Hi everyone,
Below is a thorough book review by one of our members, Nessa Jennings.
The Man Who Couldn't Stop : OCD, and the True Story of a Life Lost in Thought, David Adams. (Picador 2014)
Imagine being able to pinpoint precisely the moment
you developed a serious mental illness. David Adams locates his trigger in 1986
and a radio report about the explosion of AIDS. From that moment on, his life
turned to obsession with contracting the deadly disease, involving all expected
prevention rituals. His life no longer his own, there followed decades filled
with personal anguish. Holding himself personally responsible for the immediate
spread of AIDS all the time mentally incapacitated
him. He was locked into repetitive hygiene routines, extremely unhealthy
trapped thought.
He likens this to a window on your computer that
cannot close. Right there, as an ever-present persecutor lurking and looming in
a corner of the mind. Any other activities are nevertheless possible but
seriously impaired by the same obsessive thought. After you shut down at night
for sleep, the next day, and every day there it is, the exact same open window
to torment all your waking hours. The more you try to push it down and try not
to think about it, the stronger it comes back. This is the very nature of
thought. The saddest fact is, David Adams says, not to have enjoyed a moment of
free contemplation since that day.
There is no such thing as a little bit OCD he
insists. Bizarre detailed behaviours are often portrayed in a humorous
way. The aunt endlessly knitting tea cosies in production-line fashion;
the lady in New York City continuously ordering Chinese take-outs only to be
overtaken by the collection of the containers the food comes in. It is easy to
poke fun at these tendencies carried out to the extreme. However, the reality
for a constant hand-washer can be hours lost daily in say six hours thinking
about it and three more at the sink.
The negative impact of these thoughts ruins a
person’s inner life, by causing them persistent distress during a significant
part of every day. The rituals appear outwardly, carried out in an attempt to
efface the chronic unease of the obsession. Spontaneous recovery from OCD is
rare, about one in ten, and the disease is highly resistant to treatment. David
Adams continues his treatment, a combination of medication and cognitive
behaviour therapy. He functions better these days after many years of extreme
obsession. He admits he still has the illness.
Other forms of the illness are hoarding and
Body Dysmorphic disorder. OCD is not often discussed in the treatment room. It
carries a lot of shame for the sufferer, so has can go undiagnosed and
untreated for a long time. Alongside the deep shame of admitting it, many
survive with the belief they are not doing anything unusual at all, content
with trying to control threats in their environment by keeping things ordered
and excluding dangers.
Those suffering from body dysmorphia might be afraid
they are just very vain. It’s much more serious than that, says the author,
this perceived on going obsession about how a certain part of the body is ugly,
carries the highest risk of suicide. For example, take the very sad case of a
one teenager with body dysmorphia and couldn’t tell anyone about his image
obsession. In trying to set up his facebook page he needed a photograph, and
started to try to take numerous selfies, was never satisfied.
He took his own life because he couldn’t get the
right photo of himself for his profile picture. Body Dysmorphia sufferers are
likely to remain single and if married, less likely to have children, according
to the author. So we can see that the distorted sense of body image can seriously
hinder the person’s life path.
OCD can be latent in certain individuals, lying
dormant in them until triggered by a stressful life event. It is most commonly
seen to arise in the mid to late teens, though it can arise at any age. The
author gives the example of the school pupil who felt rejected and ostracised.
Looking around the assembly hall feeling cast out by classmates, mostly by his
friends, he reports: “Instead of crying. I started to count”. This is the
precise moment of arrival of this monster of a mental illness.
The laying bare of this illness and exposition of OCD
by using examples in a thorough examination of the author’s own particular
painful existence, brought on by media accounts of the disease AIDS in the
1980s must have important implications for psychiatry. David Adams calls for
mental health professionals to ask patients to identify the significant sand
meaningful episodes in their life history. Understanding the triggers could be
key to more accurate diagnosis and effective treatments.
Very well written Nessa, Well Done!
