Thursday, December 15, 2016

The Hair Dryer Incident

I don't have anything to say tonight except that it's dark and really cold out, which wouldn't make for very interesting reading, so let me just pass along this story from Scott Alexander:
The Hair Dryer Incident was probably the biggest dispute I’ve seen in the mental hospital where I work. Most of the time all the psychiatrists get along and have pretty much the same opinion about important things, but people were at each other’s throats about the Hair Dryer Incident.

Basically, this one obsessive compulsive woman would drive to work every morning and worry she had left the hair dryer on and it was going to burn down her house. So she’d drive back home to check that the hair dryer was off, then drive back to work, then worry that maybe she hadn’t really checked well enough, then drive back, and so on ten or twenty times a day.

It’s a pretty typical case of obsessive-compulsive disorder, but it was really interfering with her life. She worked some high-powered job – I think a lawyer – and she was constantly late to everything because of this driving back and forth, to the point where her career was in a downspin and she thought she would have to quit and go on disability. She wasn’t able to go out with friends, she wasn’t even able to go to restaurants because she would keep fretting she left the hair dryer on at home and have to rush back. She’d seen countless psychiatrists, psychologists, and counselors, she’d done all sorts of therapy, she’d taken every medication in the book, and none of them had helped.

So she came to my hospital and was seen by a colleague of mine, who told her “Hey, have you thought about just bringing the hair dryer with you?”

And it worked.

She would be driving to work in the morning, and she’d start worrying she’d left the hair dryer on and it was going to burn down her house, and so she’d look at the seat next to her, and there would be the hair dryer, right there. And she only had the one hair dryer, which was now accounted for. So she would let out a sigh of relief and keep driving to work.

And approximately half the psychiatrists at my hospital thought this was absolutely scandalous, and This Is Not How One Treats Obsessive Compulsive Disorder, and what if it got out to the broader psychiatric community that instead of giving all of these high-tech medications and sophisticated therapies we were just telling people to put their hair dryers on the front seat of their car?

I, on the other hand, thought it was the best fricking story I had ever heard and the guy deserved a medal. Here’s someone who was totally untreatable by the normal methods, with a debilitating condition, and a drop-dead simple intervention that nobody else had thought of gave her her life back. If one day I open up my own psychiatric practice, I am half-seriously considering using a picture of a hair dryer as the logo, just to let everyone know where I stand on this issue.


Shadow said...

Yeah, but what if it's the stove you keep thinking you left turned on?

G. Verloren said...

Aha! I came to the exact same solution about as soon as I read that she was driving back and forth twenty times a day.

That said, I totally understand the scandal though. This is absolutely not a proper psychiatric solution. It doesn't cure the patient, as it doesn't treat the underlying sickness. In psychiatry in particular, that's considered a major problem, and a very dangerous one - for some very good reasons.

That said, this approach does at least treats the symptoms, and offers relief that allows the patient to function despite the sickness. No doctor worth their salt wants to settle for merely treating the symptoms, but sometimes that's the best you can hope for. It'd be phenomenal if we could, for example, cure HIV/AIDS - but until we figure out how to do that, the best we can do is treat the symptoms and transform it from a death sentence into a perfectly manageable chronic condition.

Also, @Shadow Flutter, set up a webcam pointed at your stove which you can access remotely. It's far, far less disruptive to check your phone or similar 20 times a day than it is to drive home and back.

Shadow said...

G, Perfect. Just another reason not to live in the fifties.

G. Verloren said...

Well, presumably in the 50s, this lady lawyer would have been a housewife, and thus home all day anyway.

But yes, I actually fairly regularly reflect upon how glad I am to NOT live in even the fairly recent past.