David Adam - The Man Who Couldnt Stop: OCD and the True Story of a Life Lost in Thought

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For those who deserve an explanation

CONTENTS

Watch your thoughts, for they become words.

Watch your words, for they become actions.

Watch your actions, for they become habits.

Watch your habits, for they become character.

Watch your character, for it becomes your destiny.

Unknown

An Ethiopian schoolgirl called Bira once ate a wall of her house. She didnt want to, but she found that to eat the wall was the only way to stop her thinking about it. She didnt want to think about the wall either; in fact, she was greatly disturbed by the ideas and images of it that dominated her mind. The only way she could make the thoughts of the wall go away, and calm the anxiety they caused, was to follow a strange and unbearably strong urge to eat it. So she did; day after day, for year after year. By the time she was 17 years old she had eaten eight square metres of the wall more than half a tonne of mud bricks.

Bira lived in the capital city, Addis Ababa. Her father died when she was young and she grew up with her mother. Bira had eaten mud every day for as long as she could remember, since she was a little girl. It became worse when, as a teenager, she started to take it only from the wall of her home. As she did so, the images and thoughts came more vividly and more often, which only intensified her need to eat to find relief. The mud made Bira constipated and gave her severe stomach aches. Ethiopian traditional healers tried to treat her with prayers and holy water and advised her simply to stop eating the mud. But she couldnt. She couldnt stop her thoughts about the wall, and so she couldnt stop eating it.

One day, Bira couldnt cope any more. Her distended stomach throbbed with pain and her abdomen was tight with cramp. Her throat was scratched raw from the straw in the bricks and her body was riddled with parasites from the soil. In tears, she walked to her local hospital. At the time, Ethiopia had eight psychiatrists for a nation of 70 million people. Bira was fortunate. She managed to see one of them. She told him that she needed help. She knew her thoughts were wrong, but she knew she couldnt stop them alone.

* * *

An average person can have four thousand thoughts a day, and not all of them are useful or rational. Mental flotsam comes in many forms. There are the irrelevant words, phrases, names and images that flash unprompted into our minds, often as we perform some mundane task. There are earworms: tunes that wedge themselves in our heads, more prosaically called stuck-song syndrome. And there are negative thoughts I cannot do this, I must quit the sworn enemy of sports psychologists everywhere.

Then there are the very strange thoughts: those occasional, random and unprompted ideas that seem to emerge from nowhere and stun because they are vile, immoral, disgusting, sickening and just plain weird. The seductive question What if? What if I was to jump in front of that bus? What if I was to punch that woman?

These kinds of thoughts are more common than most people realize. Ask around. A friend of mine has a need to check the toilet bowl for rats before he sits. Another unplugs the iron and places it in an unusual place when he finishes with it, so he knows for certain the answer when his mind demands later: Are you sure, really sure, that you turned it off? One tortured soul spent an evening unable to ignore the repetitive thought that he may have scrawled across an application form for his dream job the word cunt. Most people have these kinds of strange thoughts. Most shake them off. Some people dont.

When we cannot make our strange thoughts go away they can lead to misery and mental illness. The friends I mention above did not convert their strange thoughts in this way. But I did.

I turned mine into obsessive-compulsive disorder.

* * *

The day that the Brazilian racing driver Ayrton Senna died in a crash during a Grand Prix in Italy, I was stuck in the toilet of a Manchester swimming pool. The door was open but my thoughts blocked the way out.

It was May 1994. I was 22 and hungry. After swimming a few lengths of the pool, I lifted myself from the water and headed for the locker rooms. Down the steps one, two, three ouch! I had scraped the back of my heel down the sharp edge of the final step. It left a small graze, through which blood bulged into a blob that hung from my broken skin. I transferred the drop to my finger and a second swelled to take its place. I pulled a paper towel from above the sink to press to my wet heel. The blood on my finger ran with the water as it dripped down my arm. My eyes, of course, followed the blood. And the anxiety, of course, rushed back, ahead even of the memory. My shoulders sagged. My stomach tightened. It had been four weeks since the incident at the bus stop, and, as much as I told myself that it no longer bothered me, I was lying.

I had pricked my finger on a screw that stuck out from the bus shelters corrugated metal. It was a busy Saturday afternoon and there had been lots of people around. Any one of them, I thought, could easily have injured themselves in the way I had. What if one had been HIV-positive? They could have left infected blood on the screw, which then pierced my skin. That would put the virus into my bloodstream. Oh, I knew the official line was that transmission that way was impossible. The virus couldnt survive outside the body. But I also knew that, when pressed for long enough, those in the know would weaken that to virtually impossible. They couldnt be absolutely sure. In fact, several had admitted to me there was a theoretical risk.

Standing quietly in the toilets of the changing rooms, still dripping wet, my swimming goggles in one hand and the bloodstained paper towel in the other, I ran through the sequence of events at the bus stop once again. I told myself how there hadnt been any blood on the screw when I had checked it, or at least I didnt think there had been. Oh, why hadnt I made absolutely sure?

Someone else banged through the door into the swimming pool changing rooms. They whistled. I looked at my finger. Wait a minute. WHAT THE HELL HAD I DONE? I had put a paper towel on a fresh cut. OH JESUS CHRIST. There could have been anything on that paper towel. YOU STUPID BASTARD. I looked at the paper towel, now soggy. THERE IS BLOOD ON IT. Well, of course, its my blood. HOW CAN YOU BE SURE? Someone with Aids and a bleeding hand could have touched it before me. OH JESUS. I threw it into the bin, pulled a second from the dispenser and inspected it. No blood. That helped, a little. No blood on the next one either. BUT THEY COULD HAVE DONE. I pulled the original paper towel back from the bin. It was bloody. IF THIS IS SOMEONE ELSES BLOOD THEN WHY ARE YOU PICKING IT UP? I quickly washed my hands. AND WHAT IF THEY BLED INTO THE SINK TOO? DONT TOUCH YOUR FUCKING HEEL. DONT TOUCH YOUR FUCKING HEEL. No chance of that. WHAT IF THAT ISNT EVEN THE PAPER TOWEL YOU THREW IN THE BIN? It could be someone elses paper towel that I was handling, someone elses blood. I looked in the bin. I couldnt see any other paper towels with blood on them. WHAT ABOUT THAT ONE?