The Man Who Couldn’t Stop (11 page)

In one bizarre case of conditioning, a man found that he was impotent when he tried to have sex with his wife – but only when the couple were at home. In therapy he described how he had previously been discovered in bed with another man's wife and how the cheated husband had thrashed him. The man remembered how his assailant's wallpaper, by unlikely coincidence, was the same as that on the walls of his and his wife's own bedroom. The beating had made him classically conditioned to associate sexual desire and the wallpaper with the fear of violence. One redecoration later, the problem went away.

Conditioning had a flip side. If someone could deliberately be made to associate undesired behaviour with an unpleasant experience, the behaviourists thought, then the drive to carry out that undesirable behaviour should cease. This spawned the era of what became known as aversion therapy. It saw compulsive gamblers play fruit machines wired up to deliver electric shocks, alcoholics given a drink together with drugs to make them vomit, and overeaters forced to watch a doughnut cooked in front of them while they sniffed at pure and rotten skunk oil.

Most shamefully, psychologists in the 1960s and 1970s used aversion therapy to try to reverse homosexuality. Gay men were shown photographs of naked men and women, and if they looked at the man for too long, their therapist would shock them with electricity. Success of the treatment was judged by how many women each homosexual managed to sleep with over the year or so that followed, and the relative size of their erections when shown straight and gay pornography. Those who failed to convert were coached on how to chat up a woman and how to read her body language.

There is some evidence that a form of aversion therapy was tried in ancient times. Roman citizens who drank too much alcohol would be forced to swallow an eel from a wine glass. And early Buddhist texts describe an over-talkative chaplain who was cured of his habit by a cripple who hid behind a curtain and used a pea-shooter to fire pellets of goat dung into the chaplain's mouth whenever he opened it to speak.

Aversion therapy was used to treat OCD. A 49-year-old obsessive-compulsive patient was equipped by a psychologist at a Birmingham, UK, hospital in the early 1970s with a device that strapped electrodes to his fingers and automatically delivered an electric shock if he washed his hands too often (the water completed the circuit). Frank Kenny, a psychologist at the Memorial University of Newfoundland, went further with aversion therapy for obsession. He thought he could use it to turn off not just the compulsions but the intrusive thoughts themselves.

Kenny would ask his patients to form an image relevant to their obsession, or to say a repetitive phrase, and then he would blast them with painful electricity. He did it thirty or forty times in each session, for up to five sessions a week. It could produce ‘lasting change' he reported.

It must have been quite a sight. Mrs D, a 33-year-old housewife and one of Kenny's first subjects, for example, would say out loud her intrusive thought: ‘I am going to have sex with my dog' and then raise her finger. Kenny, sat behind, would take this as his cue to shock her and Mrs D would react to the pain, wait thirty seconds and repeat ‘I am going to have sex with my dog.' Zap. ‘I am going to have sex with my dog.' Zap. Kenny grandly called the treatment ‘Faradic Disruption' (Michael Faraday being the scientist who invented the electric motor).

Aversion therapy was controversial among scientists, and dynamite in the media. Anthony Burgess's 1962 novella
A Clockwork Orange
graphically describes a (fictional) aversion method called the ‘Ludovico technique', in which the book's antihero, Alex, has his eyes pinned open and is forced to watch violent scenes and listen to his favourite classical music, while under the effect of a drug that induces nausea. Alex subsequently tries to kill himself.

By the time the film of the book was withdrawn from British cinemas in 1972, a full-scale backlash was under way against aversion therapy, which some critics claimed was being used to brainwash people in the style of Aldous Huxley's
Brave New World
. Opponents in the US labelled behavioural psychologists Rockefeller Nazis and said (with a confused take on politics) that they bred communists. One prominent behavioural psychologist at the time, Jim McConnell at the University of Michigan, was later targeted by the terrorist known as the Unabomber.

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I had a mild brush with aversion therapy. After several years of denying that I needed to, I eventually went to see a psychiatrist. I was still in Leeds, by now studying for a postgraduate degree, and a psychiatrist came to the university's medical centre once a fortnight. He gave me a red rubber band and told me to wear it on my wrist and snap it against my skin whenever I had an intrusive thought about HIV or Aids. That was treatment for OCD in the mid-1990s. It was called thought-stopping, and it was another idea of the behaviourists. My band lasted a few hours. The next one survived a day. I went to a budget stationery shop and asked for the biggest bag of rubber bands they had.

Thought-stopping, scientists now accept, does not help people with OCD, any more than relaxation techniques or Freudian psychodynamics do. Still, my trip to the psychiatrist was not wasted. It showed me that I was not alone. The psychiatrist had asked me if I wanted to join one of his group sessions for OCD. I didn't. I wasn't keen to hang out with hand washers because I didn't see how it would help. My problem was different I said, and I doubted anyone with OCD would truly get it. ‘David,' he replied, ‘I am seeing three other people at this university with OCD and they have the same irrational fear of HIV that you have.' I felt a strange sensation; I now realize it was hope.

He also told me the way to beat OCD. It sounds easier than it is. He told me that the compulsions, in my case the urge to make sure I had not exposed myself to HIV by checking and seeking reassurance, fuelled the obsessions. He explained the vicious circle that I was trapped inside. The way to stop the ride and get off, he said, was to resist the compulsions.

To beat OCD was as simple as that, just as scoring a hole-in-one on the golf course is as simple as hitting the ball directly from the tee into the hole. I played a lot of golf at that stage of my life. The odds that a regular golfer like me will score a hole-in-one have been worked out as twelve thousand to one. Before I was able to properly resist any of the compulsions of my OCD, I managed to score two.

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I never smoked but I imagine that to resist the compulsions of OCD is what it must be like to try to quit cigarettes. Like sticking to a diet, to stop the compulsive checks ultimately comes down to willpower. But what must be resisted in OCD is not a physical craving, but the mental pull of your own consciousness. In the grip of a compulsive urge there is nowhere to hide and nothing to reason with. To resist a compulsion with willpower alone is to hold back an avalanche by melting the snow with a candle. It just keeps coming and coming and coming. The obsessions and compulsions of OCD are linked by a force of nature so strong that to break the connection demands almost supernatural effort. When I was in the grip of the worst of OCD, if you had asked me not to investigate suspicious red stains on a communal towel, you may as well have ordered me to fly or to shoot thunderbolts from my fingers.

Some days I had more supernatural willpower than others. Some checks seemed more harmless than others. I learned which situations would prompt the thoughts and the urges, and worked out ways to avoid them. If I was unsure whether someone else had drunk from my glass, I didn't finish it. If an opponent on the Astroturf soccer field shredded his knee, I would avoid him. In that way I muddled through. I had good days and I had bad days. I had lots more bad days. When things became especially bad, when a thought just would not budge, then I would force myself back to donate blood. The blood donor service would take it only every sixteen weeks. I would count down the days in a planner.

It's not that OCD meant I could not function, and that I couldn't think of or do anything else – I did well in exams, I had friends and girlfriends, furious arguments and fun conversations, and I held down some decent jobs. It's just that I was thinking about something else at the time. I was thinking about HIV and how I might have caught it when I learned that my grandmother had died, when I found out that Princess Diana had been killed, when I saw
Pulp Fiction
at the cinema and when I watched rower Steve Redgrave claim his fifth Olympic gold medal on television. I was thinking about HIV and Aids in the days before I got married – I had met a climate scientist at a conference the previous week with a sore on his lip and I couldn't be sure that we hadn't mixed up our drinks. OCD stole something from me at that stage of my life: it took away my attention.

There is a great line in a book about famous hypochondriacs by Brian Dillon. It's called
Tormented Hope
and it talks about a point in the life of a hypochondriac when things change. They begin to secretly date everything back to the moment they first realized something was wrong. Life previous to that point, he writes, looks idyllic and elusive. In a similar way, I am a world expert on the events of 1991, or more precisely whether they happened before or after the summer, before and after my first obsessive thoughts. Those before, I participated in. Those after, I watched. Obsession meant that I navigated much of life after the summer of 1991 on autopilot. I was up front and central. I looked the part and smiled at the passengers, but something else was flying the plane.

Then there was Stoke City. As I write this book in 2013, Stoke City is a soccer club that plays in the English Premier League. As you read it, I hope it still does. I'm not one for the over-intellectualization of soccer, but Stoke City helped me through my years with OCD.

I used to go and watch Stoke play before the summer of 1991, so it offered a bridge that could connect me with those idyllic and elusive days. And then there was the impact when Stoke City scored a goal. It's tragic, I agree, but at my grandmother's funeral, my younger brother and I stood awkwardly next to each other, we barely said a word. Yet just a few weeks later, when Peter Thorne scored for Stoke City in a match against Cambridge United, we hugged and yelled at each other at the top of our voices. A Stoke City goal, a mixture of elation, release, celebration, relief and usually, quite frankly, surprise, would penetrate. I felt it. OCD put a shock absorber on most of my emotions, especially those that I could see coming. But it couldn't buffer the feeling of a Stoke goal.
*
I know, like I said, tragic. Worse, even. When you rely on goals from Stoke City to get you through life, you know you truly are fucked.

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That was my way to live with OCD. And as most people with OCD never get help, and those who do take, on average, seventeen years to see the right person, most do have to live with it. In fact, we can be pretty confident that people have lived with intrusive thoughts, obsessions and compulsions for centuries. This is not the first book to describe the impact of irrational and recurring weird thoughts. Not by some six hundred years.

Margery Kempe was born around 1373 and some experts consider her book, published in 1436, the first autobiography written in English. A clergyman took her dictation and wrote the account of her life – still in print – in the third person. Kempe fought against intrusive thoughts of erect penises. ‘She was shriven [granted absolution], and did all that she might,' the book says. ‘But she found no release, until she was near at despair.'

One of the most detailed historical accounts of the impact of intrusive thoughts was recorded by John Woodward, an early eighteenth-century fellow of the Royal Society and professor at Gresham College, London. He wrote about Mrs Holmes, a 26-year-old woman from London Bridge who became obsessed with thoughts of a porpoise that she saw in May 1716 in the River Thames:

She never awaked but this Thought first came into her Mind; and continued till she went to Sleep again … She frequently endeavoured to cast that Thought out; and to introduce another, that might be more pleasing to her; in which she sometimes succeeded; but the new Thought, however pleasant at first, became, in a little time, as troublesome and disturbing as that of the Porpoise.

An apothecary advised Mrs Holmes to ‘be cheerful and brisk' – the eighteenth-century equivalent of ‘pull yourself together'. Woodward was not impressed with this advice, lamenting that it was the common response of ‘those who are not Judges of these things, and who do not know, that People in this Case are subject to the Fury of a Morbid Principle, and wholly under the Government of it'.

There are historical accounts of what can seem compulsive behaviour too, though we should interpret them with caution. Repetitive actions, even those that seem obsessive and irrational, say little that is precise about a person's state of mind. Some stories of the history of OCD, for instance, include a tale from the ancient days of the Buddha, some 2,500 years ago, and an apparently obsessed monk who felt compelled to sweep the floor of the monastery continuously. That may look like OCD, but other accounts from the time describe how the Buddha told one of his disciples, Suddhipanthaka, to deliberately sweep the floor non-stop to reach enlightenment. We might say today that Suddhipanthaka was ‘a little bit OCD' with his sweeping. But he wasn't.

One prominent person in the past who did seem to suffer from genuinely compulsive behaviour was Samuel Johnson, the eighteenth-century English writer and dictionary compiler. His biographer James Boswell noted how Johnson would count his steps and make sure that he always started on the same foot. Often, he would stop, count again and then head back to try again, even while his companion would carry on down the street.

Many historical accounts of obsessive behaviour detail not just the presence of intrusive thoughts, but the folly of trying to suppress them. These writers may never have seen a white bear, but they knew of the effect. Martin Luther, the sixteenth-century German priest who inspired the Protestant Reformation and suffered from obsessive thoughts, gave the advice: