On my mind


Stop reading this review, and go and buy this book. I’m admittedly a biased fan – I have obsessive compulsive disorder myself. But even for those not afflicted with it, this is a wonderful, fascinating and beautifully written read – psychology, science, history and memoir, expertly and eloquently woven together by David Adam, a senior journalist at the UK science magazine Nature.

Although Adam has OCD, his account of his own battles with the disorder (in his case, they centre around an obsessive fear of contracting HIV) never overwhelms the broader narrative. He explores the OCD from every angle, looking at how and when it was first diagnosed, its possible causes (there are various possibilities but still no definitive answer) and the treatment available (including medication and cognitive behavioural therapy, among other approaches).

From the girl who couldn’t stop eating the wall of her house, to the brothers in New York who relentlessly hoarded possessions, Adam has researched widely and deeply. However, he is always engaging and easy to understand, breaking down complex neurobiological and psychological concepts with lucid ease (his explanation of the high place-phenomenon – when people feel the urge to jump from a cliff even though they’re not feeling suicidal – is a perfect example).

Adam is on a mission to explain. He wants the world to know that this frequently misunderstood disorder isn’t simply when someone has the continual urge to check a lock, for example. It can manifest in many different ways.

Virtually ever single person on the planet experiences intrusive thoughts; some of these are bizarre or embarrassing. Most of us can easily dismiss them – they rush past, soon forgotten. But those with OCD can’t. A thought comes, and gets stuck. Often these thoughts involve a fear of harming others, or of becoming contaminated by something. For religious people, these thoughts may be blasphemous. Mothers may experience thoughts about harming the children they love – and would never, ever hurt. Motorists can fear they’ve knocked someone over – even though they can see no one is around.

“OCD dissolves perspective. It magnifies small risks, warps probabilities and takes statistical chance as a prediction, not a sign of how unlikely things are,” Adams writes. He explains how often people with OCD know these thoughts are irrational. But because they won’t go away, they make them feel anxious. The harder people with OCD try to dismiss these thoughts, the more ingrained they tend to become. A compulsion of some kind is performed to try to get rid of them – it could be a prayer, or making sure that a pair of scissors is never left in the child’s bedroom, or turning around and going back to make sure the road is clear. But although performing these compulsions can bring temporary relief, they often result in the obsessive thoughts intensifying.

The result is a life increasingly consumed by worry. OCD can cripple the lives of some sufferers. Others remain highly functioning, but distracted. As Adam explains: “It’s not that OCD meant I could not function, and that I couldn’t think of or do anything else – I did well in exams, I had friends and girlfriends, furious arguments and fun conversations, and I held down some decent jobs. It’s just that I was thinking about something else at the time. I was thinking about HIV and how I might have caught it when I learned that my grandmother had died, when I found out that Princess Diana had been killed, when I saw Pulp Fiction at the cinema… I was thinking about HIV and Aids in the days before I got married – I had met a climate scientist at a conference the previous week with a sore on his lip and I couldn’t be sure that we hadn’t mixed up our drinks. OCD stole something away from me at that stage of my life; it took away my attention.”

Whether you have OCD (or know someone who has it) or are simply keen to have a better understanding of the mind, this is an essential, enlightening read.

The Man Who Couldn’t Stop is published by Picador and is available from Kalahari.com.

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