Strange but True

I know you’re going to think I’m incredibly reliant on the NYTimes, and I won’t argue the point, nevertheless its articles can be quite enlightening. Now that I’ve had a chance to catch up on some reading, I also found an article in the NYTimes Mag. from July 20th interesting. The title is “Maria Bamford vs. Her Brain.” Immediately the name Bamford jumped out at me, then I learned that she suffers from a particular form of OCD called “unwanted thoughts syndrome” which presents as compulsive thoughts that the afflicted person can’t seem to stop thinking. Later the article notes that inappropriate thoughts are not uncommon in most of us, but “in the mind of someone with O.C.D., they are more likely to lodge themselves and repeat. The thoughts don’t tend to inspire actions, only fear. It’s like having a homegrown terrorist in the brain.” According to the article about her, “[Bamford] sometimes talks about her brain as an entity not entirely in her command, as something unruly and perhaps best understood from a slight distance.” She speaks of her brain in the third person and she has found that her brain “behaves best in controlled settings, thriving on rules and boundaries.” Like ME’s interest in reading medical journals to keep up with the latest medical advances, Bamford is a voracious reader of all sorts of writing including highbrow literature.

The therapy that has been the most effective for Bamford is “a technique called ‘flooding.’ She was instructed to write down her compulsive fears in exacting detail, then to record herself reading them out loud and, finally, to play them back for herself, again and again, until they stopped causing her anxiety.” She found the procedure difficult, however, the unwanted thoughts went away.

I wouldn’t diagnose ME with OCD exactly, but he has many OCD-like behaviors that we see more pronounced in S6 when Michael’s OCD is in evidence too. His blood phobia could be accompanied by unwanted thoughts that relate to the initial reason he gives for the onset of the phobia. He met the family of a patient he was preparing to operate on and suddenly found he couldn’t cut into the patient. It’s quite possible the prospect of cutting into the patient became associated with inappropriate thoughts that were unwanted and hard to stop. ME’s inclination to stick to controlled settings that follow rules and boundaries would then be a means for him to control his brain.

They could try therapy that includes “flooding” with potential success and the potential for humor as well.

Originally posted 2014-07-28 13:54:45.

7 thoughts on “Strange but True

  1. Santa Traugott

    I wouldn’t diagnose ME with OCD either, but his phobia is really a specific form of anxiety disorder. “Best practices” treatment of phobias, at least a few years ago, is actually a controlled form of “flooding.” It’s a gradually increased exposure to the stimulus that one is avoiding — with the object being to take yourself to a level where your anxiety is very high but not yet out of control, sit with it, let it diminish — repeat until the stimulus no longer causes anxiety– then move on to something even more anxiety provoking, gradually increasing the dosage until the patient is no longer afraid of the highest height, the smallest space, the biggest spider or in ME’s case, buckets of blood. The idea is that if you can sit with your anxiety for a while, your body’s anxiety reaction automatically subsides, and that learning this gives you the ability to tolerate the feared stimulus. This is the process that Dr. Milligan was guiding him through. He needed to over-train though — probably for him, the equivalent of working in a MASH unit.

    The thing about panic disorders is that their origin is often quite mysterious to the sufferer, and the reaction to the feared thing is automatic, physiological, even before any rational thought associating with anything.

    I do think that a lot of ME’s prissiness, and orderliness, is about anxiety control. It’s a way of keeping at bay thoughts or emotions that arouse anxiety. And my tentative hypothesis, if I were to start working with him, would be that the dislocations accompanying his surrendering control of his living arrangements with his marriage and fatherhood, were very troubling to him, because it meant that his usual mechanisms of anxiety control were not as readily available to him — i.e., his ability to control his own environment is obviously vastly diminished.

  2. Post author

    Thank you Santa. You seem to be saying something along the lines of what I said some time ago — that self-desensitization therapy is rarely successful and Martin’s blood phobia is shown to be particularly intransigent. We’re on to S7 soon and he’s still dealing with it. (Of course, it’s a continuing problem not only because he hasn’t used the best therapeutic methods, but also because of its comedic and dramatic applications.)

    I definitely agree that anxiety is often controlled by a variety of methods like counting, or tapping, or other superstitious behavior (much like the show gives Tricia). Sometimes people control their anxiety with exercise or, in Martin’s case, fixing clocks. Is it possible that his compulsive medical testing is another form of anxiety control? He’s concerned about the return of his blood phobia, but the loss of control in his life that he hadn’t expected is feeling crowded and required to make too many compromises. We had not expected that either after S5 – or at least I hadn’t. What they show is how all the gear we need for children really does take over our homes. For him that’s very difficult so he often vanishes to his office. There he feels safe but adopts the use of the equipment as a means of anxiety reduction. He even works on the clocks there now that the kitchen is not available to him.

  3. Waxwings2

    What if you–Santa and Karen–did a blog together as therapists/psychologists called “Martin on the Couch–How We Would Help Him.” Both of you seem to have such good insights, and focusing them in one place could be quite informative for the rest of us. And I’m not being facetious with this suggestion….

  4. Post author

    It’s hard to know what to say to your suggestion. I have no experience with treating anyone and have no desire to start now. As you know, I also shy away from using these fictional characters as if they really existed. Although it’s fascinating and intellectually stimulating to speculate about what could be going on, I always default to remembering that this is a story created for a show and doesn’t have to follow any realistic pattern. We see a lot of “stuff” that we can associate with all sorts of intriguing propositions, but we don’t have any basis on which to develop a protocol. We can’t talk to the patient or ask him to fill out a questionnaire or take a personality test. Not gonna do it; wouldn’t be prudent at this juncture (to coin a phrase).

    I will, however, be posting an analysis of S3E5 soon.

  5. Santa Traugott

    I’ve always thought that, if there were ever a convention of Doc Martin fans, a la Star Trek, it should feature a panel of therapists giving their views on, seriously, what is wrong with this man, and how best to help him. If there were 4-5 therapists on the panel, there would probably be 2-3 different diagnoses (including a lot of disagreement about Asperger’s) and at least 4-5 different ideas of what treatments would work best for him. Of course, there might also be a separate panel on marriage counseling. So I am pretty sure that my own views would not necessarily be representative, and in a real discussion, I think a full panel of therapists/psychologists would be much more informative, and, I guess I think also, fairer to the representation of the profession.

  6. Carol

    Santa, I agree that there would be many opinions and suggested therapies but I keep saying, “Let’s Do It!” everytime this is suggested anywhere on the internet. I would absolutely love for there to be a DocMartinCon, although I’m quite sure ME and PB would not attend. I personally would love to have some of the writers talk as well. Disney World as a venue, anyone?

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