Review by New York Times Review
ONE COLD NORTHERN ENGLAND evening in November 1990, when David Adam was a first-year college student in Leeds, he enjoyed an encouraging first date with a young woman that culminated in a bit of physical intimacy ending somewhere short of intercourse. The next day when a friend asked Adam if he had sex with the woman, he lied in the traditional manner of boastful, insecure young men everywhere and said that he had, without a condom. "You could have AIDS," the friend said. That wasn't true - or was, at most, exceedingly unlikely. Nevertheless, the idea lodged in Adam's mind, where it set about establishing permanent residency. By the following summer, the fear that he might already have AIDS, or would someday contract it, had hijacked his brain. The "snowflake" of a single intrusive thought, as he puts it, had become a "blizzard" that "blew the snow into every corner of my mind, and laid down a blanket that muffled every surface." For the next 20 years, Adam was consumed by the fear that he had contracted, or would contract, H.I.V.: He called the National AIDS Helpline so many times daily that the half-dozen staffers there came to recognize his voice; he got blood tests; he compulsively examined and re-examined every red stain he ever came across to determine whether it might be AIDS-tainted blood, and whether it might somehow have contaminated him. He knew this to be irrational - he was a science writer! - yet he couldn't resist his compulsions. He had developed obsessive-compulsive disorder, or O.C.D. Despite the distress his AIDS obsession caused him, he managed to live with, and to hide, his condition for years. But in 2010, at age 38, when his compulsions started to involve his young daughter - he once felt compelled to lift her into and out of a swing 11 times to test whether she might have picked up a spot of infected blood from the playground - he decided he'd had enough. The next day he made an appointment with his doctor, and began a course of treatment that included medication (200 daily milligrams of an S.S.R.I. antidepressant), group therapy and cognitive behavioral therapy, which in combination reduced his symptoms without altogether eliminating them. Adam's case history conveys a palpable sense of what it's like to live in a brain possessed by obsessive thoughts, but it mainly serves as the launching point for a broad-ranging odyssey across the history and science of O.C.D. A writer and editor at Nature, Adam is a companionable Virgil, guiding the reader through the hellish circles of the disorder, explaining scientific concepts in clear, nontechnical prose. Obsessive-compulsive disorder can make people do weird things. The mathematician Kurt Gödel was so afraid of tainted food that he would eat only portions his wife tasted first; after she became too ill to do this, he starved to death. The inventor Nikola Tesla spent the last 10 years of his life living in a hotel, eating at precisely 8 o'clock every evening, always using a stack of exactly 18 linen napkins to clean his cutlery; he felt compelled to walk around the block three times before entering his laboratory, and he was so afraid of germs that he would not allow his friends near him. My favorite anecdote from the book: A Canadian man whose O.C.D. was so unbearable that he attempted suicide by shooting himself in the head - but succeeded only in lobotomizing himself in such a way that he was cured. ("Do not try this at home," Adam advises.) So, what is O.C.D., which will afflict some 1 to 3 percent of us over the course of our lifetimes? As with so many mental afflictions, the answer is hardly straightforward. Is it a medical condition or a psychological one? That lobotomies and drugs can (sometimes) cure the disorder suggests it has a physical basis. Neuroscientists have found that it seems to be connected to disturbances in a part of the brain called the basal ganglia. (Disconcertingly, recent studies have found that strep infections in children can produce lasting O.C.D.-like symptoms.) Is O.C.D. a discrete syndrome or a subspecies of anxiety? For 33 years, the American Psychiatric Association classified it as an anxiety disorder - but in May 2013 the A.P.A. redesignated it as an impulse disorder, like Tourette's syndrome. Is it caused by nature or by nurture? Freud famously attributed obsessive-compulsive disorder to guilt about childhood masturbation. Rather more convincingly, genetic research reveals a powerful hereditary component to obsessions and compulsions. Yet genes or physical anomalies alone cannot account for the disorder's cultural dimensions. Pathological obsessions tend to cluster around certain recurring preoccupations such as cleanliness and contamination; religious ritual; a need for symmetry or patterns; and unwanted thoughts of violence and sex (which, crucially, are almost never acted upon by O.C.D. patients). Evolutionary biologists theorize that obsessive-compulsive disorder may be a "psychological immune system" gone awry - for instance, adaptive traits (like avoiding contaminated food) that when properly deployed help keep humans alive become damaging psychopathology when misdirected or overstimulated. For sufferers, the thirst for relief from intrusive thoughts and compulsions can be unending and, ultimately, unquenchable. David Adam's book should provide them with consolation (you are not alone) and hope (he's much better now) and it provides all readers with a fascinating glimpse of an unusual but enduring form of psychopathology that sheds light on how our elegantly evolutionarily designed brains can give rise to minds that sometimes work in painful, maladaptive ways. SCOTT STOSSEL is the editor of The Atlantic. The paperback edition of his latest book, "My Age of Anxiety: Fear, Hope, Dread, and the Search for Peace of Mind," has just been published.
Copyright (c) The New York Times Company [January 25, 2015]
Review by Booklist Review
*Starred Review* For people who suffer from obsessive-compulsive disorder, knowledge is not power. They may recognize that the intrusive thoughts driving them to continually check that the stove is turned off, or engage in rituals to ward off danger, are highly unlikely or even ridiculous. But that does not mean they can escape them, as Adam, a writer and editor at the scientific journal Nature, knows all too well. His own obsession, that he might contract HIV through blood or fluids left almost anywhere, has caused him to scrutinize photographs, examine paper towels, and make a series of calls daily to the National AIDS Helpline. In this riveting, at times disturbing, but always enlightening book, he shines a light on this misunderstood condition. Adam weaves his own story within a larger examination of the illness, from its possible origins and its appearance in specific cases throughout history to the way scientific understanding of it has developed over time, and its treatments, some more successful than others. For all the impressive marshaling of information, it is Adam's own story of his struggles with the condition, which his infant daughter forced him to confront instead of uneasily accepting, that is the most captivating aspect of this impressive work. Adam clearly shows both the devastating impact our thoughts can have when they turn against us, and how science is helping us fight back.--Thoreson, Bridget Copyright 2014 Booklist
From Booklist, Copyright (c) American Library Association. Used with permission.
Review by Publisher's Weekly Review
In a wide-reaching discussion that spans the spectrum of obsession, Nature editor David Adam strikes an impressive balance between humor and poignancy, and between entertaining and informing. Adam seamlessly moves between personal stories of his own struggles with OCD and case studies of other people with the disorder. He also demonstrates that OCD isn't limited by cultural boundaries, with the chilling story of an Ethiopian girl who ate an entire mud wall and that of Austrian mathematician Kurt Gödel, whose fear of poisoning led him to starve himself to death. Adam moves from these full-blown cases to more commonplace obsessions with ease, while his smooth prose ensures an enjoyable read. Not neglecting the darker nature of obsession, Adam manages to end on a note more hopeful than harrowing: the story of how he found happiness and relief from OCD. Agent: Karolina Sutton, Curtis Brown. (Jan.) © Copyright PWxyz, LLC. All rights reserved.
(c) Copyright PWxyz, LLC. All rights reserved
Review by Library Journal Review
Writer and editor Adam (science journal Nature) spent many years overcome with worry about contracting AIDS from accidentally touching contaminated blood before fighting his intrusive thoughts with the help of medication and group therapy. In this book, which is part memoir, the author's story of his struggle with obsessive-compulsive disorder (OCD) serves as a backdrop for a historical and scientific exploration of the disorder, including descriptions of other cases of OCD, its possible evolutionary and genetic origins, its underlying brain abnormalities, its relationship to other psychiatric disorders, and historical and modern approaches to treatment. Rather than dwelling on the seemingly strange behaviors of individuals with OCD that are so often portrayed by the media, such as excessive hand-washing, checking, or counting, Adam emphasizes that it is the persistent unwanted thoughts that are most distressing and disabling to OCD sufferers. Verdict Although at times meandering and overly simplistic, this book is recommended for general readers who are curious about OCD, who have friends or family with the disorder, or who see tendencies toward obsessive thinking in their own lives.-Katherine G. Akers, Univ. of Michigan Libs., Ann Arbor (c) Copyright 2015. Library Journals LLC, a wholly owned subsidiary of Media Source, Inc. No redistribution permitted.
(c) Copyright Library Journals LLC, a wholly owned subsidiary of Media Source, Inc. No redistribution permitted.
Review by Kirkus Book Review
An engrossing first-person study of obsessive-compulsive disorder from within and without."An Ethiopian schoolgirl called Bira once ate a wall of her house," writes acclaimed British Nature editor and writer Adam in the opening of his account of OCD. "She didn't want to, but she found that to eat the wall was the only way to stop her thinking about it." Bira, who had eaten over half a ton of mud bricks by the time she was 17 and finally sought medical attention, was found to have only "moderately-severe" OCD because she spent a mere two hours per day thinking about and then eating a wall of her housethe average OCD sufferer can spend six hours per day thinking odd thoughts and then four hours acting on them. What lends especial weight to Adam's remarkable study of what psychiatrists consider the fourth most common mental disorder and the World Health Organization ranks as the 10th most disabling is Adam's admission that he, too, suffers from OCD, having been plagued for over 20 years by an irrational fear of contracting AIDS. Far from being fastidiously punctual or a tad "anal" around the house, Adam demonstrates that OCD is a serious, crippling condition capable of rendering the daily life of the afflicted virtually unlivable. "OCD," writes the author, "dissolves perspective. It magnifies small risks, warps probabilities and takes statistical chance as a prediction, not a sign of how unlikely things are." Repeatedly transfixed by a bizarre thought, which turns into an obsession, the OCD sufferer cannot find relief until compulsively acting on that obsession. Adam delves deeply into OCD's possible causes, its varietieswhether obsessed with contamination from dirt (Lady Macbeth) or disease (Howard Hughes), an irrational fear of harm or irrepressible need for symmetry (Samuel Johnson)and treatments, breaking down this complex condition in easily accessible layman's terms. Well-researched, witty, honest and irreverent, Adam's account proves as irresistible as his subject. Copyright Kirkus Reviews, used with permission.
Copyright (c) Kirkus Reviews, used with permission.
