The Brain That Changes Itself: Stories of Personal Triumph from the Frontiers of Brain Science

by Norman Doidge MD

Brain scans of OCD patients show that all three brain areas are hyperactive. The orbital frontal cortex and the cingulate turn on and stay on as though locked in the “on position” together—one reason that Schwartz calls OCD “brain lock.” Because the caudate doesn’t “shift the gear” automatically, the orbital frontal cortex and the cingulate continue to fire off their signals, increasing the mistake feeling and the anxiety. Because the person has already corrected the mistake, these are, of course, false alarms. The malfunctioning caudate is probably overactive because it is stuck and is still being inundated with signals from the orbital frontal cortex. The causes of severe OCD brain lock vary. In many cases it runs in families and may be genetic, but it can also be caused by infections that swell the caudate. And, as we shall see, learning also plays a role in its development. Schwartz