Howard Hughes and Obsessive Compulsive Disorder (OCD)

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 allâ€, 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.