I agree with your point here—strongly. But I also think you’re being unfair to Caplan. While his position is (I now realize) ridiculous, the example you gave is not.
In his “gun to the head” analogy, Caplan suggests that OCD isn’t really a disease! After all, if we put a gun to the head of someone doing (say) repetitive hand washing, we could convince them to stop. Instead, Caplan thinks it’s better to just say that the person just really likes doing those repetitive behaviors.
His position would not be that they like doing those behaviors per se, but rather, they have a very strange preference that makes those behaviors seem optimal. Caplan would probably call it “a preference for an unusually high level of certainty about something”. For example, someone with OCD needs to perceive 1 million:1 odds that they’re hands are now clean, while normal people need only 100:1 odds.
So the preference is for cleanliness-certainty, not the act of hand-washing. To get that higher level of certainty requires that they wash their hands much more often.
Likewise, an OCD victim who has to lock their door 10 times before leaving has an unusually high preference for “certainty that the door is locked”, not for locking doors.
Again, I don’t agree with this position, but it’s handling of OCD isn’t that stupid.
Let’s say I cracked my first knuckle. Well, of course I’m going to crack the other three to balance things out. But then I mess up—my ring finger is only 70% cracked. I can feel it in the joint, a sort of localized anxiety (sort of like an itch, or a joint that needs stretching, but it’s a purely psychological irritation). Obviously I can’t 30% crack my knuckle—that’s no different than moving the finger. So I have to over crack it, up to 130%, and then follow up with the other three fingers.
But now I”ve hit a problem—I’ve cracked each finger twice, that’s not a good number. Things feel worse than they did before the crack. I’d better square things out, so that each finger has been cracked four times—that’s a good number. But now my right hand is bothering me, so to even it out I crack each finger there four times. And… oh, what the hell. We’ll crack each finger sixteen times. That’s 2^8 * 2^4 - gorgeous. I mean, just look at that notation! How much prettier could you want it to be?
Everything’s fine until next time I need to crack something… shudder
I eventually forced myself to stop doing this during my last years of High School. It was ridiculous, and I knew it, but each time I encountered it I’d have that itch. But I forced myself to ignore it, the same way you can’t scratch your nose while you’re on stage, and eventually I broke the habit. But even thinking about it now makes me want to do something that’s exponentially symmetrical...
Why is it specifically locking up ten times (it would actually need to be an odd number)? Someone with OCD will do things in, say, multiples of three. Under the certainty view, 14 times would be better than 12, but someone who needs to work in multiples of three would not find it preferable.
Because their utility function (as believed by Caplan) is not strictly increasing in the number of times you do it. Utility goes up as you approach the desired level of certainty (such as 1,000,000:1 odds), then you hit diminishing returns.
Just like how you like clean hands, but will be okay with only being 99% sure they’re clean enough.
As I understand it, a person (or at least some people) with OCD will need to, say, lock a door precisely nine times. If he somehow locked it 11 times, he’d be very distressed. It’s like I’m happy when I’m 99.9% sure my hands are clean, but miserable when I’m 99.99% or 99 % sure they’re clean. It doesn’t make sense. That’s not a preference for cleaner hands, or more locked doors. It’s, gasp, crazy.
Not to mention some of this behaviour is binary, like locking doors or turning on lights. No matter how many times I flip a switch or turn a lock, if it’s odd, it’ll be locked/on, and if it’s even, it’ll be unlocked/off. I just don’t think most OCD behaviour actually follows patterns that “additional certainty” would predict.
i have some experience with OCD and i think a good way of defining it would be: people with OCD repeat their compulsive rituals as a form of negative reinforcement. when a ritual is interrupted or unable to be completed in some way, the person will usually suffer a tremendous amount of anxiety. this anxiety is relieved upon completion of the ritual making it a strong source of negative reinforcement and causing that person to repeat it in the future. while the initial [i]basis[/i] of the ritual is “crazy” or irrational (obviously locking a door nine times serves no practical purpose in of itself), the [i]use[/i] of the ritual is not—it removes or prevents anxiety.
Hey, take it up with pjeby if you think you understand the issue better, it’s well beyond my pay grade at this point. He linked to a peer-reviewed paper substantiating the certainty thesis.
You should at least consider the possibility that OCDers really do just need to be more sure, and the number-based rituals are simply the result of them having noticed that that number comforted them in the past, and then cargo-cultishly inferring that the number is somehow special.
I still think that Caplan’s position is dumb. It’s not so much a question of whether his explanation fits the data (although I think Psychohistorian has shown that in this case it does not), it’s that it’s just plain weird to characterize the obsessive behavior done by people with OCD as a “preference”. I mean, suppose that you were able to modify the explanation you’ve offered (that OCD people just have high preferences for certainty) in a way that escapes Psychohistorian’s criticism. Suppose, for instance, you simply say “OCD people just have a strong desire for things happening a prime number of times”. This would still be silly! OCD people clearly have a minor defect in their brains, and redefining “preference” won’t change this.
Ultimately, this might just be a matter of semantics. Caplan may be using “preference” to mean “a contrived utility function which happens to fit the data”, which can always be done so long as the behavior isn’t contradictory. But this really isn’t helpful. After all, I can say that the willow’s “preference” is to lean in the direction of the wind and this will correctly describe the Willow’s behavior. But calling it a preference is silly.
Thanks for the comment. This discussion has helped to clarify my thinking.
Because I think people with OCD do have, contra Caplan, a compulsion to do those specific acts, not a compulsion to be 99.99999% sure of certain things. Wanting that much certainty in such a narrow area is a very unlikely state, and if it were just about certainty, they would come up with different ways to achieve that certainty, not just do the same thing over and over.
“Because I think people with OCD do have, contra Caplan, a compulsion to do those specific acts, not a compulsion to be 99.99999% sure of certain things. ”
Person with OCD here, reporting late to the party (I’m always behind in my reading).
SilasBarta, you are correct.
It must be remembered that sometimes what OCD people do is not check the lock nine times, but touch the red dish every time we go out the back door. Sometimes we have a nagging doubt that our mom will die if we don’t (magical thinking). This isn’t to be read as a preference for being more sure that mom won’t die, since we know damn well that if she does it won’t be because we didn’t touch the dish. It’s, as someone said, crazy.
The compulsion and the attempt to satisfy it are uncomfortable.
Sometimes we have a nagging doubt that our mom will die if we don’t (magical thinking). This isn’t to be read as a preference for being more sure that mom won’t die, since we know damn well that if she does it won’t be because we didn’t touch the dish.
What you’re describing isn’t an OCD symptom; it’s just a garden-variety irrational belief. The fact that you “know” something is false doesn’t stop you from behaving as if it’s true—see the previous examples here about haunted houses and serial killers.
(To be clear: I don’t mean the entire combination of behaviors isn’t OCD; I just mean the part where you act on a belief you “know” to be untrue. That part, everybody has.)
Has anybody ever tried installing a little camera above a stove with a live feed (checkable by cell phone) to see if that helped people panicking about having left it on?
I sometimes control my OCD by crossing my fingers in a certain very odd pattern whenever I do something (like locking a door). Then, as soon as I come to a notebook or a computer with my fingers still crossed, I write down “I locked the door at 5:27 PM, August 10, 2009”. When I’ve done this, I can just look at the paper and my compulsion to check whether or not the door is really locked mostly goes away.
I used to try the same thing without the finger crossing, and I found that I was always able to believe there was just the tiniest chance that I might have formed the false memory of having locked the door between locking it and reaching the notepad. Because I don’t cross my fingers except while in the act of locking the door and I don’t write a note unless my fingers are crossed, I can dispel that last nagging doubt. From a rational point of view it’s not very sensible, but it seems to work okay.
Yes—it’s definitely good to have a reliable source of information about these things. Like having the days-of-the-week written on certain everyday medications. You can just go look and know whether or not you’ve taken today’s dose. On the occasions where I’ve had to take medicine that doesn’t have these (eg a course of antibiotics) I’ve had that “nagging sense” too → not knowing means you could either skip a dose, or double-dose. So writing the days of the week on the plastic next to each pill helps with that. Having something that you can check easily and that you trust helps reduce the anxiety a lot.
This was particularly a problem for me after my stroke, because the brain damage made my memory unusually unreliable. Eventually I put a sheet of paper up by my pills and checked off each day after I took them. (Actually, on bad days, I would sometimes lose track between the first bottle and the third of which pills I’d already taken, so I established the habit of moving each one from left to right after I took it.)
...I was always able to believe there was just the tiniest chance that I might have formed the false memory…
…
From a rational point of view it’s not very sensible, but it seems to work okay.
A healthy skepticism about the reliability of memory is actually very rational (the subject of the worry is a different story). I’m rather good at remembering facts, but I’m positively terrible at remembering things like “when I leave I must take this item that I usually don’t”. I’ve tried constantly reminding myself, worrying that I’ll forget, and then I occasionally forget anyways. But this sort of memory is very easy to outsource, eg I can misplace my keys, shoes, or glasses on something and then there’s no way I’m forgetting it when I leave, nor do I have to worry. I’ve occasionally forgotten the basement lights on (kick door closed while carrying a basket of laundry, wouldn’t be noticed until next visit to basement or outside at night), now I never close the basement door until I turn off the lights. My street has alternate parking, and I set an alarm so I won’t forget.
If I worried excessively about the state of my door, I’d keep a binary toggle on my keychain, and toggle it when I locked/unlocked the door. Dunno if that would work for OCD, I’m only absent-minded. But locking the door would be a habit with a reliable trigger. I can fight any specific case of absentmindedness easily with a habit and reliable trigger.
Unless you have OCD yourself, I’m not sure your opinion on that counts. You should probably ask Yvain… who appears to indeed be controlling certainty, not being compelled to engage in specific behaviors.
Okay, fair point. Still, you gotta give me props for noticing the right hypothesis[1] based on such little data—that’s half the battle, remember! -- even if I did subsequently reject it because OCDers are so predictably bad at identifying the regularity behind their compulsions.
Arguably, I have a low-grade form of OCD myself. I always have to check the back end of my car when I park it in my garage to make sure the garage door won’t close on it, even though I’ve used the same garage and roughly similar cars for the last four years, and have a wooden block to mark when it’s in far enough.
But unlike cargo cult OCDers, I don’t find some kind of magic number that satisfies me. Sometimes I just say “to hell with it” and don’t check. Sometimes I go back twice to check. Usually, just once. But I always recognize that I’m doing it to make sure my car is in far enough, and so I can identify ways of making myself not “have to” check, if I ever thought it was worth the effort, or found my ritual too bizarre. I can put a mirror or camera in, for example.
In fact, the reason I never considered my habit OCD until now was because it isn’t accompanied by a hard-headed focus on a specific act, as opposed to a specific level of certainty.
I agree with your point here—strongly. But I also think you’re being unfair to Caplan. While his position is (I now realize) ridiculous, the example you gave is not.
His position would not be that they like doing those behaviors per se, but rather, they have a very strange preference that makes those behaviors seem optimal. Caplan would probably call it “a preference for an unusually high level of certainty about something”. For example, someone with OCD needs to perceive 1 million:1 odds that they’re hands are now clean, while normal people need only 100:1 odds.
So the preference is for cleanliness-certainty, not the act of hand-washing. To get that higher level of certainty requires that they wash their hands much more often.
Likewise, an OCD victim who has to lock their door 10 times before leaving has an unusually high preference for “certainty that the door is locked”, not for locking doors.
Again, I don’t agree with this position, but it’s handling of OCD isn’t that stupid.
I used to have a mild case of OCD.
Let’s say I cracked my first knuckle. Well, of course I’m going to crack the other three to balance things out. But then I mess up—my ring finger is only 70% cracked. I can feel it in the joint, a sort of localized anxiety (sort of like an itch, or a joint that needs stretching, but it’s a purely psychological irritation). Obviously I can’t 30% crack my knuckle—that’s no different than moving the finger. So I have to over crack it, up to 130%, and then follow up with the other three fingers.
But now I”ve hit a problem—I’ve cracked each finger twice, that’s not a good number. Things feel worse than they did before the crack. I’d better square things out, so that each finger has been cracked four times—that’s a good number. But now my right hand is bothering me, so to even it out I crack each finger there four times. And… oh, what the hell. We’ll crack each finger sixteen times. That’s 2^8 * 2^4 - gorgeous. I mean, just look at that notation! How much prettier could you want it to be?
Everything’s fine until next time I need to crack something… shudder
I eventually forced myself to stop doing this during my last years of High School. It was ridiculous, and I knew it, but each time I encountered it I’d have that itch. But I forced myself to ignore it, the same way you can’t scratch your nose while you’re on stage, and eventually I broke the habit. But even thinking about it now makes me want to do something that’s exponentially symmetrical...
NO! NO, I WON’T GIVE INTO YOU OCD!
;)
Why is it specifically locking up ten times (it would actually need to be an odd number)? Someone with OCD will do things in, say, multiples of three. Under the certainty view, 14 times would be better than 12, but someone who needs to work in multiples of three would not find it preferable.
Because their utility function (as believed by Caplan) is not strictly increasing in the number of times you do it. Utility goes up as you approach the desired level of certainty (such as 1,000,000:1 odds), then you hit diminishing returns.
Just like how you like clean hands, but will be okay with only being 99% sure they’re clean enough.
As I understand it, a person (or at least some people) with OCD will need to, say, lock a door precisely nine times. If he somehow locked it 11 times, he’d be very distressed. It’s like I’m happy when I’m 99.9% sure my hands are clean, but miserable when I’m 99.99% or 99 % sure they’re clean. It doesn’t make sense. That’s not a preference for cleaner hands, or more locked doors. It’s, gasp, crazy.
Not to mention some of this behaviour is binary, like locking doors or turning on lights. No matter how many times I flip a switch or turn a lock, if it’s odd, it’ll be locked/on, and if it’s even, it’ll be unlocked/off. I just don’t think most OCD behaviour actually follows patterns that “additional certainty” would predict.
i have some experience with OCD and i think a good way of defining it would be: people with OCD repeat their compulsive rituals as a form of negative reinforcement. when a ritual is interrupted or unable to be completed in some way, the person will usually suffer a tremendous amount of anxiety. this anxiety is relieved upon completion of the ritual making it a strong source of negative reinforcement and causing that person to repeat it in the future. while the initial [i]basis[/i] of the ritual is “crazy” or irrational (obviously locking a door nine times serves no practical purpose in of itself), the [i]use[/i] of the ritual is not—it removes or prevents anxiety.
Hey, take it up with pjeby if you think you understand the issue better, it’s well beyond my pay grade at this point. He linked to a peer-reviewed paper substantiating the certainty thesis.
You should at least consider the possibility that OCDers really do just need to be more sure, and the number-based rituals are simply the result of them having noticed that that number comforted them in the past, and then cargo-cultishly inferring that the number is somehow special.
I still think that Caplan’s position is dumb. It’s not so much a question of whether his explanation fits the data (although I think Psychohistorian has shown that in this case it does not), it’s that it’s just plain weird to characterize the obsessive behavior done by people with OCD as a “preference”. I mean, suppose that you were able to modify the explanation you’ve offered (that OCD people just have high preferences for certainty) in a way that escapes Psychohistorian’s criticism. Suppose, for instance, you simply say “OCD people just have a strong desire for things happening a prime number of times”. This would still be silly! OCD people clearly have a minor defect in their brains, and redefining “preference” won’t change this.
Ultimately, this might just be a matter of semantics. Caplan may be using “preference” to mean “a contrived utility function which happens to fit the data”, which can always be done so long as the behavior isn’t contradictory. But this really isn’t helpful. After all, I can say that the willow’s “preference” is to lean in the direction of the wind and this will correctly describe the Willow’s behavior. But calling it a preference is silly.
Thanks for the comment. This discussion has helped to clarify my thinking.
Why not?
Because I think people with OCD do have, contra Caplan, a compulsion to do those specific acts, not a compulsion to be 99.99999% sure of certain things. Wanting that much certainty in such a narrow area is a very unlikely state, and if it were just about certainty, they would come up with different ways to achieve that certainty, not just do the same thing over and over.
“Because I think people with OCD do have, contra Caplan, a compulsion to do those specific acts, not a compulsion to be 99.99999% sure of certain things. ”
Person with OCD here, reporting late to the party (I’m always behind in my reading).
SilasBarta, you are correct.
It must be remembered that sometimes what OCD people do is not check the lock nine times, but touch the red dish every time we go out the back door. Sometimes we have a nagging doubt that our mom will die if we don’t (magical thinking). This isn’t to be read as a preference for being more sure that mom won’t die, since we know damn well that if she does it won’t be because we didn’t touch the dish. It’s, as someone said, crazy.
The compulsion and the attempt to satisfy it are uncomfortable.
What you’re describing isn’t an OCD symptom; it’s just a garden-variety irrational belief. The fact that you “know” something is false doesn’t stop you from behaving as if it’s true—see the previous examples here about haunted houses and serial killers.
(To be clear: I don’t mean the entire combination of behaviors isn’t OCD; I just mean the part where you act on a belief you “know” to be untrue. That part, everybody has.)
Has anybody ever tried installing a little camera above a stove with a live feed (checkable by cell phone) to see if that helped people panicking about having left it on?
I sometimes control my OCD by crossing my fingers in a certain very odd pattern whenever I do something (like locking a door). Then, as soon as I come to a notebook or a computer with my fingers still crossed, I write down “I locked the door at 5:27 PM, August 10, 2009”. When I’ve done this, I can just look at the paper and my compulsion to check whether or not the door is really locked mostly goes away.
I used to try the same thing without the finger crossing, and I found that I was always able to believe there was just the tiniest chance that I might have formed the false memory of having locked the door between locking it and reaching the notepad. Because I don’t cross my fingers except while in the act of locking the door and I don’t write a note unless my fingers are crossed, I can dispel that last nagging doubt. From a rational point of view it’s not very sensible, but it seems to work okay.
Yes—it’s definitely good to have a reliable source of information about these things. Like having the days-of-the-week written on certain everyday medications. You can just go look and know whether or not you’ve taken today’s dose. On the occasions where I’ve had to take medicine that doesn’t have these (eg a course of antibiotics) I’ve had that “nagging sense” too → not knowing means you could either skip a dose, or double-dose. So writing the days of the week on the plastic next to each pill helps with that. Having something that you can check easily and that you trust helps reduce the anxiety a lot.
(nods) Absolutely.
This was particularly a problem for me after my stroke, because the brain damage made my memory unusually unreliable. Eventually I put a sheet of paper up by my pills and checked off each day after I took them. (Actually, on bad days, I would sometimes lose track between the first bottle and the third of which pills I’d already taken, so I established the habit of moving each one from left to right after I took it.)
Repeated checking CAUSES memory distrust.
In obsessive-compulsive disorder (OCD) checkers distrust in memory persists despite extensive checking.
Source: http://www.ncbi.nlm.nih.gov/pubmed/12600401
A healthy skepticism about the reliability of memory is actually very rational (the subject of the worry is a different story). I’m rather good at remembering facts, but I’m positively terrible at remembering things like “when I leave I must take this item that I usually don’t”. I’ve tried constantly reminding myself, worrying that I’ll forget, and then I occasionally forget anyways. But this sort of memory is very easy to outsource, eg I can misplace my keys, shoes, or glasses on something and then there’s no way I’m forgetting it when I leave, nor do I have to worry. I’ve occasionally forgotten the basement lights on (kick door closed while carrying a basket of laundry, wouldn’t be noticed until next visit to basement or outside at night), now I never close the basement door until I turn off the lights. My street has alternate parking, and I set an alarm so I won’t forget.
If I worried excessively about the state of my door, I’d keep a binary toggle on my keychain, and toggle it when I locked/unlocked the door. Dunno if that would work for OCD, I’m only absent-minded. But locking the door would be a habit with a reliable trigger. I can fight any specific case of absentmindedness easily with a habit and reliable trigger.
Unless you have OCD yourself, I’m not sure your opinion on that counts. You should probably ask Yvain… who appears to indeed be controlling certainty, not being compelled to engage in specific behaviors.
Or of course, you could always consult some of the research...
Okay, fair point. Still, you gotta give me props for noticing the right hypothesis[1] based on such little data—that’s half the battle, remember! -- even if I did subsequently reject it because OCDers are so predictably bad at identifying the regularity behind their compulsions.
Arguably, I have a low-grade form of OCD myself. I always have to check the back end of my car when I park it in my garage to make sure the garage door won’t close on it, even though I’ve used the same garage and roughly similar cars for the last four years, and have a wooden block to mark when it’s in far enough.
But unlike cargo cult OCDers, I don’t find some kind of magic number that satisfies me. Sometimes I just say “to hell with it” and don’t check. Sometimes I go back twice to check. Usually, just once. But I always recognize that I’m doing it to make sure my car is in far enough, and so I can identify ways of making myself not “have to” check, if I ever thought it was worth the effort, or found my ritual too bizarre. I can put a mirror or camera in, for example.
In fact, the reason I never considered my habit OCD until now was because it isn’t accompanied by a hard-headed focus on a specific act, as opposed to a specific level of certainty.
[1] in a devil’s advocate defense of Caplan