Wednesday, November 11, 2015

David Adam: The Man Who Couldn't Stop

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I grew up with AIDS. Not *with AIDS, but around AIDS. In the Bay Area, in the 80s, with a heightened awareness of AIDS, stigma and the concept of disease. I would say that I'm reasonably terrified of the disease, even as my peers now say (ridiculous) things like, oh, you don't die from it anymore (sorry, what?). David Adam, author of 'The Man Who Couldn't Stop,' has an irrational obsession with catching HIV/AIDS, and I say that as a person who has a rational fear of AIDS and who might even say any fear of the disease is well-founded when you've watched an entire generation of men be decimated by it. That said, Adam consumed by obsessive thoughts of getting AIDS (not HIV, interestingly) and has developed a routine of compulsions he has to go through whenever he thinks he (or a loved one) might have been exposed. Exposed not like sexual contact or sharing needles or coming into contact with blood at a crime scene because he's a police officer. Exposed like, he pulled a towel out of a towel dispenser at a bathroom to dry his hands and later realized it might have had a smudge on it, and was the smudge blood and could the blood have been HIV+ and could he have gotten it when he wiped his hands? Or if his daughter falls on astroturf in the park and she scrapes her knee, could the blade of synthetic grass have had a speck of blood that could have gotten into her bloodstream and now what should he do? He suffers from OCD. I have to say that, though this may sound unreasonable to you and (in my calmer moments) does to me, as a person who a) has a heightened sense of awareness about HIV/AIDS and b) has grappled with OCD, this book actually sent me into a little bit of a tizzy. Then I came back.

We all have intrusive thoughts- this part of Adam's book is very reassuring. Maybe we all think bad things about the person sitting next to us on the bus and a wish comes into our head that they would trip on their shoelaces on the way out and always thought it was just us (maybe it's just me!). Some people, however, can't get rid of those intrusive thoughts, and they become repetitive- obsessions. This is when the smudge on the towel becomes blood, and every situation becomes a possible contamination situation (not an uncommon obsession, apparently!). In most cases, our brain either takes our unwanted and sometimes bizarre thoughts and gets rid of them. In fact, our brain needs them: "To consider all possible solutions, it's important for the mind to generate novel ideas and not immediately censor them... The cognitive idea generator does not have to anchor its responses to reality. Intrusive thoughts are what happens when the mind says 'yes, and' rather than 'yes, but.'" My brain (hopefully!) hears "damn, that dude is annoying, I should just trip him myself... but that would be wrong." A truly intrusive thought might pass the ellipses with "... and I could" or "...and that thought needs to be scrubbed from my brain with x, y, z action."

Then come the compulsions: "an irresistible internal urge to act in a way that is irrational." Again, we all have some kind of ritualistic or compulsive behavior. We all check doors that we are almost positive we actually locked. We all have an order that we get dressed in every morning. Some of us eat the same cereal for breakfast every day for years or get a little disoriented. It's when compulsions are tied to the obsessive thoughts that the OCD comes together. The compulsions seem to make the obsessive thoughts go away, but only for a short time. And, sadly, "one of the many cruel ironies of OCD is that the compulsions, the weapon that obsessed people reach for, make the situation worse... An intrusive thought silenced with a compulsive act comes back. It comes back hard."

So with that mini-backstory, 'The Man Who Couldn't Stop' is a combination mini-memoir and science book wrapped in a readability cloak. It was recommended by THB, so I picked it up. It has some insight and I learned some things about other, related disorders- tourette syndrome (it looks like I never reviewed "The World's Strongest Librarian" which was great), autism- and some back story on the history of treatment of OCD. There are a lot of case stories here- maybe too many, as it starts to feel like Adam has pulled the most exotic sufferers out of every source he used and plopped them into the book, when his argument is- and we all know- that OCD is everywhere and doesn't need to be exotic. My favorite part was the bit where scientists speculate about who is more likely to have/get OCD. Fascinating. If you're interested in a quasi-pop-science, mental health type, book, I think it's a good read. I'm going to go return it to the library now- only ... $20 in fines this time. (JUST KIDDING!)


thb said...

Best breakfast ever: grape nuts, apple (pink lady, ambrosia, pinova, honey crisp, something in that range), ollallaberries, 1% milk....REPEAT! REPEAT! REPEAT...