Hi everyone,
Below is a thorough book review by one of our members, Nessa Jennings.
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!
