The Hair Dryer Incident (2014)

You're elaborating on how the categories are intended to be meaningless, but you're not doing much to claim that they are in fact not meaningless.

If someone has low occupational functioning, you could call that a disorder. But why would you call it "ADHD"? Why would you call it ADHD for some people and OCD for other people? Suppose you have two lists of symptoms:

  Attention Deficit Hyperactivity Disorder
   - Patient has an active mind.
   - Patient has a crummy job.

  Borderline Personality Disorder
   - Patient rubs me the wrong way.
   - Patient has a crummy job.

And you have several people who display every combination of mental activity, mental lethargy, likeability, unlikeability, good jobs, and bad jobs. You say everyone with a good job has no mental disorder, unlikeable people with mental lethargy and a bad job have borderline personality disorder, likeable people with mental activity and a bad job have ADHD, and unlikeable people with mental activity and a bad job have borderline personalities _and_ ADHD. Likeable people with mental lethargy and a bad job have a disorder as yet unnamed.

What did you learn about the reasons why people with bad jobs (your primary diagnostic criterion, after all!) have bad jobs?

People are not software :)

I've suffered from symptoms of OCD on and off, and, personally, I totally believe this anecdote and think it's a great parable.

I think the world is probably split into pro- and anti-hair dryerism, both among people who do and don't have OCD.

>First, giving into compulsions just legitimizes them and reinforces the patterns that are central to OCD and can ultimately make things worse.

Of course, but that's the whole crux of this story: "She’d seen countless psychiatrists, psychologists, and counselors, she’d done all sorts of therapy, she’d taken every medication in the book, and none of them had helped." It's paved over for conciseness, but I think it's implied that what you said is definitely not news to the patient.

Of course the first, second, third, and fifteenth thing you should and must try is what you say. I'm sure Scott would agree. This was a Hail Mary when every attempt to do that so far failed.

To give another example: I think ECT is terrible. But if nothing else has remotely helped someone with severe depression over a very long period of time and they hate every waking moment and are close to suicide? Throw that brain in a Tesla coil, I say. Another facet of hair dryerism would be stances on body identity integrity disorder. I won't write at length, but I think anyone can guess my position on it.

>Secondly, OCD has a habit of changing how it manifests.

Yes, this was my first thought, but I think that's also part of this parable, too. It likely will manifest in other ways for the patient, but this is a simple hack that actually helped resolve one immediate issue that was causing her a lot of difficulties at that time.

Some of the other issues will probably cause less severe of a life impact. There's a decent chance some won't, since it could be something thing like an oven, but the point is that this was one method to immediately address one pressing problem that was heavily affecting her life. Obviously you wouldn't just say "okay, you're fine now" and tell her to never come back; this would just be a stopgap while the patient is further treated.

On the topic of OCD, one thing that surprisingly helped me a lot and continues to help me came from what I believe was a random reddit or perhaps HN comment I happened to stumble across a few years ago. It was a short sentence from someone quoting their psychiatrist - essentially a suggestion of a different way of mentally framing things. It actually was "one weird trick" that really did immediately work in my case.

I think it was the precise phrasing of it that helped me, so I don't want to try to roughly paraphrase it from memory, but it definitely made it clear that while OCD is certainly a neurological problem, psychological techniques can help guide your neurology, like the proverbial elephant rider prodding the elephant a bit in one direction or another. Hopefully something like that, or perhaps something entirely different, will help this patient so they don't need to take their hairdryer with them anymore.

I used to work with someone who had that same problem with door locks, he'd sometimes leave work to make sure he locked his door. This was well before the days of ubiquitous web based home security cameras, but he rigged up a video camera and a video capture card on his PC to take a picture of the door (and door lock) and post it on a web page every minute. So he could easily check to verify that the door was closed and locked.

Nowadays, maybe an electronic lock would be an easier solution, though I'm not sure that would satisfy the urge to be sure it was locked, would he trust it?

I think what you wrote perfectly describes the correct approach to mental health _in general_. Not just OCD, but also many other mental disorders like anxiety, and just emotions in general. Trying to ignore or repress our thoughts and emotions just serve to "give [them] strength". It's a life lesson I wish a lot more people knew.

[NOTE: This thought got me going on a random train of thought below, not really directed at the person or comment I'm replying to above. Sorry for the slight tangent...]

I've recently started taking on a unique viewpoint of my own psychology. It's more of an interesting way to think of one's mind than an actual theory on the mechanisms of the brain. But basically I started thinking of my mind in terms of the classic conscious/subconscious split, but thinking of the subconscious as less like a ... primitive/instinctive part of myself and more like a separate system with its own thoughts and desires. Kind of like how we imagine the body to be conceptually a separate entity from our minds. Though they're quite intertwined, its easy to imagine that we could transplant our mind into a different body and still be ourselves. I imagine that I could transplant my consciousness into a different brain and still be _me_, but with a different subconscious. That sounds strange, because we're so used to the idea of the subconscious being a part of our us, but hopefully it makes more sense momentarily.

The point of viewing the subconscious like this is then one can say that, like the body, if you don't take care of your subconscious's needs and desires, if you don't give it space to be heard, it will lash out. Trying to repress one's emotions, anxieties, OCDness, etc, you're making your subconscious unhealthy in the same way that you can make your body unhealthy by not eating healthy, not working out, or ignoring pain. Emotions are the way our subconscious tells us its in pain or in need.

More importantly, this allows a subjective _detachment_ from one's emotions and anxieties. To view them objectively. Whereas it's really easy to feel anxious and then believe that that anxiety is _part_ of yourself. That you, yourself, are anxious. But viewing the subconscious as a separate system that must be managed like the body allows one to feel anxiety and acknowledge that it isn't _you_, yourself, that are anxious. It's your brain that's anxious. And it's a signal that you need to do X, Y, and Z to take care of your brain. Much like one would rest when your body is telling you it's hurt.

Again, this is more of a way of viewing the brain, rather than a psychological theory with any basis in reality. It's definitely very derivative of archaic psychology theories like Freud's theories and bicameralism. But I find it helpful none the less. The most important component, and something I think a lot of people with mental disorders have trouble grasping, is that this idea that one's identity is not tied to their disorder. I'm lucky in that I've experienced what my brain is like without anxiety and found out that I'm still the exact same person, just minus anxiety. I know prior to that experience I probably would have said that _I'm_ an anxious person, as if it were some fundamental part of my personality. So that experience has better enabled me to make clearer divisions between self and the flaws of the substrate my conscious mind is running on.

N.B. I'm just sharing a (hopefully) interesting viewpoint. This isn't "do this one weird trick and you won't have a mental disorder anymore!" kind of thing. Anyone who suspects a mental disorder, no matter how small, should seek guidance from a medical professional. Seriously. There's no shame in any of it, and treatments are better today than they've ever been. My little pet theory above is, again, just something I found interesting in the way I view my own psychology.