All three are described as suffering from obsessive compulsive disorder in this study of the condition by the science journalist David Adam. Bira was in her early teens when she began to suffer from a powerful urge to consume the wall of her home in Addis Ababa, Ethiopia. By the time she was 17, she had eaten eight square metres of mud bricks. Gerald Kaufman’s self-diagnosed OCD was revealed during the 2009 expenses scandal, when he blamed the malady for his decision to claim £220 for the purchase of two crystal grapefruit bowls.
Andersen, meanwhile, rose several times each night to check he had extinguished his bedside candle and suffered from a crippling fear of being buried alive – a surprisingly common 19th-century preoccupation, which he sought to calm by leaving a note on the bed reading “Jeg er skindød”, or “I only seem to be dead”. Andersen saw his troubling thoughts as the shadow side of his creativity, but most people with OCD find it a condition with few redeeming features, as Adam knows only too well, having lived with it for more than 20 years.
He writes that his problems began “with an intrusive thought, a snowflake that fell from a summer sky”. As an 18-year-old student in 1990 he spent the night with a pretty girl. The following morning, a friend crassly joked that he might have caught Aids. There wasn’t the faintest chance – the evening had been disappointingly innocent. But the idea lodged in his mind and eventually developed into the incapacitating obsession with Aids that has troubled him since.
Adam understood that his fixation with contracting the disease was irrational, but it took him a long time to identify it as OCD. Popular perception tends to view the condition as a quirky or even comic collection of traits. The expression “a bit OCD” is often used as shorthand for neurotic behaviour such as that of Monica, the uptight character in the sitcom Friends, with her mania for cleaning and her fixation with crumbs in the bed.
At first Adam found it hard to accept that his intrusive thoughts might mean he was ill. In this he was not alone. “Mental health professionals refer to OCD as a silent epidemic,” he writes. The difficulty of treating the condition is compounded by the fact that even the experts seem unable to agree on a definition. It is a mental illness? An abnormality? An anxiety disorder or a syndrome? Adam uses the terms interchangeably in a narrative that combines a scientific account of OCD from ancient times to the most recent research with passages of tenderly written memoir.
OCD may lack a fixed definition, but anecdotal descriptions of it abound, from Boswell’s tales of Samuel Johnson’s compulsive behaviour to Freud’s case study of the sadistic fantasies of the “Rat Man”. As early as 1834, Jean Étienne Dominique Esquirol, director of the Charenton asylum, wrote a history of one of his patients, Mlle F. Though otherwise rational, she was tormented by the fear she might accidentally steal something.
The hypochondriac in us all is invariably gripped by a colourful medical vignette, and Adam’s narrative is punctuated with them. The story of his own OCD makes a moving counterpoint to the complex and occasionally lurid history of the disorder and its treatments: the chapter on lobotomy makes particularly grim reading, with its description of “brains irreversibly damaged by cavalier surgeons armed with nothing more precise than knitting needles…”
After enduring his OCD for 19 years, Adam was finally driven to seek treatment when he accidentally smeared blood from a cut finger on his baby daughter and realised that while his fear of infecting her with Aids was groundless, the danger of passing on his obsessive behaviour was all too real (OCD, he notes, tends to run in families).
Cognitive behavioural therapy, plus a daily dose of antidepressants, has brought him to the point where he is able to control intrusive thoughts by thinking, “What would most people do?” But as his book so graphically demonstrates, the inside of the human mind is a stranger place than we who think of ourselves as “normal” would ever care to admit.
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