disease is not so uncommon: 1 in 50 of the population is afflicted with it. OCD is manifested by obsessive thoughts and compulsive behaviour. Hughes was haunted by the threat of microbial infections – from food and from his surroundings – and reacted by avoiding contact with possible sources of dirt and by constant washing of his hands. Typically of OCD sufferers, he also could not stop himself from repeating again and again certain phrases that came to his mind.

What underlies OCD?

Deep within our brain lies a structure called the striatum. This is made up of two parts, known as the caudate nucleus and putamen. Each part consists of a mass of nerve cells, that are involved in the processing of messages from other parts of the brain. The messages are concerned with sensory information (like seeing a speck of dirt) and with translating such information into body movements (like rubbing one’s hands together). In people with OCD, it appears that the caudate nucleus may not be functioning properly. Normally the translation of sensory inputs into motor outputs (moving parts of the body through the innervation of particular muscles) is smooth and finite: a speck of dirt is seen, the hands react to wipe it away. End of story. Any misdirected feelings and stray movements are somehow filtered out. In OCD the filtering mechanism is faulty. Obsessive movements, like rubbing the hands together or repeating phrases, results.



Persons with OCD use different brain circuitry in performing a cognitive task than people without the disorder


Dr Jeffrey Schwartz, a UCLA neuroscientist and Director of the Westwood Institute for Anxiety Disorders, advised Martin Scorsese (the Director of The Aviator) and Leonardo DiCaprio (who played Hughes) on the manifestations of OCD. He is well qualified to do so. Many of his patients suffer from OCD and his book, Brain and Mind, is what first drew DiCaprio to him. The film star then spent many days with some of Schwartz’s patients. “No one had a clue what the causes of obsessive compulsive disorder were in those days. As a result, those with the symptoms were stigmatized and were not properly treated, if at all”, Schwartz says. Now the situation has changed. Behaviour therapy, in Dr Schwartz’s hands, appears to be remarkably successful. It depends on the patient recognising that the thoughts that lead to his or her particular behaviour result from inappropriate signals in the striatum and learning not to react to them. The therapy is not unlike that for curing a phobia of snakes by having a python placed on one’s lap and learning to stroke it.

Dr Schwartz’s treatment consists of teaching the patient a number of steps that he/she must follow. The essence is to recognise intrusive thoughts and urges, and to ‘relabel’ them as obsessive thoughts and compulsive urges. For example, learn to say ‘I don’t feel that I have the need to wash my hands. I’m having a compulsive urge to perform the action of washing my hands’.

The technique is the same for other obsessions and compulsions, like checking doors and appliances, and needless counting of certain objects (‘I don’t need to check the door: I know I’ve locked it’, and so on). The goal is to control one’s responses to the thoughts and urges, not to try to control the thoughts and urges themselves. If patients learn to perform these actions on a daily basis, and continue with these essentially self-taught measures for periods of weeks or months, their OCD will gradually be cured.



Howard Hughes standing in front of his new Boeing Army Pursuit Plane, Inglewood, California


Would that my mother had had the benefit of Dr Schwartz’s method! She suffered from OCD for most of her life. In her case it involved clasping and unclasping her hands as though in prayer, while repetitively muttering words of gibberish. Treatment by the method of the day (electro-convulsive therapy, that consists of passing currents of huge voltage through the body) did her no good at all.

Hughes’ OCD was not treated: he simply became a recluse, and died – largely of starvation - at 71 years of age, alone in a room at the Acapulco Princess Hotel in Mexico, with the windows and door sealed by masking tape.

Those of you who have seen The Aviator will recall the last words of the film, obsessively spoken by Leonardo DiCaprio as Howard Hughes: ‘The way of the future, the way of the future, the way of the future, … ‘. I believe that the film reminds us of three facts. One I have already referred to: OCD should no longer be considered a stigma but a treatable disorder.

The second is that Hughes’s ambitions did not exclude the making of money. If Hughes’ legacy is not in his films or his aeroplanes (or in beautiful descendants), it is in the ultimate success of his financial transactions. Before he died, he left his entire wealth to fund what has become one of the largest private medical foundations in the world: the Howard Hughes Medical Institute. Hughes’ philanthropy puts him firmly alongside such men as Andrew Carnegie, Sir Henry Wellcome, and John D Rockefeller. Of what other movie mogul can you say the same?

The third point concerns my meeting with Jeffrey Schwartz in Pasadena, California, as a result of us both being interviewed for a journal entitled Vision – Journal for a New World. This is the house magazine of an organisation called Vision. Its aim is to bring the hope that was inherent in the early Christian Church back to the world – without liturgical dogma, and to Jews and Christians, Muslims and non-believers alike.

Now what is wrong with that?

Charles A Pasternak is a biochemist, author of Quest: The Essence of Humanity (John Wiley, 2003; now out in paper-back) and founding director of the Oxford International Biomedical Centre (see www.oibc.org.uk). For more information about Vision see www.vision.org .

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First Science 2014