Genetics verses environment (learnt behaviour)

For about 8 years I studied with the Open University, completing my BSc Open Degree in 2013. During that time I studied a variety of modules, many of which were Psychology based. At the heart of what I learnt was the 'nature/nurture debate' which focuses on whether human behaviour is a product of genetics (inherited); or whether it is a product of learnt behaviour (from our surroundings and environment). From what I learnt I believe that it is a combination of both and this is very much what the nature/nurture debate argues. I myself believe that OCD is more the result of genetics rather than what is learnt from our environment. 

I believe that a person is born with the genetic tendency towards OCD and that something, either learnt behaviour or in the environment acts as a catalyst to trigger the manifestation of OCD. This is rather like the chicken pox virus which lies dormant at the bottom of the spine until it is triggered. In a similar way I believe that OCD can lie dormant until it is triggered by something in the environment. This could be either a traumatic event or a particularly negative experience. However, with this theory there are still further questions that need answering. 

It could be argued that most children, whatever background they come from might experience at least one traumatic experience in their childhood. For example, most children will lose something, (such as a very special toy), or someone that is particularly special to them. Why then is it that such a traumatic event, causes the OCD, which at this point is lying dormant, to become evident in some people who carry the OCD gene and not others? Why do some people only develop OCD as an adult? Surely if OCD was purely genetic it would show itself earlier. I will now explore the possible answers to these questions.

To explain why the same traumatic event might cause OCD to manifest in one person, with the genetic tendency, and not another I will turn to my working experiences as a nurse. Everyone, feels pain differently and has different pain thresholds. To explain this, I will use the example of two men who have broken their arm and who have exactly the same brake. One might feel the pain intensely and the other less so. In the same way two people who have a genetic tendency towards OCD and who experience the same traumatic event may experience different levels of anxiety. Therefore, the person who experiences more anxiety will develop OCD whereas the other won't.

Over the years, I have spoken to many people who as adults have developed OCD. thie sudden onset has been explained by perhaps a break up of a relationship or the death of a close family member. I have asked them if they have been aware of any OCD tendencies earlier in their lives and many have said ''No.'' With this in mind, if OCD is genetic, why didn't they suffer from OCD symptoms much earlier in life. I believe that one possible answer is that they did but it was not significant enough to be a problem. Therefore, they were never aware that anything was wrong.

Lack of serotonin in the brain

One other theory is that OCD is caused by a biological imbalance in the brain. It is widely believed that there is a lack of serotonin, (a chemical neuro-transmitter), in the brain and that by taking a Selective Serotonin Reuptake Inhibitor (SSRI), this imbalance will be rectified. 

Two parts of the brain that appear to play a part in the manifestation of OCD are the orbitalfrontal cortex and the ventral striatum. Among the different functions of the frontal cortex, (amygdala) are the regulation of emotions, decision making and memory; whilst the fuction of the ventral stratium's lies in that of reward processing. In a person who doesn't have OCD these two parts of the brain work together both smoothly and in a logical fashion to solve any problems in a rational and sensible manner. However, what appears to happen in people who have OCD is that, due to lack of serotonin, there is a miscommunication or misfiring somewhere between these two parts of the brain. This leads to confusion and irrational behaviour where any logic is lost and the person with OCD trying to solve the problem through ritualistic behaviour and compulsions. From my own experiences, I would describe this miscommunication like a record that gets 'stuck in the groove' and never finishes. In essence it gets stuck in an endless 'loop.'

To describe this another way, we can take a look at the 'fight, flight, freeze response.' and the role that this plays in someone who has OCD. The fight, flight, freeze response occurs when a person feels vunerable or threatened by something or someone within the surrounding environment. An example of this might be being caught in a ferocious storm. Here there is an immediate threat to the persons safety and wellbeing. The fight, flight freeze response is activated which prompts the person to make a decision whether to fight (ride the storm out), flee (run from the storm and find a place of safety) or freeze (and hope that the storm passes by quickly and without incident). These are the ways that a person might react psychologically when the fight, flight freeze response is activated.

Along with the psychological, there is also a physical component to the 'fight or flight' response which includes an increase in heart rate, feeling tense, agitated and on edge, pale and flushed looking skin, dilated pupils and increased pain threshold. However, with the 'freeze' response the following symptoms may include an inability to move (frozen to the spot), increased muscle tension and a decreased heart rate. Such symptoms help prepare the individual to assess the danger in a rediness to act as-well as increasing visual perception and sensitivity to sound.

With someone who doesn't have OCD once the threat is over the bodily functions, both psychologically and physically, will return to normal. However, for somebody who has OCD this process may take much longer. Not only this but people who have OCD tend to perceive situations that are not dangerous as posing a threat. Often when this happens they get 'stuck' in fight, flight freeze mode and it can be difficult to break the viscious cycle.

Waxing and Waning

Over the course of a lifetime OCD will wax and wane. It never goes away totally. Instead a person will learn to manage it. This might be through therapy (most notably Exposure Response Prevention Therapy, ERP), medication or often by a combination of both. 

Often the symptoms of OCD will dissipate during times of stability but increase when a person faces times of adversity or stressful situations. For OCD symptoms to increase the situation doesn't have to be a negative one. Both negative and positive situations can be stressful. Examples might include:

1. Bereavement

2. Losing a job

3. Diagnosis of severe or terminal illness

4. Divorce or breakdown of an important relationship

5. Failing an important exam

6. Getting married or the start of a new relationship

7. Moving house

8. Going on holiday

9. Starting a new job