OCD Gets the Memoir Treatment

By Carmela Ciuraru 04/08/16

The Fix Q&A with David Adam, the author of the award-winning memoir The Man Who Couldn’t Stop: OCD and the True Story of a Life Lost in Thought.

Q&A With The Man Who Couldn’t Stop
via Author

In 1994, when David Adam was in his early twenties, he developed a curious fixation: whenever he accidentally scraped himself and drew blood, he became overwhelmed by fears of contracting AIDS. Piercing his finger on a screw sticking out from the corrugated metal of a bus shelter, he panicked—what if someone before him had done the same, and what if that person were HIV positive? His mind descended into a spiral of terrifying thoughts.

Weeks later, having scraped his foot after swimming laps in a pool, things got worse. Soon, he writes, "I see HIV everywhere. It lurks on toothbrushes and towels, taps and telephones. I wipe cups and bottles, hate sharing drinks and cover every scrape and graze with multiple plasters. My compulsions can demand that after a scratch from a rusty nail or a piece of glass, I return to wrap it in an absorbent paper and check for drops of contaminated blood that may have been there."

Although fully aware that his intrusive thoughts were not rational—and despite living with a considerable degree of anxiety and distress—Adam felt helpless to do anything about his suffering. For years he masked his OCD, hid it from friends and family, and otherwise managed as best he could. In 2010, at the age of 38, he finally sought help after he realized his behavior was affecting his interactions with his young daughter. "I now have two children who need me," he writes. "I don't want them to go through what I did...to be held hostage by their strange thoughts, to think up a monster."

via Amazon

The Man Who Couldn't Stop is an incisive investigation through the author's own case history, involving cognitive behavioral therapy, medication, and other forms of treatment, yet it's also an examination of the tortured experiences of others: someone who must check a toilet bowl for rats before sitting down; the job seeker who fears he may have inexplicably scrawled a nasty expletive across his application form; the man who compulsively prods his eye sockets until he blinds himself. 

Adam details the implications of OCD with astonishing specificity and detail. He gives empathetic attention to a mental illness (falsely) considered rare by psychiatrists just a few decades ago. "Strange thoughts, the seeds of obsession, are everywhere," he writes.

Adam, who lives in Hertford, just north of London, is the op-ed editor at the weekly science journal Nature. He has also worked as a science and environmental correspondent for the Guardian. 

The Man Who Couldn't Stop was recently published in paperback by Picador.

"OCD" is a term carelessly, and often incorrectly, tossed about—but it's the fourth most common mental disorder after depression, substance abuse, and anxiety. Millions suffer from it. What are some of the biggest misconceptions?

I think the single biggest misconception is that OCD is a behavioral quirk. It persists for two reasons. The compulsions, unlike the obsessions, are visible, indeed sometimes impossible to hide. And because most people with OCD don’t talk about their thoughts, because they tend to be in taboo topics.

You write that "sometimes the nature of the compulsions seems to bear no relation to the subject of the obsessions at all."

Someone might think that their parents are going to die in a car crash, unless they tap a wall three times. That might help them feel better, but there is no conceivable way doing that could alter what will happen, unlike, say, calling their parents and begging them not to drive.

As you note, the average person can have around four thousand thoughts a day—not all of them useful or even rational. For you, how did things evolve from what you call "mental flotsam" into a crippling affliction? Did becoming a parent encourage you to get help?

It happened almost immediately. I can remember almost everything about the first time I realized I couldn’t make the irrational thoughts go away. I went, almost in an instant, from the old me to the new me. And the new me was frightened and miserable. Being a parent changed everything. When I started to involve my baby daughter in my obsessions, I knew I had to act.

How did OCD affect the relationships in your life—familial, romantic, professional?

It affected all my relationships because I was distracted, and I had something else going on in my head that always seemed more important than whatever was going on outside.

Why did you want to write this book?

After I had the treatment and started to feel better, I wanted to know more about what happened to me, and I couldn’t find a book that answered my questions, so I thought I would try to write one. I think the most challenging aspect was balancing the personal and conventional strands. I thought nobody would be interested in what happened to me, but at every stage, everyone who read bits of it said they wanted more of that.

Did the writing process prove consoling?

Not really—OCD is a serious mental problem and only serious medical help is really therapeutic. What does help is that everyone knows, so I don’t feel like I am concealing it. My family has been great—very understanding and supportive.

How do you manage intrusive and irrational thoughts now?

On a good day, I’m a model patient. I observe them, and don’t react, and don’t perform the compulsions. and this usually leads to the thoughts fading. On other days, well, not so good.

Having written this book, what did you learn about that you didn't know before?

That almost everybody has the kinds of weird thoughts that OCD patients do. Ask around!

Carmela Ciuraru's most recent book was Nom de Plume. She writes the newly released books column for The New York Times.

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