An article in the current Discover Magazine (November, 2013) describes Jeffrey Schwartz’s method for curing OCD, which he derived from his practice of Buddhist mindfulness. “If the practice of mindfulness is to stand back dispassionately from all our ideas and impulses, couldn’t an OCD patient use mindfulness to step back even from mortal fears and compulsions?”

Schwartz describes his method in four steps that he put together sequentially over a period of time. These four steps are also used as a sequence in treatment: relabeling, reattributing, refocusing, and revaluing. Below are quotes from the article describing each of these steps.

Relabeling: “Recognize an OCD-related thought as early as possible and relabel it as unreal — merely a symptom of their OCD — without giving in to it.” “Schwartz urged the patient to think, ‘This is not an urge to wash my hands; this is a bothersome thought brought about by my OCD.’ One patient exclaimed, ‘It’s not me, it’s my OCD.’ ”

Reattributing: He teaches his “patients to reattribute their OCD symptoms to some gnarled brain wiring, teaching them to see the functioning of their brain as meaningfully separate from their sense of self.”

Refocusing: “He gave his patients license to replace monitoring their breath with whatever behavior they felt most compelling. Some patients found it useful to turn back to the same healthy behavior each time an OCD episode struck — going for a walk perhaps, or gardening.”

Revaluing: “The OCD thoughts that patients once considered so important were to be systematically deconstructed, understood, and revalued as, in Schwartz’s words, ‘trash . . . not worth the gray matter they rode in on.’ Conversely, Schwartz’s patients were taught to value their alternative behavior highly. ”

Commentary

Schwartz’s treatment apparently does work, though it is slow and takes a lot of effort (more on that later) and his client’s reported changes have been objectively verified by differences in brain scans pre- and post-treatment. Let’s take a close look at the different steps in his method, which he has written about in two books (J. Schwartz, 2002, 2012)

Relabeling, often called redescription, or recategorization, is a very useful — and very old — way to redirect attention and reframe an event or a response to an event. When an experience is recategorized, it is experienced together with a different set of experiences — changing what is attended to, and its meaning. One aspect of this particular kind of relabeling was described long ago by Michael White as “externalization,” changing the location of a problem from being part of the self to being external to the self. This can be quite useful, because it refocuses attention from judgments about the problem to the problem itself.

At other times externalization is not so useful, for instance when an alcoholic says, “It’s not me, it’s the bottle,” or a schizophrenic who hears external voices, and gives up any responsibility for what they say. Externalization alone is not a solution in itself, only an interesting first step, which can be utilized to discover more about how the problem functions. “How does the bottle get you to drink? “Does it whisper to you seductively? Does it tempt you with a promise of escape from torment? Does it give you visions of power and sexual conquest? Talk to the bottle and find out more about how it has power over you.”

The other aspect of Schwartz’s particular kind of relabeling is to recategorize the symptom as being “not real.” If OCD thoughts can be successfully experienced as “not real,” then there is no longer the slightest need to follow their demands. (And if you can accomplish this, Schwartz’s admonition “without giving in to it,” becomes completely unnecessary.) If you make an image of the devil telling you to murder your child, that will only be disturbing or compelling if you experience that vision as real.

A wide variety of different problems would vanish instantly and completely if a client succeeded in realizing that something that bothered them was no longer real. If you have any doubts about this, think of a current problem in your life.  . . .

Now think about what you believe to be real in order to have that problem. For instance if you are inhibited in social situations, you probably believe that others are judging you, and that this has serious consequences. If you are depressed, you probably believe that your future looks black, and that you are unable to do anything about it.  . . .

Now for a moment imagine that whatever you thought was real was totally unreal, and you will find that your problem no longer exists.  As the old joke goes, “Mind over matter; if you don’t mind, it doesn’t matter.” . . .

Most people find it relatively easy to think of a symptom as being outside themselves and not a part of who they are, because that only requires a change in its location in space. However most will find it much more difficult to actually experience their symptoms as “not real,” just because they have relabeled them as being “merely a symptom of their OCD.” Many people with phobias will readily agree that their fear is “not real,” but they still respond to the stimuli for their phobia as if they experience them as real. Relabeling an OCD symptom as “not real” is a good start, but it will seldom be effective in itself, without more detailed instruction in how to actually accomplish this. Schwartz offers no specific methods for this; he seems to think that relabeling them is enough — leaving the client to figure out how to actually do it.

Stepping back from a problem experience.

Now let’s examine the instruction to “Stand back dispassionately” and “step back.” This can be understood metaphorically, as a “figure of speech,” in which case the client has to figure out how to actually accomplish that. Or it can be understood as a literal instruction to take a step back out of an experience and view it at a distance objectively. This is a very useful ability that we all have, but most people don’t realize that they have the choice to use — an example of the importance of “what you know, but you don’t know that you know,” often pointed out by Milton Erickson.

Some people may be able to successfully use the instruction to “step back” in order to relabel an experience as “unreal.” But for many others it will be inadequate to actually achieve an objective viewpoint, for a number of possible reasons.

One step back may not be nearly enough. A client may need to back up ten steps — or two hundred — in order to create sufficient distance to view a disturbing memory objectively.

Even at two hundred steps, a client may need to shrink a troubling image to make it small, flat, dim, or black and white — or all of these — before being able to view it without being distressed or compulsed.

To be really effective, the client needs to be at sufficient distance that they can see themselves responding to the troublesome event, not just the troubling event itself. When a client sees an image of himself freaking out “over there,” that implies that he doesn’t have to feel those feelings himself.

People suffering from traumatic memories often speak of feeling “frozen in time” because they have an unchanging still image of the traumatic event at the peak intensity of their terror. Even if they are able to step back and view it at a distance, they may still be stuck with that static troubling image. If a client remembers a point in time that is still disturbing, you can ask them to make that still image into a movie, and continue the movie until later, when the terror is over and they are safe, so that they are not left with an image that is still troubling.

When a client is already experiencing overwhelming feelings, it can be very difficult or impossible for them to take an objective point of view because of their emotional arousal. However, if they are first distracted, and then asked to imagine sitting in a movie theater before playing a movie of the disturbing memory, they will usually be able to do that.

The many unspoken implications of a movie theater — that the movie is only a record on film or video of what happened in the past, some of which may have been achieved through makeup, special effects or other fakery, etc. — are far more effective in conveying the message “This is not real” than simply asking someone to verbally relabel it.

Asking the client to notice the heavy curtains and the ornate decorations on the theater walls, the spring-loaded seats as they sit down in the theater, and the feel of the arms of the chair they are sitting in, adds sensory detail that will strengthen the experience of actually being in the theater, and all the implications of that.

But even all that may not be enough; the client may need to float up into the projection booth of the theater and look down at himself sitting in the audience in order to achieve sufficient separation from the troubling experiences that will be displayed on the movie screen.

Asking the client to reach out and place her hands on the plexiglass in the front of the projection booth concretizes the separation from the events on the movie screen, making it even more difficult for her to “fall back into” the terrifying feelings being felt by that woman in the movie. It also occupies the kinesthetic system with the feeling of the plexiglass, making it less likely that there will be sufficient remaining “bandwidth” for feeling terror.

All these elements and more have been built into a detailed protocol that has been the core of the NLP phobia process since the late 1970’s, and which is the process of choice for the phobic core of PTSD. This protocol takes the simple conscious mind instruction to “step back” from a problem thought into an experience of doing it that speaks silently to the unconscious through implication. It is very frustrating to keep seeing others reinventing clumsy wooden wheels, when a smoothly machined and balanced steel one with a radial tire has been available in the field of therapy — but mostly ignored — for a third of a century.

How do you know what’s real?

There is an even more direct way to make a troublesome experience less real, which you can discover for yourself if you are willing to try a simple little mind exploration. Think of an animal that you know is not real, such as a unicorn, or a dragon,  . . . and then think of a somewhat similar animal that you know is real, such as a rhinocerous or a horse.  . . .

Now think of these two images simultaneously and compare them to discover the sensory differences between them that allow you to know that one is real and that one isn’t. For instance, the real one may be solid and 3-D, while the unreal one is transparent and 2-D. The real one may be closer or moving, while the unreal one may be farther away or a still statue. One may be solidly grounded, while the other is floating off the background. One may be clear and vivid, while the other is fuzzy and dull, etc.  . . .

Different people use different sensory parameters to distinguish between something real and something unreal. (Some people are not very good at making this distinction, and may often be uncertain about whether something actually happened or not.) Whatever sensory differences you found, you can now use in either direction. You can make something that is unreal to you — like the real dangers of not wearing seatbelts, or the hazards of texting while driving — more real by making your images of the consequences larger, closer, more solid, vivid, or whatever you use to distinguish a real image. This can be a useful change.

Or you can make an image of something that troubles you because it seems very real to you much less real by making that image farther away, more vaporous, less vivid, etc. Someone who has OCD images or thoughts can use these kinds of changes to make them much less real and compelling, reducing or eliminating the strength of their compulsive feelings.

Reattributing If you read Schwartz’s description of reattributing, quoted above, you will find that it is essentially identical to relabeling. Apparently Schwartz has not noticed this obvious and curious redundundancy, casting a lingering shadow of doubt over the rest of his thinking.

 Refocusing Redirecting attention from a troubling thought to the breath, or to a candle flame, etc., has been a part of many meditation traditions for thousands of years. Although it can be used to withdraw attention from a problem experience, it usually takes a lot of effort, and a lot of practice, before it becomes an automatic response, and it is still likely to fail in an intense situation. Personally, I find observing a candle flame only a trifle more interesting than following my breath — or watching paint dry. I quickly get bored with that and move on to think of something more engaging. In meditation practice this is thought to be evidence of inadequate concentration, but I think of it as a sign of health. Do you really want to spend years of your life paying attention to your breathing, or watching a candle flame? I hope you have much more interesting things to do, and if you don’t, it is time to start discovering some of them.

There are many ways to alter a response to a thought that are much faster and more effective than focusing on breathing or a candle flame. Schwartz’s suggestion to think of a satisfying and resourceful activity is a step in the right direction. But unless you are a really avid walker or gardener, the suggestion to think of  “going for a walk perhaps, or gardening” may not be much more engaging. Why not think of something more exciting and attractive, such as enjoying great sex, a superlative meal, a concert of your favorite music, or whatever else “blows your dress up”? If you do that, it will be easy and natural to continue to attend to that enjoyable experience rather than returning to a troubling one.

However, attempting to think of something different implicitly means trying to avoid and negate the troubling experience, in order to think of a different one. This has the paradoxical effect of making us think about it even more, as the old instruction, “Don’t think of pink elephants,” points out. Instead of attempting to negate the troubling experience, you can accept it and then add to it or adjust it in some way. As Milton Erickson advised: “Your task is that of altering, not abolishing.”

Putting experiences together

One way to do this is to think of an exciting resourceful activity at the same time as the troubling thought, instead of sequentially, and there are a variety of ways to do this. One of the simplest is to think of two images side by side. If you think of an old resentment at the same time as you think about having great sex, which one draws your attention most? Which one would you rather spend time contemplating?

These two images could be either still pictures or movies. You could also experiment with making one of them a still picture and the other into a movie, to find out how that changes your experience. If you make the image of resentment into a still, black-and-white picture, and your image of having sex as a colorful movie, that will probably draw your attention away from the resentment — without negating it. Then if you step into that movie of having sex, you can enjoy it even more; that still image of resentment will be so far in the background that it won’t concern you at all.

Another way is to superimpose the two images, making one of them somewhat transparent, so that you can see one through the other. Whenever you have an unwelcome thought, you can play a simultaneous background movie of yourself doing whatever “toots your whistle.” Then an easy next step is to switch which one is foreground and which is background, to find out how that changes your response. Do you respond more positively to a solid image of a resource in the background, or the same image transparent in the foreground?

With only a little practice, this can become an automatic response to any such thought, giving you a somewhat more enjoyable and interesting ongoing perspective. (Many depressed people do the reverse; no matter how much they are enjoying themselves in the moment, they visualize a grim movie of the inevitable decline and ending of their life, with funereal music playing in the background.)

The following account of a single session with a young OCD client shows the power of pairing a positive resource experience with the symptom. This example was sent to me about four years ago by Ron Soderquist, an NLP-trained hypnotherapist in the Los Angeles area.

“Anxious parents called, each in turn, about their 17-year-old daughter Bev, who for the past six months had obsessively washed her hands 3-4 hours a day. Both parents reported they had ‘tried everything.’ including counseling and drugs. They were so desperate they were now exploring hypnosis, about which they were very skeptical. Somewhat worn down by their skepticism, I said to the anxious mother, ‘Look, because you are desperate and because you worry that once again you will be throwing money away, I will offer you a complimentary consultation. I will evaluate your daughter’s symptoms and only schedule a therapy session if I believe I can help her.’ With this assurance, she made an appointment.

“As family members settled into their chairs, they all appeared relaxed. They communicated with ease, and there were no overtones of hostility. Turning to the girl I asked about school and extracurricular activities. She immediately replied, ‘I have studied piano for many years and enjoy it very much.’ Because I play both classical and ragtime piano, this was a natural opening for building rapport.

When I asked about her favorite composer, she quickly said, “Chopin.” Because Chopin is also my favorite, we were now in perfect sync. We agreed we both loved Chopin’s Nocturnes and we both played most of them. I asked about her favorite and she hummed the melody. I said, ‘When I practice a nocturne in the evening I often can hear that melody in my head all next day,’ and she nodded in agreement. ‘You can hear that melody right now, can’t you?’ I said. She smiled and slipped into a nice little trance. As she did so, I ventured, ‘Perhaps, when you get the urge to wash your hands, you might enjoy turning on that nocturne.’ I observed her trance deepen as she considered this, and then she nodded her head and said quietly and confidently, ‘I can do that.’

“After some further rehearsal, and talk about other matters, I concluded the session. I didn’t suggest another session. The mother wondered, ‘Do we need to make an appointment for Bev?’ I looked at Bev as I said, ‘Perhaps she has already found a solution,’ and Bev nodded her head.

“A week later the mother called to say Bev was doing fine. I was a little annoyed with myself for solving the problem when I should have held back and scheduled a regular appointment with a fee. But I just couldn’t help myself; it was too much fun just to do it. And while there was no fee, I did get a good story, and the mother soon referred a friend.

“When I followed up some months later, I asked for more details of what she experienced internally. She said that when she got stressed, she first ‘felt germs on my hands, and then pictured them on my hands. Then the voice in my head that said, ‘You have germs on your hands. You have to wash them.’ went faster and louder and got more intense. When I turned on the nocturne, I would usually just hear the music, but sometimes I would imagine myself playing it.’ ”

Revaluing Revaluing an experience is a useful goal that is applicable in a very wide variety of human problems, from simple habits and addictions, to more complex problems. If you valued experiences differently, you would never be tempted by that second piece of chocolate or cheesecake, you wouldn’t be consumed by thoughts of resentment or retribution at what someone did to you, etc. Schwartz tells someone who suffers with OCD thoughts to change them so that they are “deconstructed, understood, and revalued as, in Schwartz’s words, ‘trash . . . not worth the gray matter they rode in on.’ ” Again Schwartz doesn’t provide any instruction about how to actually accomplish this.

There are many different specific protocols for revaluing experiences. One is to pair experiences so that they are evaluated in relation to each other. Things or events are not just valued in themselves, but always in relation to others, so the key question is “valued or important in relation to what?” This is a key principle in valuing and importance that is easily forgotten.

For instance, think of something that is troublesome to you — which means that it is important to you in some way — such as a resentment about what someone else did to you that is intrusive and disturbing.  . . .

Now think of the positive value that was somehow violated by this experience, and notice your image of this.  . . .

Now think of something that is important to you in some other way — a satisfying experience of achievement, great beauty, a trusting relationship, incredible courage — and notice your image of this.  . . .

Now think of these two images simultaneously, and ask yourself the question, “Which of these is more important to me?” . . .

Now here is an interesting question that you may not know how to answer immediately, “How do you know that one of these is more important to you than the other?” . . .

Probably the more important one was higher in your visual field, or closer to you, or larger, or more vivid or colorful etc. than the other. Whatever differences you find, those sensory parameters are what you unconsciously use to code the importance of an image, and what it represents. Once you have this information, you can deliberately change these sensory parameters to alter the relative importance of any two images. If you really don’t want that image of an old resentment to occupy so much of your mental real estate, move that image lower, farther away, or make it smaller, less vivid, etc. (These are the ways many people use to code importance — yours could be different.) and you will find that it has become less important to you, and you respond to it less intensely.

Effort

The methods I have briefly outlined for making an experience less real and less important are very rapid, dependable, and lasting, and they take very little effort. In contrast, “Schwartz’s four steps worked, but it wasn’t easy. It took, and these words struck Schwartz as key, a tremendous force of will.”

I think his methods are difficult and slow for a very simple reason; he tells clients what to do, but he doesn’t tell them how to do it, so the client has to try to figure that out on their own. That is a bit like taking your malfunctioning computer to an IT gal, and having her tell you, “You need new software,” or “You need a new video card,” without telling you anything about how to do that. If you know as little about computers as I do, that would be a very difficult instruction to follow, and it would take me a lot of time and effort. If something is difficult, it just means that the method you are using needs to be refined, described in more specific detail to make it easier to follow, or discarded in favor of some other method.

“Free Will”

Schwartz concludes that because his method takes great effort, that is an indication of “free will.” “Eventually Schwartz began to feel that he was seeing free will in action: the people under his care choosing, again and again, to engage in a new behavior.” The logic underlying Schwartz’s statement seems to be this: “If someone persists in a difficult task, that is evidence of free will.” In shorthand, Schwartz is saying, “The fact that OCD clients have to work hard causes me to think that they have free will,” which is more than a little paradoxical, because it uses causal logic as a basis for the existence of free will, which is generally understood to be free of causality!

I think that it is much simpler to assume that the process takes great effort simply because it is crude and incomplete, and that his clients are so highly motivated by the discomfort of OCD that they are willing to work hard because of Schwartz’s promise of eventual relief. Some people spend ten years (or more) of their lives in an ashram in India in response to similar promises.

The treatment of many serious diseases used to be very difficult and the outcome extremely uncertain. Was that an indication of the doctors having “free will”? Or was it simply that the doctors didn’t have the knowledge and technology to get results quickly? Since vaccination now routinely prevents many of these diseases (and has even completely eradicated smallpox) does that mean that doctors now have less free will? I don’t think so. I think that the reverse is true. The deterministic causality inherent in vaccination makes doctors (and their patients) more free, not less. If you disagree, by all means forego vaccination and revel in the freedom to die horribly from a preventable disease!

The Structure of Tenacity or Persistence

If you know someone who is really tenacious in working toward a goal that requires a lot of effort or time, ask them about their experience and they will tell you some variation of the following. They have a goal in mind, which could be as specific as a cure for cancer, or as vague as intense curiosity about the unknown. This goal is represented in robust sensory qualities (large, close, color, 3-D, etc.) so that it is important and compelling — perhaps even compulsively. They will say that they continue to pursue this goal despite many obstacles, because it is so important to them, and that it satisfies many goals, from simple ones like earning money or fame and status, to more transcendent ones like improving the lot of all humanity.

The image that drives them is also very persistent; it is there 24/7 — sometimes in the foreground, sometimes in the background, but always there, pulling them forward. Many will tell you that it’s not a matter of free will at all, and that they couldn’t choose otherwise, no matter how much they would like to be released from it. The image of their mission causes their persistence. As Ursula LeGuin wrote: “As a man’s knowledge grows, and his power increases, the road he takes grows ever narrower, until at last he does only and wholly what he must.” And I would add that he does so wholeheartedly and happily.

Free Will

Now lets return to the title of Schwartz’ article, “In Defense of Free Will.” Probably more has been written about free will, and/or its apparent opposite determinism, than any other topic other than god(s). To many, the question seems like a completely irrelevant mental exercise; if you agree with this, you may want to skip the rest of this article, and do something more interesting.

With only one exception that I’m aware of, everyone who has written about “free will” has assumed that determinism and free will are opposites, and many have attempted to find an escape from causality in some kind of randomness — quantum mechanics is the current favorite.

Long ago I proved to my satisfaction that the age-old puzzle of free will vs. determinism is completely bogus. Any experience that one might describe as “free will” or “freedom” is completely dependent on causality.

Our lives are completely dependent on literally thousands — perhaps hundreds of thousands — of physiological feedback systems that causally maintain our body temperature, oxygen concentration, blood pH, etc. within normal limits. If we didn’t have these deterministic systems we would quickly die, eliminating any possibility that we could experience anything that we might call “free” or “free will.”

Our brains are composed of neurons that fire in logical causal chains, and we all use causal “If-then” thinking to understand everyday events and ourselves — even if philosophers prove that causality is only an unverifiable hypothesis. Our brains use past experience to forecast the future, so that we can avoid forecasts that we don’t like, and pursue forecasts that are desirable and satisfying. Would your life be better if you introduced randomness into your brain’s functioning, so that its predictions were less reliable? Curiously, even those who want to establish a basis for “free will” have to do it using causal chains of logical arguments! Randomness provides no basis for any kind of “free will,” but determinism provides a solid foundation for it; the complete details are in my free online article (Andreas, 1967).

“We cannot command nature, except by obeying her.” —Sir Francis Bacon

References

Andreas, Steve. (1967) “Determinism: prerequisite for a meaningful freedom.” Review of Existential Psychology and Psychiatry, Vol. VII, No. 3. http://www.steveandreas.com/Articles/determinism.html.

Andreas, Steve. (2012) Transforming Negative Self-Talk. New York, W. W. Norton.

Schwartz, Jeffrey M. & Begley, Sharon. (2002) The Mind and Brain: neuroplasticity and the power of mental force. New York, Harper/Collins.

Schwartz, Jeffrey M. & Gladding Rebecca (2012) You are Not Your Brain: the four-step solution for changing bad habits, ending unhealthy thinking, and taking control. New York, Penguin.

Schwartz, Jeffrey M. (2013) “In Defense of Free Will.” Discover Magazine, November, pp. 52-57.