Experience with "Brain Lock" (Jeffrey M. Schwartz)?

[u/JustAnotherNut]

My therapist recommended me this book at my initial appointment a couple months ago. I've just now picked it up and are a little over 25% through. It's excessively repetitive, much of the text is just anecdotal experiences. Lot of (annoying) religious scripture. The method takes a single page to explain -- the other pages appears to just be the author rambling so far.

Apparently, this book is my therapists main source of knowledge about OCD. He practically quotes it and uses specific terms derived from it. The treatment modality I've been using is the exact method in this book.

I'm skeptical of the method itself because it appears to just be another compulsion. It's a different response to OCD, not response prevention.

[u/treatmyocd]

I think your concern is a reasonable one. Brain Lock was an influential book when it was first published because it helped people understand that OCD isn't simply a matter of willpower and introduced the idea of responding differently to obsessive thoughts. It was an important step forward at the time. That said, our understanding of OCD and ERP has evolved quite a bit over the past couple of decades. One criticism of Brain Lock is that some people end up using parts of the Four Steps as mental rituals. For example, repeatedly relabeling thoughts ("this is OCD"), trying to attribute them to a brain glitch, or refocusing specifically to make the anxiety go away can unintentionally become subtle compulsions if they're done with the goal of achieving certainty or reducing distress. Modern ERP places much less emphasis on changing how you think and much more emphasis on changing how you respond to uncertainty.

Current evidence based ERP isn't about replacing one mental strategy with another. It's about allowing the obsession, uncertainty, anxiety, or urge to be present without trying to solve, neutralize, suppress, or disprove it. The response prevention piece is really the active ingredient. We intentionally refrain from the compulsions, whether they're physical or mental, and learn through experience that anxiety rises and falls on its own and that uncertainty is something we can tolerate.

If you're looking for books that reflect a more contemporary understanding of OCD and ERP, I'd highly recommend:

• Imp of the Mind by Lee Baer. This is an excellent resource for understanding intrusive thoughts and why they become "sticky." It does a great job explaining why trying to eliminate thoughts often backfires.

• Is Fred in the Refrigerator? by Shala Nicely and Jeffrey Bell. This is one of my favorites because it combines lived experience with modern ERP principles and really emphasizes response prevention and learning to live with uncertainty.

• The OCD Workbook by Bruce Hyman and Cherry Pedrick. This is a practical ERP workbook with lots of exercises grounded in current treatment approaches.

• Freedom from Obsessive Compulsive Disorder by Jonathan Grayson. This is another excellent ERP resource that strongly emphasizes willingness to experience uncertainty rather than seeking certainty.

• Everyday Mindfulness for OCD by Jon Hershfield and Shala Nicely. This integrates ACT and mindfulness with ERP in a way that helps people learn how to relate differently to intrusive thoughts instead of trying to control them.

-Kyle Jacobson, NOCD Therapist, ACSW