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Mindful : April 2017
cool aloofness. Having her fate in the hands of another was disquieting enough, but it was made even more stressful by never knowing, she said, “which mother I would have each morning.” Bianca coped by developing a strategy that crystallized one year when her family arrived at their summer home. The dusting, de-cob- webbing, and other work overwhelmed her mother, leading Bianca to tell her, “ We don’t have to do all of it right now. Let’s just clean up a little bit of lawn, and put out some chairs and a table so we can have a nice haven,” she recalled. “That was when I realized, even if I can’t fix everything, as long as one little place is in order, as long as there’s one little island where I can think clearly, it’s OK.” That drive to create an island of order and calm in a sea of chaos and tumult grew stronger when Bianca—now a divorced, single mother— struggled to make her way after she emigrated from Switzerland to the United States. She needed “to have things where they belong and to do things in a certain way, even little things like arranging chairs or hanging coffee cups in the right place,” she said. Her compulsions “give me a sense of peace, a feeling that there are some things I have control of.” As for Suzanne, by the time her five children were in school, she felt trapped in a marriage that brought her little joy and many bruises. “ I remember thinking, I don’t want to live anymore,” she told me. She threw herself into her children’s activities, putting aside her own: “I thought, ‘Some day I’ll read that book. And some day I’ll get back to knitting.’” Her husband regularly brought home empty boxes from work (the only “gifts” he ever gave her), and gradually Suzanne filled them with her deferred dreams: books she hoped to read one day, magazine articles about a home improve- ment project she aspired to do, newspaper clip- pings about wonderful places to visit, materials to make Boy Scout projects and reupholster furniture—all “one day.” Hoarding keeps her dreams in the eternal realm of possibility, sparing her the anxiety of confronting the reality of her life. Waving at towering boxes of newspaper and magazine clippings and more stuff than she can identify, Suzanne told me, “I had a dream that our life would be nice, that we’d go on vacation, or I’d have a beautiful garden, or a pretty room, like in magazines. But it didn’t work out. Instead of having the things I dreamed about, I have pieces of paper. It’s all I have.” Addiction vs. Compulsion One might say both women are addicted to what they’re doing: Bianca to tidiness and order, Suzanne to hoarding. The two terms are often used interchangeably not only in casual conversation (compulsive shopping seems synonymous with shopping addiction) but by experts. “ It’s a real scientific controversy, how and in what ways addictions are or are not like compulsive behaviors,” James Hansell, a clinical psychologist at George Washington University, told me. But recent research in psychology and neuro- science is starting to resolve that controversy. An addiction, goes the emerging understand- ing, begins with a flash of pleasure overlaid with an itch for danger: It’s fun to gamble or to drink, and it also puts you at risk (for losing your rent money, for acting like an idiot). Addictions bring pleasure, though they also build up a tolerance over time, as the addict requires more and more of the behavior (or substance) to get the same hedonic hit. Compulsions, by contrast, are about avoid- ing unpleasant outcomes. They are born out of anxiety and remain strangers to joy. They are repetitive behaviors we engage in over and over to alleviate the angst brought on by the possibil- ity of negative consequences. If I don’t check my phone constantly, I’ll miss an urgent demand from my boss or will feel like I don’t know what is going on. If I do not religiously organize my closets, my home will be eng ulfed in chaos. If I don’t shop, it will be proof that I can’t afford nice things and am headed for homelessness. “A compulsive behavior is one that’s done with the intent of decreasing an overwhelming sense of anxiety,” said Jeff Szymanski, executive RESEARCH What Is OCD? Obsessive- Compulsive Disorder is a chronic, long- lasting disorder involving uncon- trollable, recurring thoughts (obses- sions) and behav- iors (compulsions). Common obsessions: fear of germs; unwanted or forbidden thoughts about sex, religion, and harm; aggressive thoughts toward self/others; creating sym- metry. Compul- sions: excessive cleaning, ordering things in a partic- ular way, repeat- edly checking if you locked the door, compulsive counting. In OCD, the urges are strong, joyless, and uncontrol- lable without intervention. See the National Institute of Mental Health’s website for more information on OCD 20 mindful April 2017 brain science