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The Man Who Couldn't Stop: The Truth About OCD    by David Adam order for
Man Who Couldn't Stop
by David Adam
Order:  USA  Can
Picador, 2015 (2014)
Hardcover, Softcover
* * *   Reviewed by Carrol Wolverton

The Story of Unreal Logic ...

In 1949 brain scientist, Egas Moniz, couldn't travel to claim his Nobel Prize in physiology because he'd been shot by a patient whom he partially paralyzed during one of his operations, a lobotomy-type procedure done in the interest of helping people with mental illness. This and other gems populate this most interesting book written by a man who has been there.

The author freely admits he's OCD and suffers bouts of terrible anxiety cause by the disorder. He blames his cause on extreme guilt of suspect origins. His fear of HIV infection and focus on blood infection came about when the world was coming to grips with the terrible AIDS disease. He was scared to death of getting the illness or of infecting his baby daughter, and his fears spun out of control. The was no rational cause for his angst, but that doesn't matter to a person with OCD. They worry, they count, they check and recheck repeatedly, they horde, and they spin in a never ending cycle that prevents them from functioning.

He tells the story of the 1930's era wealthy New York Collyer brothers who horded and became the subject of curiosity and interviews by the media. One brother lost his eyesight and his brother cared for him. When asked about all the newspapers in the mansion, the sighted brother said they for when his brother's eyesight returned. He was treating him himself by feeding him hundreds of oranges. Both died after the sighted brother was trapped under a pile of collapsing debris while trying to serve his brother's breakfast. Should you try to find any logic in this, there is none. This is the essence of OCD: compulsive non-logical thoughts and behaviors that are out of control. The whole disorder is unreal logic.

Where does this affliction come from? He traces possibilities in depth. It may be nature or nurture or both. He also traces treatments from early times, through the long Freud years, to the present. He even explains the DSM classification origins and how designations have changed. Mental health is clearly a problem area for medicine and the changing classifications of disorders proves this. The history of treatment is as scary as the disorder.

For him both meds and therapy worked for the most part. He speaks at length about cognitive behavioral therapy and how it helped. Sometimes nothing works. There is no one good answer.

OCD patients have been favorite targets for those who worked with lobotomy. Famously, Rosemary Kennedy had a prefrontal lobotomy. As may have Eva Peron sometime prior to her death. It's been used to try to cure or treat most mental illnesses. Sadly, it still is under the guise of other forms and names. Adams labels lobotomy-type procedures as ice-pick surgery.

Most people have unwanted thoughts and fleeting compulsive ideas such as driving off embankments or thoughts of hurting others. These are flights of the imagination on which most people would never act, including OCD sufferers. But, for the afflicted, the thoughts keep coming back. Even though he would never purposely get HIV infected blood on his little girl, or even have access to such blood, the thoughts and fears wouldn't leave him. He was treated by a cognitive behavioral therapist who told him that he, the doctor, would take responsibility for the problem, telling him that the therapist would never do anything that would hurt his own career. It would be too dumb and risky. That shifted the responsibility to the therapist and eased the author's fears. Logical? Hardly. But it worked. Just as the disorder is not logical, the solution may not be either.

He concludes that modern psychiatry is a castle built in sand. He tells us that most people with OCD can't be cured, but they can be helped. Because of his depth of research and his 'I have been there and I understand' approach, this book should be of major value to persons suffering from this disorder. 'You are not alone' is his message. Too many people hide their disorder fearing job loss and ridicule. That fear is real.

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