Held hostage to the inner control freak
MOST of us know the feeling, or think we do. We know what it’s like to go back for one last look at the gas burner we know isn’t on. Some of us, after filling the car, have a thing about double-checking the petrol cap. And who among us hasn’t wondered, just for a second, how it would feel to shout something offensive on a crowded street?
David Adam, author of The Man Who Couldn’t Stop, does not reject the popular notion that we are all a bit OCD. Obsessive Compulsive Disorder, he explains, begins with the kind of unwanted irrational thought that nearly all of us seem to have. But for most of us, such thoughts are fleeting rather than crippling. For most of us, one superfluous check of the stove will be enough. We can then forget about it and enjoy the rest of the evening. Imagine, though, not being able to forget about it. Imagine not being able to enjoy anything through the suffocating burden of the uninvited thought. “Imagine,” as Adam puts it, “that you can never turn it off.” That is OCD.
To help us imagine, Adam retails some hairraising case histories. There is the African schoolgirl with an uncontrollable compulsion to eat the wall of her house. By the time she is 17, she has consumed half a tonne of mud bricks. There is the woman who can’t leave her pimples alone. One day she goes at one on her neck with a pair of tweezers. She picks her way through tissue and muscle until she has exposed her carotid artery. When her husband gets home he thinks she’s been shot.
And then there is Adam’s own case. In addition to being an accomplished science writer — he has worked for The Guardian, and is at present an editor at the journal Nature — Adam has suffered from OCD since the early 1990s, when he was a college student. He is therefore ideally qualified to write about the disorder, although he undoubtedly wishes he wasn’t. His book vividly blends his own story with a broader account of the way that psychiatry, after some regrettable false starts, has at last begun to get to grips with the condition.
Adam can clearly remember the moment, in 1991, when OCD hijacked his life. “My happiness did not end that day, but it was the last time that I felt happy — truly happy — for a long time. It was the last time that my thoughts were free to move and to transform.” The rest of us are at liberty to use the word “obsession” pretty loosely, but on that day Adam fell victim to an obsession that has put a ruinous shadow over every minute of his waking life.
Adam’s obsession is about AIDS. “I see HIV everywhere,” he says. In an effort to get his increasingly rampant fear of the virus out of his head, the young Adam found himself resorting to compulsive activities. He kept ringing the national AIDS hotline, seeking reassurance about the most far-fetched of infection scenarios. When the operators started to recognise his voice, he put on fake accents. If he scratched himself on a nail at a bus stop, he would return to the scene with absorbent paper to check the area for foreign blood.
In reality, HIV is not so easily contracted, and Adam knows that — with the merely rational part of his mind. He goes online to remind himself of the hard facts: the virus is fragile; it can’t live outside the body for long. He turns his computer off. Then he turns it back on and rereads the same pages. That is the essence of OCD. “To check, I thought, would make my life easier. Each time, I believed that one more, one last, check would give me the certainty I craved. But one check was never enough.”
OCD is a vicious spiral. The compulsive activities — the rituals — are meant to dispel the anxieties. The actions are meant to get rid of the thoughts. But they also make the thoughts
April 26-27, 2014 more real. They fuel the mental fire, until the heat gets so intolerable that more action — one more check — is needed for relief.
Trapped in that cycle, Adam does things he knows to be crazy even while he’s doing them. By bravely recounting such incidents, he underlines the point that OCD is nothing to be ashamed of. How can you be ashamed of something you can’t control? His book demonstrates that an intelligent and rational man can be defeated by thoughts he doesn’t want and knows to be nonsense.
His case reaches its nadir shortly after he becomes a father. One day, after taking his baby daughter to the playground, he notices a smear of dried blood on her thigh. Although her skin isn’t broken, and although the blood has almost certainly come from a scratch on his own finger, Adam can’t shake the thought that the baby has contracted HIV at the park. He repeatedly takes her back there and lifts her in and out of the swing, checking for sharp metal protrusions and suspect bloodstains. At first the little girl quite enjoys this. But after being put back into the swing for “about the eleventh time” she starts to object. That night Adam returned to the park solo, with a torch. The next morning, appalled by his behaviour, he finally sought the medical help he needed. Enough was enough.
Adam’s story has a happy ending, more or less. He hasn’t been cured: that, apparently, is still too much to hope for. But thanks to various forms of therapy, he has reached the point where his OCD “rarely causes me distress.” For a long time Adam kept his disorder a secret from everybody, including his doctor. If he inspires fellow sufferers not to make the same mistake, he’ll have done them a great service. As for those of us who don’t have OCD, Adam’s enlightening and scary book should make us feel a lot luckier about that than we already did.
When Mr Dog Bites, Brian Conaghan’s new novel for young adults, is narrated by one Dylan Mint, a 16-year-old Glaswegian who suffers from Tourette’s Syndrome. Tourette’s, one has learnt from Adam’s book, lies on the OCD spectrum. Sufferers experience a build-up of inner tension, similar to the pressure that precedes a sneeze. They will then blast the tension away with action: tics, twitches, vocal explosions. About 10 per cent of sufferers are compelled to shout out obscenities.
Mint falls into that 10 per cent. Conaghan’s novel is peppered with language that would make Derek and Clive blush. None of it feels gratuitous, and quite a lot of it is exuberantly creative, like the novel itself. Still, if there are any extant teenagers who have somehow contrived to remain innocent of the Big Two cuss words, their parents had better heed the warning on the back cover.
All other young adults would be well advised to tear themselves away from their “devices” and read this book instead. Exposure to a bit of vigorously deployed foul language can’t possibly be as damaging to the teenage brain as a week of Snapchatting. The same goes for the adult brain, come to think of it.
Conaghan’s novel, as well as having a big heart, has a narrative catchy enough to rope in readers of any age. Dylan, in the opening chapter, learns that he has only a few months to live. He compiles a bucket list, whose most pressing item is to yield his virginity to the least attainable girl at his school.
But Dylan is an unreliable narrator. Gradually he finds out that his understanding of the grown-up world isn’t all that it could be. Finding out with him is a lot of fun. Back when I was a young adult — which I swear was not all that long ago — books written for young adults were about the last thing a young adult wanted to read. The genre seems to have taken some lusty strides since then. If writers as good as Conaghan stay on the case, reading might have a future after all.
David Free is a writer and critic. The application form to bury you in the memorial garden beside your parents is lost, the salesman on the phone is saying, the office, they’ve looked everywhere, it’s awful, they’re so sorry. The telephone receiver in my hand has a zapping quality, a distancing effect, that in the middle of my losing you they’ve lost you. And there’s guilt at this end of the line, too, more than his; that our connection, umbilical without benefit of children, is disrespected. This process is all mine; you hated earth, the thought of waking there; you wanted fire, the fiercer, quicker element. I gave it you. You came home with me in bridal white, white as polystyrene. For four months you waited on the lowboy, an incompleteness, with half my life, our life, thirty years, made a different entity, burned away. My first intention was our scrap of garden along the fence, fringing the tiles; impractical, too narrow. Then the thought — your parents, whom you loved, the memorial garden. The salesman keeps insisting, the site’s still there, we’ve kept the place, it’s just the form, so regrettable, we’re so sorry. How to calm the office, repair their loss? We settle on him faxing a blank form for me to fill in — or is it out? — and return, a.s.a.p.
The OCD sufferer is unable to
stifle irrational thoughts