The Man Who Couldn’t Stop Read online

  Obsession has no regard for rational explanation. No pathology of thought can be solved with more thought. The brilliant twentieth-century mathematician Kurt Gödel, a friend and colleague of Albert Einstein, lived his life for rationality. His incompleteness theorem used logic to explore and expose the limits of logic. Yet Gödel suffered from the wildly irrational and obsessive idea that he would accidentally be poisoned, from tainted food perhaps, or by gas that escaped from his refrigerator. He would eat no meal that his wife did not taste first. When she became ill and could not do this for him, the obsessive siege on his mind made Gödel starve himself to death.

  * * *

  Why I am writing this book? Obsession encourages attention to turn inward and drains focus from relationships with others. OCD cements the presence of an individual at the centre of their mind and their actions. And it distracts. There is always something else that you would rather think about, or not think about. I don’t want to be selfish any more. I now have two children who need me. I don’t want them to go through what I did. I don’t want them to develop obsessions, to be held hostage by their strange thoughts, to think up a monster. And if they do, I want to be able to help them.

  The best way to do that, I believe, is to investigate these strange and obsessive thoughts, to see how they work, where they come from and what we can learn from them. To question how the brain, our closest ally and biggest asset in millions of years of evolution, can turn against us so. To see what forces to the surface the obsessive Mr Hyde who lies dormant inside every Dr Jekyll − inside you − and how his betrayal can be stopped. And, as it turns out, it is a terrific story.

  Strange thoughts, the seeds of obsession, are everywhere. They scatter across the population. Yet only occasionally do they take root. The first step in our journey to understand obsession is to see how this happens.

  TWO

  Bad thoughts

  ‘How easy it would be for me to stick this kitchen knife into him.’ Most people have thoughts like that. They are called intrusive thoughts. Most people don’t talk about their intrusive thoughts.

  They don’t talk about them, that is, until psychologists take the trouble to ask. When they do, then survey after survey shows that about nine in ten people admit they experience intrusive thoughts that distress, bewilder, shock and perplex them. Most people have thoughts about driving their car off the road. A third of us say we have thoughts of grabbing money. More than four in ten get an urge to jump from a high place, an impulse so common that it has its own scientific name: the high-place phenomenon. Half of all women and eight out of ten men have thoughts of strangers in the nude, while half of all people cannot help but think of sex acts they consider ‘disgusting’.

  Intrusive thoughts are everywhere. But it took until the late 1970s for anyone to notice, when the South African-born psychologist Stanley Rachman and his Sri Lankan colleague Padmal de Silva made a stunning discovery. In trying to understand the nature of obsession, the two realized that many normal people seemed to have the same kinds of strange thoughts and impulses as patients with OCD.

  Their obsessive-compulsive patients had urges to insult and physically attack people, but so, it turned out, did their friends. The patients reported impulses to push people under trains and buses, to jump from high places and to deliberately crash their car. So did their colleagues. Both groups had ideas of violence during sex, had thoughts that they might have committed a crime they heard about on the news and harboured irrational fears that they might have suffered some contamination, such as from radiation or asbestos.

  When the psychologists wrote down the weird thoughts harvested from the minds of their OCD patients and those from their ‘normal’ associates on index cards, and mixed the cards up, even their most experienced clinical colleagues could not correctly distinguish which thoughts came from the damaged minds of patients considered mentally ill and which came from the highly respected people they worked and socialized with.

  * * *

  My OCD began with an intrusive thought, a snowflake that fell from the summer sky. ‘Shall we go upstairs?’ the girl had asked me. She was pretty, with long black hair that she had to push back from her eyes as we kissed. The skin on her arms was smooth and her hands, I remember, seemed so small. She was older than me, though she didn’t think so. Her question: ‘You’re not a first year are you?’ hadn’t left me much room to manoeuvre. I had lied about my university course too. I knew nothing about the politics of the French Revolution but it sounded of more appeal to her than chemical engineering. I knew little about chemical engineering either, but then I had only studied it for a couple of months.

  I was eighteen and a happy college student. Real life was on hold and time was a string of fun nights and daytime lectures on fluid dynamics and mathematics. I had little idea what a chemical engineer did, but I didn’t care. That was the future. And right now it felt good to think about only the next day.

  It was November 1990 in northern England so she wore a baggy white T-shirt with a purple skirt over Doc Marten boots and black leggings. I was pleased with my newly-grown sideburns. I thought she might mention them as we stumbled through the dry sand of our early conversation. By the time we headed from the university campus and into the neighbouring maze of terraced houses I realized that she wasn’t going to. We walked and we talked, about music and our friends. We reached her house and, as she invited me inside and closed the front door behind us, a new world beckoned.

  It was one of those frozen Leeds nights that Yorkshire folk are so proud of. The wheezing gas fire in her kitchen generated more light than heat and the cold chased us around the room like the smoke from a wood fire. Upstairs sounded good.

  * * *

  ‘Did you have sex with that girl?’ my friend Noel asked the next day.

  ‘Yes,’ I lied.

  ‘Did you use a condom?’

  ‘No.’

  ‘You could have Aids.’

  ‘Don’t be daft.’

  Had I had sex with that girl? No. Had we used a condom? No. Could I have caught Aids? Don’t be daft. Still, I hadn’t even considered the threat, despite all of the warnings. I should be more careful next time, I thought as I bought Noel a drink that night. I should have been more careful. The same thought, an echo of our conversation – you could have Aids – floated back into my mind from time to time over the next few months, but on each occasion I could muster the mental puff to blow it out. Don’t be daft. Then, one hot night in the August of 1991, I couldn’t.

  On holiday from university as I walked back to my parents’ house, with no warning the thought came again. You could have Aids. Only this time I couldn’t move past the idea, or the cramps of panic it caused. ‘Don’t be daft’ suddenly seemed an inadequate response to the scale of the threat, the possible consequences. I could have Aids. And if I did, then I was doomed. My life was over before it had truly begun. Worse, no matter what I did, no matter what anybody said, I could not change it. They could not fix it. I had lost the power over my own fate. As I tried to brush away the thought, the snowflake, it squirmed from my mental grasp and settled. Quickly it was joined by another, then another, then another. The blizzard that followed blew the snow into every corner of my mind, and laid down a blanket that muffled every surface.

  I gulped for air when I opened the window in my stuffy bedroom. I heard the scratch on the ceiling of the summer insects when I turned out the light. I saw the red glow of the stereo, still switched on from when I had lain on the same bed that afternoon, which already seemed a lifetime ago. I ripped down the dog-eared posters on the wall in terror. Why me? I was so frightened that the tips of my fingers tingled. I remember I told myself that all would be fine when I woke up the next morning. That was how life was – everyone had night terrors and everyone saw things differently the next day.

  The sun rose and the windows and curtains were still wide open. The thought was still there. You could have Aids. I went downstairs to the kitchen and had b
reakfast in the new world I would inhabit from that day, the first of the rest of my life. I watched my mum and dad gently bicker across the wooden kitchen table, and I thought how sad they would be if I did have Aids. I decided I would not tell them. I went back upstairs to my bedroom and buried my face in my pillow and wept. I could have Aids.

  * * *

  The obsessive thoughts of OCD are different to those that tend to dominate other types of mental anguish. Recurring and distressing thoughts are not always an obsession – at least not in the clinical sense. We can find our minds dominated by exaggerated and distressing thoughts of whether our child will survive and flourish in the world, for instance, or crippling nerves before an exam or driving test, but thoughts like that are in step with the rules and rhythms of our life. We want our child to be happy. We want to pass. We can think and worry non-stop about whether we might lose our job, but only because we know we need the money it brings to feed and clothe our family, which we feel and instinctively sense is the right thing to do.

  Thoughts like that are ‘ego-syntonic’. They are in harmony with our drives and motivations. Ego-syntonic thoughts can make us unhappy, but when they do it is their contents and not the thoughts themselves that are the problem. We do not question why we have them. Indeed, sometimes we resent others who do not have ego-syntonic thoughts as acutely as we do. ‘I can’t believe you left this to the last minute.’ ‘It’s only been a month. Of course I still miss him.’

  Taken to extremes these types of ego-syntonic thoughts can cause mental disorder, usually anxiety. But at their heart most concerns of anxiety are rational. So, usually, are the dark thoughts of depression: endless rumination on external events, regret of decisions and how life has unfolded. Severe grief, hysteria even, is based on the rational sense of loss.

  Unwanted and intrusive thoughts, the raw materials of obsession, are different. They are irrational. They strike a mental discord. They are ‘ego-dystonic’. They clash with how we see ourselves, and how we want others to see us. Just to think these thoughts is enough to make us question who we are. We are not dishonest, yet we could snatch the money from that open till so easily. We do not want to be the dreadful person who could think such terrible and ridiculous things. But most people are.

  Winston Churchill, a one-time First Lord of the Admiralty, didn’t like to travel by ship because of the ego-dystonic urge he had to jump into the water. Churchill was a well-known depressive but these, and similar thoughts he had of jumping in front of trains (he liked to stand with a pillar between himself and the edge of the platform) do not appear to have been genuinely suicidal impulses. Talking once of how he hated to sleep in a bedroom with access to a balcony from which he felt the urge to jump, he told his doctor Charles Moran:

  I don’t want to go out of the world at all in such moments. I’ve no desire to quit this world, but thoughts, desperate thoughts, come into my head.

  As Churchill observed, to have intrusive thoughts is not a sign that someone wants to act on them. A disturbing thought of sex with a child does not make someone a paedophile, just as an unwanted urge to hit someone with a hammer does not make someone a thug or a murderer. In fact the opposite is true. To consider such a thought or urge unwanted, disturbing and unwelcome – and so intrusive − is usually enough to show it is ego-dystonic and so contrary to someone’s normal personality and actions.

  Where do these bizarre thoughts come from? The simple, if unsatisfying, answer is that we don’t know for sure. The theory used by psychologists who study OCD is that our brains have something they call a cognitive ‘idea generator’. On most other occasions, this generator helps us to solve problems.

  To consider all possible solutions, it’s important for the mind to generate novel ideas and not immediately censor them. It’s a similar principle to a corporate brainstorm exercise and how every idea to boost sales or attract customers – however stupid – gets written on its own sticky note and given a nod of approval from an overenthusiastic manager. The cognitive idea generator does not have to anchor its responses to reality. Intrusive thoughts are what happens when the mind says ‘yes, and’ rather than ‘yes, but’.

  Not all unasked-for thoughts are unwanted or unpleasant, far from it. Mozart revelled in musical thoughts he did not command. Beethoven said something similar:

  You will ask me where I get my ideas. That I cannot say with certainty. They come unbidden, indirectly, directly. I could grasp them with my hands; in the midst of nature, in the woods, on walks, in the silence of the night, in the early morning, inspired by moods that translate themselves into words for the poet and into tones for me, that sound, surge, roar, until at last they stand before me as notes.

  Random inspirations of musical genius are all very well, if you’re fortunate enough to have them. But the thoughts most likely to make the rest of us sit up and take notice are odd and unpleasant. Those are also the ones that tend to stick around. Nobody gets obsessed by thoughts that they will be too nice to people, or by urges to give all their money away to a tramp. People do not complain to psychologists of intrusive thoughts of pushing someone with the build of a heavyweight boxer under a subway train. Intrusive thoughts bother us because the usual imagined victims are the small and the weak, the puny and the vulnerable; the child and the little old lady. It’s what psychologists label the Arnold Schwarzenegger effect.

  This might make sense, given the theory that a mental idea generator helps us to navigate through life. We may consider it uncivilized, but there are some situations where a natural and useful reaction when one sees a stranger would indeed be to beat them over the head. The smaller the stranger is than you, and so the lower the chance that they can hurt you, the more attractive that option becomes.

  According to the theory, sometimes an external cue – the rattle of a train or a dirty floor – can kick the idea generator into action, and make it churn out intrusive thoughts. At other times the trigger is internal – the result of stress or a low mood or a subconscious emotional shift, or the residue of an incomplete memory. In this case, the intrusions appear almost at random.

  It’s hard to test these ideas, so there is no experimental evidence to support them. All we know for sure is that intrusive thoughts pop up more in certain circumstances than others, under stress for instance, and that when they do appear, how we react is critical. A natural reaction, especially if the thoughts will not recede by themselves, is to try to force them to go away, to squash the idea, to deliberately shove the unpleasant notion behind the mental furniture or under the rug. That’s a bad idea. That’s when the problems can begin.

  * * *

  Leo Tolstoy knew well the mind’s inability to repel unwanted thoughts. When he was a child, the Russian novelist would play a game with his siblings. To join a secret club called the Ant Brothers, whose members would discover wonderful things, they had only to stand in one corner of a room and try to not think of a polar bear. As hard as they tried, Tolstoy and the others could not manage it.

  Fyodor Dostoyevsky, a contemporary of Tolstoy, knew of the bear conundrum too. In his 1863 book Winter Notes on Summer Impressions he wrote: ‘Try and set yourself the task not to think of a white bear, and the cursed thing comes to mind every minute.’ A century later, that Dostoyevsky quote appeared in an article in the US magazine Playboy, where it was read by a university psychology student called Daniel Wegner.

  Wegner, who died of motor neurone disease in July 2013 just as I was finishing this book, rose to run the Mental Control Laboratory at Harvard University, but he will always be remembered as the white bear guy. His work with the bears can explain why, even though we see a hole in the road ahead, we steer our bike right into it. It shows why forbidden love offers the most thrills. It can reveal why soccer players, desperate not to hit penalty kicks straight at the goalkeeper, go ahead and do just that. In 2009, he wrote an article for the prestigious journal Science titled ‘How to Think, Say, or Do Precisely the Worst Thing for Any Occasion’. Mo
st of all, Wegner’s research shows why unwanted intrusive thoughts can hang around; why some people find them so difficult to brush off. It shows how we can turn them into obsessions.

  In the 1980s at Trinity University in San Antonio, Texas, just a quick gallop from the Alamo and one of the last places on Earth that anyone would associate with a polar bear, Wegner asked some of his students to repeat the Tolstoy trial under scientific conditions. He asked them to try to not think of a white bear.

  Students told not to think of the bears found it difficult. And students told to do the opposite and to encourage thoughts of white bears, of course, thought of more. (Wegner kept track by asking them to ring a bell.) Most surprising was what happened next, when Wegner reversed the tasks so those students previously told to think of the bears were now asked not to, and vice versa. Those students who had originally tried to keep away the white bears now found their minds flooded with them – more so than the students instructed to think about them originally.

  It’s an experiment that has been repeated many times since with similar results. It is hard, if not impossible, to suppress unwanted thoughts. And to try leads to an increase in the thoughts later on, after someone has stopped attempting to suppress them. The latter effect appears in psychology textbooks as the rebound effect of thought suppression. Most psychologists call it the white bear effect – try to make an unwanted thought go away and it will bounce back, harder and stronger than before.

  Anyone who, to borrow a phrase from Oscar Wilde, can resist everything except temptation – who has tried to give up cigarettes, or to stick to a calorie-controlled diet – will recognize just how hard thought suppression is. That feeling, the urge and craving, is the sound of the white bear as it paws at the door.