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Medical Which Mental Illness Encompasses This Problem?

  1. May 25, 2012 #1
    The problem is: the overwhelming compulsion to do something because you know you shouldn't do it.

    I'm reading a biography of Edgar Allan Poe and he complains of this compulsion having ruled his life, particularly in the case of his binge drinking.

    Derren Brown also exploits this compulsion in one of his segments in which he induces a girl to electrocute a kitten simply by giving her the task of not electrocuting the kitten. (He puts her in a room with a kitten in a metal cage, an on button, and tells her her job is to stay there alone for five minutes without pressing the button.)

    I'm thinking this must be a part of OCD or an anxiety disorder, but it might be something else, and I'm too lazy to hunt for it just now.
  2. jcsd
  3. May 25, 2012 #2
    Whatever it is, it has nothing to do with OCD.
  4. May 26, 2012 #3
    Are you sure about that?

    Here's a test for you:

    Don't think about white bears.
  5. May 26, 2012 #4
    As somebody who suffers from OCD himself, I am quite sure that it has nothing at all to do with OCD. And your example also has nothing to do with OCD.

    OCD has to do with frightening or obtrusive thoughts. These thoughts are so disturbing, that you usually feel compelled to do some kind of action to "eliminate" the thought.
    That said, everybody has that, but OCDD sufferers have it really bad.

    A typical OCD person would think of pushing the button and hurting the poor little cat. But the thought would frighten and disgust him so much that he ends up counting to 1024 (for example). OCD does not make people push the button. Pushing the button is evil and disturbing, and OCD does not drive you to doing evil things.
  6. May 26, 2012 #5
    Hehe, this isn't the same thing. In order not to think about polar bears you have to remember what not to think about. It's a joke catch 22.

    As I recall it was the initiation rite of some British men's club. They give you this task, not to think about polar bears, leave you alone for a while, then come back and ask if you thought about polar bears. The right answer is "No", i.e. to pretend you didn't.

    It's not impossible to avoid pressing the button at all in the case of the kitten. Certain people are susceptible to the urge to do it strictly because they were told not to. It has something to do with maintaining your autonomy at all costs. They would have no desire to kill the kitten at all. The point is to never let anyone else control you.
  7. May 26, 2012 #6
    this is not OCD. no anxiety.
    OCD is an anxiety disorder.
    this can be a fictional illness.
    it is not listed in DSM.
  8. May 26, 2012 #7
    I agree that it's not OCD, but not that it has nothing to do with OCD. I can say this from personal experience1 as well as someone with a family history that covers half the DSM. The idea is that it's the inability to suppress an unwanted thought, which can become amplified. I know there's some suggestion involved in this particular example which isn't usually the case with OCD (though it is, with the example I'll list below), but it's conceptually similar, even if not directly related.

    I personally have sought treatment2 for having compulsions wherein I imagine jumping in front of the trains I take every morning to school. It's not a voluntary thought and it's not a suicidal ideation, either. It's more comparable to the "what if?" thoughts that might intrude atop a tall building. While I wait for the train, I experience psychogenic pain, sweating, heavily breathing, and usually tense up and twitch pretty hard immediately before boarding and living the rest of the day, normally.

    1. My official diagnosis is actually autism.
    2. It doesn't work.
  9. May 26, 2012 #8
    What you're describing sounds similar enough to Poe's compulsions to be a lead. A couple of the characters in his stories have the same sort of panic and struggle not to throw themselves over cliffs. Did the therapist give you a name for this sort of thing?
  10. May 26, 2012 #9
    That looks like OCD. I know cases where people are driving a car and suddenly think that they're going to crash the car on purpose. Everybody has these thoughts usually, butThe OCD people think the thought is so bad that they avoid driving the car in the future. So this type of behaviour fits with OCD.
  11. May 26, 2012 #10
    O.K. Do you know if there's a name for this particular thing?
  12. May 26, 2012 #11


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    Obsessive (but not a disorder)?
  13. May 26, 2012 #12
    I think I found it: Intrusive Thoughts

    There are more listed at the site: http://www.peaceofmind.com/symptoms/thoughts/ [Broken]

    Edit: They are calling it "Pure Obsessional OCD".
    Last edited by a moderator: May 6, 2017
  14. May 26, 2012 #13
    Here's Poe's descant on the subject from The Imp of the Perverse:

  15. May 26, 2012 #14


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    Its part of the constellation of impulse control disorders. There are a lot. Some are specific (such as stealing), while others involve increased thrill seeking (think about it like a natural high). In terms of neural circuitry and pathophysiology they are somewhat (or thought to be) related to OCD. The mechanism to cope is different however. I don't think they are that well understood and like with other complex mental disorders this falls on the spectrum of human behavior (think some people are bigger thrill seekers than others), however we don't consider them a disorder until they are pathological (ie; causing harm to self or others).

    Often they are related to substance abuse and substance abuse in and of itself can kind of be thought of as an acquired impulse control disorder (don't have time to elaborate, but do look into how addiction affects dopaminergic systems in the reward circuitry of the brain--good introduction at wikipedia)
  16. May 26, 2012 #15
    Thanks, bobze. The first wiki article is pretty short. I found some more comprehensive ones on the subject and it seems to fit as well as the "pure-O" explanation.

    Poe was a binge drinker, not the type that is always somewhat drunk every day. He could abstain for periods of months, but then, suddenly, he'd drink. Once he got started he might go on a 5 day bender before he stopped. He claimed he got no pleasure whatever from it. Indeed, there are reports of him drinking so much so fast that he'd be passed out in half an hour. Many people saw him take whole glasses of wine in one gulp. He always said he did it because he felt he shouldn't, and that thought, that he shouldn't, is what tantalized him, not being drunk.
  17. May 26, 2012 #16


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    The root of it is that the brain is wired to respond to the focus of attention with action. So the simple uncomplicated thing is you notice the traffic lights have turned green and you go.

    The more complicated thing that brains can do is inhibit action. So the fact we can sit quietly at a red even while we are itching to go, is due to prefrontal control over habitual responses. We can be focused on a possibility - driving away - and yet hold off until the moment is right. Some further thing happens, like the light changing.

    What you are talking about is when we become caught up in paying strong attention to something we must absolutely not do - swerve into other cars, jump off buildings, electrocute a cat.

    We know that we could just automatically suddenly do these things. All the triggering stimuli are horribly bright in our minds. The edge of the building, the presence of the other cars, the sight of the button. In effect, we are seeing screaming green lights that raises the fear our bodies will suddenly betray us and act. So now we are caught up in a battle to suppress those urges.

    An obssessive personality might find it difficult to control their attention enough to just stop noticing the other cars, the edge, etc. But it is actually unlikely they will act out of habit unless they had previously practiced such lethal reactions to these stimuli.

    The Derren Brown example you cite - I see he calls it negative suggestion - does not really fit into this explanation for intrusive thoughts.

    You seem to be suggesting the girl was showing something a bit more pathological - a bloody mindedness or oppositional defiant disorder. Being told strongly not to do something would make you strongly want to do it.

    Well we all feel that too. But the girl, again apparently selected following pre-show quizzing to find susceptible types, would seem to be complying to the unspoken demands of a "hypnotic" situation rather than reacting willfully against an authority figure.

    So it is all related to the same basic brain architecture - the interaction between conscious level planning, willing, attending, and habit level acting, executing, responding.

    But hypnosis is the opposite of defiance perhaps. It results from allowing someone else to direct your attention and produce responses "out of your control".
  18. May 26, 2012 #17


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    Whatever it's called, judging by the contents of folk tales, fairy stories, etc from all over the world it's a very common human condition. Disobeying an "arbitrary" order not to do something occurs often as a plot device.

    Arguably the first recorded example is in Genesis chapter 3...
  19. May 26, 2012 #18

    I would call it the power of suggestion.
  20. May 26, 2012 #19
    Yes, the classic one might be the story of Bluebeard. You could call it Bluebeard Syndrome. Maybe Phizer can come up with an expensive pill for it.

    I once saw a Tamil movie in which the hero gets taken up to heaven by a goddess. He gets shown a door and told to never enter it. After having beaten up the god of Death he goes back to the door alone. Then he turns around and walks away. I thought that was SO cool.
  21. May 27, 2012 #20
    I think you're right.

    My goal here is to figure out what was going on with Poe and to name it in modern psychological/psychiatric terms.

    In the story I linked to, The Imp of the Perverse, he is very articulate but he's describing this from scratch with no body of psychological/psychiatric rigor to draw on, because there was no such discipline in place at the time (1845). He is left having to allude to, but dispute, phrenology, the only thing there was in his day that made claims to having sorted any of this out. That being the case, I am extremely impressed by his powers of self-examination and ability to articulate his experience.

    However, he seems to fit into an area of Psychiatry I'm not all that conversant with, so I'm inviting others to be a sounding board for me.

    I am glad you brought up Oppositional Defiant Disorder. It's the third dynamic that has to be considered in sorting this out.

    The list is now:

    1.) Pure OCD

    2.) Impulse Control Disorder

    3.) Oppositional Defiant Disorder

    Number 2 is the one I most suspect applies least to Poe. In this disorder the person's internal censor simply fails to kick in. There is no struggle to control themselves: they have an impulse, they act on it. Phineas Gage. The brain circuit that would normally warn them an action might be dangerous or wrong is simply not operating.

    I'll stop here and see if you agree or not that Impulse Control Disorder probably doesn't apply to Poe.
  22. May 27, 2012 #21
    It can be separated into different classes, though. The Genesis story is more about falling prey to a sociopath than about disobedience. Adam and Eve were completely fine with the prohibition until the smooth talking third party persuaded them otherwise.

    This is quite a bit different than disobeying an order because you don't want some monkey on your back giving you orders. In Oppositional Defiance Disorder, anyone who gives you an order is perceived as merely trying to control you.

    Pandora's Box is about yet a third dynamic. She was quite simply overwhelmed by curiosity, not the desire to disobey Zeus:

    This is the Derren Brown video:


    Jump forward to 6:25, and we see a segment where small kids succumb to opening the box very much like Pandora, out of overwhelming curiosity. The task of sitting with the box right there in front of them, nothing else to think about or do, is too much for them.

    That's followed by a segment showing a bunch of adults unable to resist looking through a hole in a fence surmounted by a sign saying, "Do Not Look Through This Hole."
  23. May 27, 2012 #22


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    This discussion from Daniel Wegener is possibly useful.

    http://www.wjh.harvard.edu/~wegner/pdfs/Wegner%20Ironic%20Processes%201994.pdf [Broken]

    But having watched that Derren Brown clip, what was going on there looks more like a case of straight suggestion.

    Note the way Brown kept banging the table and clicking his pen - clearly this was about implanting the urge to hit the button, creating a non-verbal kinesthetic image that would sit separately from the verbal command not to push the button.

    So the girl is conflicted by two competing ideas. And the suggestion to "be mischevous", along with the fact that the whole set-up was deliberately disorienting and unreal, creates a permissive context,

    The fact that she did push the button was remarkable - I know I wouldn't :smile:. The way the tension built up on her face as the clock ticked down shows there was an actual conflict of ideas. And being presumably chosen as one of the highly suggestible 10 per cent, the implanted idea won out over the verbal command.

    The kids failing the pop-up box test, and adults the don't look here test, seem different again as this would be simply curiosity getting the better of them. So no different from giving in to the temptation of a drink or a chocolate. Satisfying the itch of curiosity is rewarding. And we often choose short-term gratification over longer-term rationalisation.

    I wouldn't really call this an impulse control failure either as the decision is a straightforward balancing of a significant reward that is close at hand against punishing consequences that are judged to be either small or remote.

    All these different scenarios illustrate the complexity of the mental machinery involved.

    Take Wegner's mention of Baudouin's law of reversed effort. I've learnt from bitter experience on the mountain bike trail that the way to avoid big rocks and rutted corners is absolutely not to look at the hazards. Look ahead to the clear path where you want to emerge. Fill your motor pathways with the right target information because they are trained to aim for where you attend.
    Last edited by a moderator: May 6, 2017
  24. May 27, 2012 #23
    I read the abstract at the top and the first paragraph. Very interesting to see someone use Poe's observation as a springboard. It's an awfully long paper, though, and if there's something in particular you think I should look at I'd be grateful if you just quoted it here.

    I wish they had interviewed her afterward and asked why she thought she ended up pushing it.

    What he said toward the beginning is that he selected her because she demonstrated a tendency to be self-critical. This suggest to me that he was hoping to get her ruminating on, and eventually believing, the notion she couldn't pass this "test", to criticize herself to the point she had to relieve the tension by intentionally failing it and getting it over with. It's not clear from the video that's what he did, though, but it might have been too subtle to catch. The things that read to the audience as suggestions are the ones you pointed out.

    Extending your observation he created a permissive atmosphere:

    He advises her not to play with the cat, to think about something else. He actually sets her the task of drawing to get her mind off it. She draws a cat, thereby defying his advice. To my surprise, he approved of the drawing. But, approving of her rejecting his advice tells her he will approve if she also presses the button. I think that's how that went down, anyway. I wonder how confident he was that she would draw a cat. I suspect he was 80% sure.

    Yeah, I agree with this take.


    I'm intrigued to uncover why it becomes pathologically intense, as in Poe's case. He tended to fall off the wagon right at the critical points when that would do the most damage, when months of sobriety has started to pay off and things were looking up. These are the times he'd be most likely to say to himself, "Everything's looking good and will proceed nicely - if I don't start drinking again." Which thought would torment him until it drove him to a bar.
    Last edited by a moderator: May 6, 2017
  25. May 27, 2012 #24
    Please correct me if I'm wrong but you do seem to be implying that mental illness is folk tales, fairy tales, etc. Just a warning if that is the case, children in elementary schools are encouraged to write fairy tales:

    Also, many major universities have "Creative Writing" courses wherein you are instructed to write fiction stories. :biggrin: We can't be knocking down "Creative Writing" courses at major universities. :smile: They sure aren't supporting or endorsing mental illness in their students!:biggrin:
  26. May 27, 2012 #25
    He didn't say that at all... Read his post again.
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