A Memoir on OCD 1
A New Perspective on the Effects of OCD on Life
Evan J. Green
Xavier University
OCD
A New Perspective on the Effects of OCD on Life
Introduction
Obsessive Compulsive Disorder is publicized by the media as a disorder that always
affects individuals the same way: germophobic, orderly, hyper-organized, and stress over
symmetry, straightness, and grouping. These demonstrations have even cascaded down the
popularization of such platforms into the average person’s vernacular. If someone constantly
sanitizes their hands, colour coordinates their closest, or alters the objects on their desk to be
straight or in a symmetrical fashion…they are considered “OCD.” The term is an abused version
of the word, but it is almost impossible to have not used it or not heard it to describe someone
with such tendencies. “You’re OCD” is a phrase commonly used to describe someone with the
characteristics previously described. It is used as if the individual displaying such qualities is the
disorder itself. While people with Obsessive Compulsive Disorder can show such behaviours,
the disorder has many more facets of complexity often misunderstood by people using the term
to describe someone with above-average sanitation rituals.
There are many perspectives on the disorder, but most agree that the problem is two-fold.
It is the unstable relationship between obsessions and compulsions. Hence, the inclusion of both
terms in the label. “Obsessions are recurrent and persistent thoughts, urges, or images that are
experienced as intrusive and unwanted, whereas compulsions are repetitive behaviors or mental
acts that an individual feels driven to perform in response to an obsession or according to rules
that must be applied rigidly” (DSM-5 300.3 F42.2). Most individuals clinically diagnosed with
OCD understand and even admit that their obsessions are intrusive and alien. The compulsion
part is a form of stress relief. The undesired thoughts come, bringing stress with them, and
compulsions are believed to be the behaviour performed in response to that stress in hopes of
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alieving it. Previously thought to be an anxiety disorder, the American Psychological Association
gave OCD a classification of its own in the Diagnostic and Statistical Manual of Mental
Disorders, Fifth Edition (DSM-5). Part of the reason it received its own classification was the
increase of related disorders such as body dysmorphic disorder, hoarding disorder, and
trichotillomania. As the OCD family grows, it also becomes increasingly important that people’s
education on the effects, characteristics, and destructiveness should grow as well.
Book Summary
David Adams opens his book up with a memory of when his Obsessive Compulsive
Disorder was preventing him functioning normally. It makes sense that his book is titled The
Man Who Couldn’t Stop: OCD and the True Story of a Life Lost in Thought. He goes on to
explain that his obsessions revolve around HIV/AIDS. He knows his fear is irrational but
anytime he has a cut, shakes hands with someone who has a cut he compulsively cleans that cut
area or the area that came in contact with blood. He cannot tolerate sharing drinks with others.
As he advanced into his adult years, his fear of contracting HIV complicated and negatively
affected his sex life. He is aware that his thoughts are intrusive and irrational, but he feels the
urge to take all the caution he can to prevent the contraction of HIV. Nonetheless, Adams
delivers a personal testimony that not only displays the maladaptive nature of OCD, but also
what OCD is and how it works.
Symbolically, he provides an explanation that accurately sums up the disorder and is easy
to remember. “Like the shape of the letter C in OCD, compulsions are open to the world; they
offer a handle on the condition. And like the shape of the letter O, obsessions are sealed off”
(Adams 32). People see the compulsive side of OCD, but they have no idea what thoughts cause
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the compulsive behaviours. Adams continues with his in depth analysis of OCD with thought.
Intrusive thoughts are not exclusively limited to those with the disorder. Everyone has intrusive
thoughts regardless of their cognitive deficiencies or giftedness. What is unique to OCD is the
anxiety from such thoughts, and the need to perform some compulsive behaviour to relieve the
stress of the intrusive thought(s). Compulsions can be internal or external. Some people need to
execute a physical compulsion such as washing their hands, while other people perform mental
compulsions such as counting.
Adams provides a bountiful variety of real life examples when explaining others with
OCD and how the disorder affects their lives negatively as well. These examples, as well as his
own memories, are intermixed with a description of OCD that closely resembles the book. He
explores the history of OCD and how it was originally called monomania because of the
tendency for disorder’s focus on one issue such as a fear of germs, focus on HIV, or fixedness on
counting. He then goes about to continue his description with the Freud and the psychodynamic
view of the disorder. He highlights the importance of differentiating the symptoms of people
with OCD. Psychologists “found two separate and distinct patterns, which they labelled the Atype
and the B-type” (Adams 63). The A-type describes people who are very systematic and pay
close attention to detail. They have a strong dislike for dirt, and are very punctual. Today, the Atype
is referred to as Obsessive Compulsive Personality Disorder (OCPD). The B-type is people
highly affected by intrusive thoughts and find it impossible to not carry out compulsive
behaviours they know to be irrational.
Something that was new to me was just how differently OCD affects people. Not
everyone is germophobic. “An OCD washer who cleans his hands 200-odd times a day can wear
the same underwear for weeks” (Adams 65). To further development of a comprehensive
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explanation, the behavioural, cognitive, and biological perspectives were explored. In the
textbook, as well as the DSM-5, there is a section referred to as “OCD and Related Disorders”
(Comer 169). Adams has a similar section (Chapter 5), in which he looks at other related
disorders with examples of each one. Each disorder had the potential to be equally debilitating.
In the more personal part of the book—intermingled with scientific explanations—that
Adams states that he, as well as most people with OCD, can pinpoint an exact circumstance
when their OCD began. For him, it was a rusty screw on a subway that he had scraped. His
intrusive thoughts about OCD began when he was in university in London. While he attempted
to see people, he could not find solace with psychodynamic therapy. He saw benefits to cognitive
therapy but knew he needed medication. It was not until his daughter was born that he found the
motivation he needed to get medicated. For him, his daily regimen consists of taking 200 mg of
Sertraline Hydrochloride every morning. He then goes into the more scientific justification of the
drug’s process. SSRI’s are defined by the textbook as “a group of second-generation
antidepressants drugs that increase serotonin activity specifically, without affecting other
neurotransmitters” (Comer 268). While effective for depressive disorders, they do not seem to
have much use for those diagnosed with OCD. In its early days of study, they were believed to
help OCD patients—Adams was even offered some at one point by a clinician—but are no
longer used as treatment for OCD.
Adams concludes with just how maladaptive his OCD is. It has affected his relationship
with his wife and daughter, and it continues to be a struggle for him. The Sertraline
Hydrochloride is a savior to the atheist. It has made a significant impact on the author’s life and
continues to do so. Although he stresses the hardships OCD patient’s face, he more strongly
stresses “scientists are constantly finding out more about the condition and the best way to
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diagnose and treat people with it” (Adams 282). Without seeking clinical help, it is doubtful that
the symptoms of the disorder will vanish on their own. However, the future of those affected by
it is becoming increasingly optimistic.
Author’s Experience Vs. Initial Impressions
My initial impression of the disorder was fairly limited. It was mostly constructed around
the USA Channel’s character Adrian Monk. A private detective on the show “Monk” who has
severe OCD. He is germophobic, wears the same outfit everyday (although clean), has every
wall/house decoration symmetrically numbered, needs hand wipes after shaking hands with
someone, counts posts and street signs as he walks past them, and has photographic memory.
“Monk”, although odd, popularized OCD. I wanted OCD! Adrian Monk was the best detective
there was—he was brilliant. David Adams, completely shifted that view. His testimony opened
my eyes to the damage OCD can have on one’s life, which was an aspect I never considered
about my favourite television character. The Man Who Couldn’t Stop also displayed the
broadness of Obsessive Compulsive Disorder. Not everyone is a neat-freak or germophobe. Not
everyone displays external compulsions. However, the book did coincide with the fact that an
irrational fear of germs, necessity for organization and order, and unconfirmed repetitive
checking were typical characteristics of the condition.
Author’s Experience Vs. Typical Presentation
OCD is a highly misunderstood disorder even though it is the fourth most common
mental disorder after depression, substance abuse, and anxiety; tenth most debilitating medical
condition, and twice as common as autism and schizophrenia (Adams 9). Most people are aware
of the symptoms and behaviours displayed by those affected by it, but they do not understand its
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flexibility in variety or the process of how it works. The textbook defines OCD as “a disorder in
which a person has recurrent or unwanted thoughts, a need to perform repetitive and rigid
actions, or both” (Comer 163). Adams did have these, but he never said he is organized, counts,
or has a need for symmetry as are often seen by those with OCD.
There is also evidence to suggest an increase in diagnosis if other family members are
diagnosed with the disorder. For one study identical twins showed 53% correlation while
fraternal twins showed 23% (Comer 167). Genetics may play a role. So might the nurture part of
nature versus nurture conundrum. “Parents' own psychological states may significantly impact
the experiences of their children and may contribute to the emergence and maintenance of
obsessive behaviours and rituals” (March and Curry 26). While this is the case for some, Adams
differed. In his conclusion, the author goes through each perspective and explains it was not his
genetics nor his upbringing. He sarcastically goes down the list of perspectives finding a possible
explanation for each one stating possibilities such as “it was my parents who did it or my
childhood fear of dogs” (279). While he does not have an exact genesis of his condition he tries
to provide a possible one about a bullying accident. His only comfort was to start counting.
While this was not a compulsion he later carried out, he believes it to be the first time he could
have had symptoms defined as OCD.
Something Adams did share with the scientific community and its outlook on Obsessive
Compulsive Disorder was his treatment. He decided to attack his OCD with medication and
therapy. Evidence suggests this is the best treatment. In one study involving 97 people over the
course of 12 weeks, “Intent-to-treat random regression analyses indicated a statistically
significant advantage for CBT alone (P = .003), sertraline alone (P = .007), and combined
treatment (P = .001) compared with placebo. Combined treatment also proved superior to CBT
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alone (P = .008) and to sertraline alone (P = .006)” (Pediatric OCD Treatment Study Team). The
combing CBT with sertraline was more effective than doing either one alone or none at all. This
is exactly what Adams did. Today, he still has the intrusive thoughts, but they rarely affect as
they used to. He is aware of them, but is able to more easily let them go without the fear of being
contaminated by HIV.
Illness Impact
The author was negatively impacted by his condition. However, it was not largely
external. In front of people he kept his thoughts to himself, but later he would replay the moment
in his head when he had come in contact with bodily fluids or he would go to the bathroom to
clean his wound or affected area. In university his sex-life was somewhat affected by his fear of
contracting HIV, but he would find excuses to go about this. He would spend hours researching
about HIV/AIDS to figure out if he could have contracted it from specific encounters he had had.
On a ski trip he went on with family and friends he spent an entire day inside after he had seen
blood the previous day. While he does not say it affected his wife, I am sure it was not something
he could not hide from her. Even though it was his daughter who motivated him to become
medicated, she was only a toddler when the book was written. He had once scratched himself
and the blood got on her. The intrusive thoughts came flooding in that he may have jeopardized
her future by transferring the virus (that he did not have) from himself to her. Two years later by
the time his son was born, he had been medicated for some time and receiving therapy. So, by
the time the kids will be old enough to be affected by it, he will have probably had it
undetectably under control. Nonetheless, as the title will attest, he truly has spent much of his
life lost in thought.
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Conclusion
Adams depth did not blur his explanation, and in the places of brevity there was only
further utilization of his arsenal writing techniques. His concoction of scientific explanation,
graphic examples, and personal memories made for the best comprehension of OCD in the daily
life of those affected by the disorder. He delivered perspectives and reasons I had never even
began to consider. Although a popularly known conduction, the knowledge of its workings is
less. “Obsessive-compulsive disorder (OCD) occurs in between 1% and 4% of children and
adults” (Geller et al. 5). The field of psychiatry/psychology has come a long way from its
original thoughts about the disorder and continue to find more discoveries and treatments for it in
the future. While Adams demonstrated and enlightened new facets of the disorder, he did differ
from other people with OCD. Not everyone obsesses over HIV as he did, and not all people
receive the same treatment he did. Some individuals do not receive any treatment. However, as
Adams suggests, OCD will not dissipate on its own. Treatment should be sought, and his
testament is living proof of that.
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References
Comer, R. J. (2015). Abnormal Psychology (9th ed.). New York: MacMillan Learning.
Diagnostic and statistical manual of mental disorders (5th ed.). Arlington, VA: American
Psychiatric Publishing.
Geller, D. A., Biederman, J., Jones, J., Shapiro, S., Schwartz, S., Park, K. S. Obsessive
compulsive disorder in children and adolescents: A review Harvard Review of
Psychiatry 5 260–273 1998.
March, J., Curry, J. Predicting the outcome of treatment Journal of Abnormal Child
Psychology 26 39–51 1998.
POTS Team. (2004, October 27). Cognitive-behavior therapy, sertraline, and their combination
for children and adolescents with obsessive-compulsive disorder: the Pediatric OCD Treatment
Study (POTS) randomized controlled trial. Retrieved March 13, 2018, from
https://www.ncbi.nlm.nih.gov/pubmed/15507582
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