Psychiatry professor takes new approach to helping compulsive washers

(Medical Xpress)—Stanley Rachman, emeritus professor at the Institute of Psychiatry in London, has published a World View column in the journal Nature, detailing a new strategy for helping people overcome obsessive washing—an OCD affiliated condition that comes about quite often after someone experiences a traumatic event. Rachman's article is part of a series Nature is running in response to a new initiative being undertaken by the European Union and the United States to mimic the human brain in an artificial setting. The point is to highlight how such research might help better understand the real brain and perhaps offer ways to help fix problems in it, when they arise.

Obsessive washing, whether just the hands or the whole body, can be a debilitating condition. People who suffer from it feel as if no matter how much or often they wash, they are still dirty. Over the years, psychiatric researchers have developed a technique to help people with the condition—it's called exposure and response prevention. The idea is to expose the person in a safe way to whatever they feel is causing them to feel dirty, until they no longer feel it. More recent research has found that there is another type of compulsive washing, however, one that is based more on mental dirtiness than on something in the real world. They call in mental contamination and say it generally comes about as a result of a traumatic incident, most often rape. Women feel that hard as they try, they cannot wash away the dirty feelings that are left behind. And unlike other forms of germ-phobic type obsessive washing, it is not based on something physical, such as fluids that may have been involved. In this instance, it is of course impossible to expose sufferers to the real world embodiment of their fear, thus another approach must be used.

That new approach has been developed by Rachman and colleagues, and involves reprogramming the neural circuits that exist in the brain—similar in many respects to the way researchers hope to reprogram artificial circuits in the future. They take a cognitive approach that delves into the circumstances of the trauma in an effort to dig out the cause of the feelings of dirtiness and then to help them find another way to deal with it. Rachman and his team have even tested their approach, running a trial with female rape victim volunteers. He reports they found significant improvements in symptoms in a many of them.

The approach taken by Rachman and his team to treat compulsive washing suggests that reprogramming artificial neural networks of the future might take a far different form than what has been used up to this point, namely, reworking code. Instead, networks may be taught to unlearn "dirty" things that have been learned, or to heal circuits that have been damaged due to traumatic events by using what are now considered therapeutic methods.

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