Held hostage to the in­ner con­trol freak

The Weekend Australian - Review - - Books -

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.

John Up­ton

The OCD suf­ferer is un­able to

sti­fle ir­ra­tional thoughts

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