Schwartz set out to develop a treatment that would change the OCD circuit by unlocking the link between the orbital cortex and the cingulate and normalizing the functioning of the caudate. Schwartz wondered whether patients could shift the caudate “manually” by paying constant, effortful attention and actively focusing on something besides the worry, such as a new, pleasurable activity. This approach makes plastic sense because it “grows” a new brain circuit that gives pleasure and triggers dopamine release which, as we have seen, rewards the new activity and consolidates and grows new
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