Sunday, June 26, 2022

Hair Dryer Obsession

Scott Alexander Siskind, the psychiatrist who writes Astral Codex Ten relates the story of an agency he worked for splitting over the appropriate treatment for one of his patients. She had an obsession whenever she left the house that she had left the hair dryer on and worried the apartment was going to burn up. He suggested she simply bring the hair dryer with her whenever she left.  Problem solved. Some of his staff thought this was a great solution.  Others thought it inadequate because "he had not solved her underlying problem." If you have worked in the field you can picture the arguments easily, and even zip people you have known into one group or the other.

I am very much in the first group.  If there are underlying problems that need to be addressed, they are remarkably difficult to discern and define. The hydraulic pressure theory of anxiety and stress, which claims stopping up one leak will only cause another to burst out in another place just seems intuitively right to many people, but I just figure if that happens after a couple of leak-stoppages, we can look for the source of the pressure then - and we will have more diagnostic information to work with. I suspect that in many cases stopping the leak equals Problem Solved.

I say this a one who had OCD (still residual, but I hardly think about it now) and believes I would have had some obsession just from biology.  But odd factors in my environment likely influenced the content of the obsessions and compulsions. So I believe the second group is on to something. I just don't think they are right often enough.  Also, if you can make one of those hair dryer solutions you should just try it first, watching what happens.

I think this applies to social problems as well. Maybe there are always root causes somewhere, but I doubt it.  I think most of us have seen life problems resolve in almost humorously easy fashion with some adjustment when then smack our foreheads over, saying "I should have done this years ago!" Also, even when there are root causes I think we are overfond of assuming what they must be, based on what we think we can fix, rather than well-evidenced drivers of outcomes. Just because an associated condition is chronic does not mean it is a cause. It might also be an effect itself. Poverty, lack of school success, and unemployment come to mind as problems that are as likely to be carts as horses. Downstream effects of problems we dare not notice and name. There are few phrases as worrisome as "Well it just stands to reason..."


David Foster said...

I think the concept of 'Ask Why Five Times' is relevant here:

David Foster said...

Oh...I see that the post I linked above was never promoted to the Main Feed at Ricochet. Here's an open version at Chicago Boyz:

Grim said...

"Take the dryer with you" strikes me as perfectly acceptable.

james said...

Amateur hour: feel free to correct me.

I'd draw a distinction between a quirk and a mental illness. The latter prevents you from living a normal life. If some harmless role or habit lets you live reasonably normally, that doesn't seem to differ from a prescription drug that does the same thing. If you believe there are witches behind every tree, you probably don't go out much, but if your horseshoe amulet protects you, you run errands.

In another direction, autism makes certain modern jobs impossible, but there used to be room for sufferers--they just had certain quirks.

Maybe there's some deep underlying problem that will surface again somewhere else--but maybe your history has made the problem express itself in a specific form that you can manage.

JKS said...

I remember that article; I believe the story of the woman with OCD was part of a larger discussion of transgenderism. The implication, if I understood it, was that if you could resolve her obsession with the hair dryer by the relatively simple device of telling her to take it with her, why not tell a man who thinks he's a woman in the wrong body to grow his hair long and put on a dress? We'll all say you're a woman -- problem solved!

But the woman's OCD problem wasn't just a quirk; she was working but felt compelled to leave the office two or more times a day to drive home and check the hair dryer. It got so bad that she was in danger of losing her job. Scott and his colleagues may have risked dislocated shoulders from reaching around to pat themselves on the back for the brilliance and elegance of their solution . . . but it's not as if they actually, you know, cured her of anything. What are they going to suggest if two weeks later she starts to think she may have left the stove on . . .?

I realize that mental illness is a slippery concept and that you are the expert here, not I, but I still think that maybe sometimes looking for root causes is not such a bad idea.

Assistant Village Idiot said...

I think I hit that in my third paragraph. That there might be something that remains or returns is still a possibility, yes.

Donna B. said...

OCD behaviors are protective, though can certainly be taken to extremes. Some of us who weren't born with them have deliberately trained ourselves to such.

EXAMPLE - keys. After spending a lot of money on locksmiths to get me into my car, my office, my house, I deliberately trained myself to not close a door unless I could touch my keys. That was in the 1980s but I'm still beholden to it. Newer (or at least newer takes on old technology) are changing the way I deal with this. Now, I can close my car door if I can feel the fob in my pocket. This is a dramatic improvement from having to see and feel the keys in my hand before closing a car door. As a passenger, this was often awkward... as I'd stand outside the open car door and insist on seeing the keys in the driver's hand. It was only a few days ago, that I had to explain to my granddaughter why I didn't close the car door until she assured me she showed me the key fob.

As for appliances, for me it was the iron and the coffee pot. These days, I don't iron and the coffee pot turns off automatically, so I'm okay. However, I will not run the washing machine, dryer, or dishwasher unless I'm home during the entire cycle. OK, maybe I was born with some OCD tendencies...

Anamaria said...

And if the problem is not solvable by such an easy method? If the problem is unsolvable and untreatable? What then? All I can say, is the woman in the story was lucky. That would not have worked on me.

Earl Wajenberg said...

The take-the-dryer=with-you solution reminds me of Granny Weatherwax, the foremost witch in Terry Pratchett's acclaimed Discworld fantasy series. Her solution for a man who thought monsters were coming around his house at night was to give him a club. (She called this "headology.")

In the same vein, she never bothered to turn enemies into frogs; she made them think they had been turned into frogs. ("Dug a big swimming pond in his back yard. His wife says it's given him a whole new interest in life.")

Assistant Village Idiot said...

OCD is regarded as an anxiety disorder these last few decades, an attempt to bind anxieties that has run amok. And the OCD solutions are often quite good solutions and not out of control for some situations. It is only when they repeatedly do not work, but the sufferer keeps returning to them anyway that we try to vary that. A lot of "try this" solutions work, and should be our first pass. Yet after a few goes at it, sometimes we have to say "Okay, something else is happening." Sometimes those also are easy. Here. Take an SSRI. Or Prazosin for nightmares.

The opposite was psychoanalytic theory, which dictated that people spend years in personality dynamic therapy. Almost no one got better, most got stuck, a fair percentage even got worse. I now trust almost no therapy that has you referencing your childhood, unless it was in the worst 1% of abusiveness or neglect. I did it and it was a relief to tell the stories. It did no good I can see.

Assistant Village Idiot said...

As for monsters, fathers usually stumble upon this one with their children afraid of what is under the bed or in the closet. Instead of trying to explain that there are no monsters there, they learn to come in and yell at the monsters in a meaningful way to get out and leave their kid alone or there will be hell to pay.

We are not very different from those children. Hence politicians.

Grim said...

“As for monsters, fathers…”

I’ve probably told you this story, but I came at this one the other way. When my son complained about monsters, I said that yes, those frogs he was hearing outside were vampire frogs.

“There’s no such thing,” he protested.

“You’ve heard of vampire bats?”

“I don’t believe it,” he stiffly maintained.

“Do you ever hear those frogs in the daytime?”

After that I would sneak outside his window by night and scratch at it once in a while.

One night he threw in all the lights and came out with a Nerf gun, and I knew my work as a father was complete.

Cranberry said...

Many quirks like "have I left the oven on" are a way of dealing with something. I once did discover that I had left the oven on, upon returning to the house, which surprisingly neither reinforced nor stopped the quirk of oven worries popping up 1 mile down the road. (Teasing from my family has decreased the tendency.)

The something we are dealing with may not bother anyone else. Having no cause to be anxious may itself be a cause. Think of the hygiene hypothesis for allergies. As we live in a sterile environment, our immune system is uncalibrated by actual challenges, such as parasites. Thus, it overreacts to trifles like birch pollen.

I notice my children's peers are extremely likely to suffer from anxiety, much more than my generation suffered from anxiety. That may be an aftereffect of affluence, a surfeit of a lack of challenge.

Assistant Village Idiot said...

I still worry about dropping my keys down a storm drain or similar. I never have. A psychiatrist friend laughed that he actually had once dropped his keys down a storm drain - but still doesn't worry about it.