The UK parliamentary record Hansard notes every word spoken in the House of Commons and the House of Lords since 1909. Winston Churchill’s battles as first lord of the admiralty to convert the Royal Navy from coal to oil in the years before the First World War are in there. So is the famous put-down from Labour politician Denis Healey that to be attacked in a speech by Conservative rival Geoffrey Howe was to be savaged by a dead sheep. The compilers of Hansard have seen it all. But if they can still be surprised by a political turn of phrase, then Charles Walker probably managed it. In the summer of 2012, Walker, the Conservative MP for the Hertfordshire town of Broxbourne, told the House of Commons he suffered from OCD and had done so for thirty-one years. During a debate on mental health, Walker announced to the centre of British democracy that he was a ‘practising fruitcake’.
He described his compulsions to count and turn off lights four times, and his fears of contamination – he must leave biscuit wrappers throughout the house because of anxiety around bins. He touched also on the darker side of OCD – the terror of thoughts he cannot control. He said:
One is constantly striking deals with oneself. Sometimes these are quite ridiculous and on some occasions they can be rather depressing and serious. I have been pretty healthy for five years but just when you let your guard down this aggressive friend comes and smacks you right in the face. I was on holiday recently and I took a beautiful photograph of my son carrying a fishing rod. There was my beautiful son carrying a fishing rod, I was glowing with pride and then the voice started, ‘If you don’t get rid of that photograph, your child will die.’ You fight those voices for a couple or three hours and you know that you really should not give in to them because they should not be there and it ain’t going to happen, but in the end, you are not going to risk your child, so one gives in to the voices and then feels pretty miserable about life.
Following his speech, Walker received deserved plaudits for his honesty and his bravery, including from the prime minister. People wrote to thank him for raising the issue in such a public way. But he is not the first MP to talk about his obsessions and compulsions. Gerald Kaufman, the former Labour government minister, received a different reception.
At the height of a 2009 scandal over abuse of parliamentary expenses, Kaufman was ridiculed when he blamed (self-diagnosed) OCD for his decision to claim back £220 of taxpayers’ money for the purchase of two crystal grapefruit bowls for his London home. He had identical bowls at his constituency home in Manchester, Kaufman said, and his OCD demanded that he repeat the same breakfast each morning: half a grapefruit, a bowl of muesli with semi-skimmed milk and a cup of coffee with a Rich Tea biscuit. Given what we’ve seen of OCD in this book, we shouldn’t jump to conclusions. It’s possible that Kaufman’s thoughts did demand superior crockery. But it’s much less clear why he thought the rest of us should pay for it.
Part of the reason that Charles Walker wanted to speak out, he said, was to tackle prejudice. That’s a goal that lots of people credited me with, when they found out I was writing this story of OCD. They assumed I wanted to raise awareness. I didn’t, not at the beginning at least. I hadn’t faced prejudice, because I had kept my OCD to myself. Perhaps I feared prejudice and that’s why I kept it a secret, but I don’t think it was that either. I just didn’t want people to know I was a practising fruitcake. I didn’t want to accept it myself.
The reason it is important to raise awareness, I realize now, is more fundamental. The reality of OCD is scary for all involved. But it’s not dangerous. Yet it can be, especially for people who believe the condition is nothing more serious than a need to wash hands. That’s why it’s necessary to show and talk about the reality of what OCD is and what it is not. That’s why there’s no bar of soap on the cover of this book.
* * *
On a rainy day in Wales in November 2012, the charity OCD-UK organized a series of talks and discussions at Cardiff University. On the bill were numerous experts – academic psychologists, psychiatrists and former sufferers turned advocates. And in the audience were people from across the UK with OCD. A room full of two hundred people with OCD sounds like the set up to a joke, the punch line of which would be something like ‘and you should have seen the queue for the sink’. But for the people who attended it was a serious matter.
Many had brought along friends and family for support. Teenage girls were there with a best friend. Men in their twenties were accompanied by both parents. I heard one husband tell his wife, in the queue for their lunch, that only now did he understand her. Many of the attendees were probably confronting their OCD for the first time. Certainly some were speaking in public about it for the first time. Lots were in tears, while others sat in silence and shook their heads gently or closed their eyes as they listened.
Yvette sat a few rows behind me, towards the back. A few people craned their necks to look as she indicated she wished to speak and asked for the microphone. By the time she handed it back, all eyes were on her. Yvette wasn’t keen to cooperate for this book, so what appears here is what she said at the open meeting, which was broadcast on the Internet, and no more.
Yvette (not her real name) was a secondary school teacher. She suffered from OCD and was visited by a particular type of intrusive thought. When Yvette drove her car, she could not shake the feeling that she had been in an accident. She worried that she might have knocked someone down as she drove through dark country lanes at night.
This is a fairly common obsession. The driver finds their thoughts are not relieved by a quick glance in the rear-view mirror, so sometimes they stop and reverse or circle around to check. They might get out and check their car repeatedly for damage, paint or blood. Some ring hospitals and ask if any victims of road traffic accidents have been brought in. One night, convinced she had hit someone yet equally certain that she hadn’t, Yvette called and checked with the local police. No, the confused officer on the phone replied, there had been no such accident. But, why do you ask? Who are you? The police reported Yvette’s enquiry to her school’s headmaster, who then suspended her for nine weeks, while the school tried to decide if Yvette was a danger to the children. She had worked as a teacher for nine years. The kids she taught, Yvette said, understood her condition better than her colleagues.
Of course, those who work with children must be checked out. And Yvette was later able to return to work. But others are not so fortunate. Mental health advocates regularly deal with cases of people who have been separated from their families because a medical professional became alarmed when they reported harmless obsessions. Even when the facts of OCD are made clear, and the individual reunited with their family, the problems and the injustice can continue. If they go for a job that demands a criminal records check, and many do – in counselling or charities, for example – then the question of their mental health is often raised. In a section of the records check that asks for other relevant information, chief constables have the discretion to write: ‘We are aware that this person was detained for a mental health problem at this institution. We are not aware that they are a threat to adults or children.’ Would you give them a job?
Charles Walker raised this issue in his speech to Parliament. ‘I am afraid that in our ultra risk-averse world, that is a career death sentence for those people.’ In September 2012, after pressure from campaigners, the UK government did tweak the emphasis of the records check with respect to mental illness. Police are now asked only to report incidents they believe are relevant. The changes introduced an appeals procedure too. It remains to be seen how effective they will be.
A more fundamental way to sort this out is increased awareness. At first I thought awareness was a worthy sentiment but too vague and nebulous to address directly, but I was wrong. The more that OCD is cemented in the public consciousness as a behavioural tic, the more times that a Hollywood celebrity who likes to keep their house tidy describes themselves as having OCD, the more times companies cash in on the apparent quirks of the condition as a gimmick, then the more times people like Yvette suffer. Some National Health Service trusts in the UK demand their psychiatrists refer any parent who reports intrusive thoughts about harming children to child protection authorities.* One impact of that can only be that more parents with OCD fail to seek help, and so continue to believe they are a danger to their child when they are not.
We’re getting there with other mental illnesses. Schizophrenia is no longer acceptable shorthand for a split personality – its use in that way was banned by the style guide at The Guardian, which told writers how to use language. People with autism are not expected to memorize and recall the order of three combined packets of cards. Some who suffer from depression may still be told to pull themselves together, but hopefully fewer than a decade or so ago. OCD is perhaps a more serious challenge because fewer people regard it as a serious illness.
The US television show Monk features a policeman with OCD – the defective detective – whose obsessive attention to detail gives him superior ability to solve crimes, even though he regularly has to interrupt interviews or stop pursuits of villains to touch and arrange objects. Jack Nicholson won an Oscar for his quirky and humorous portrayal of a misanthropic obsessive-compulsive in the film As Good as It Gets, who skipped down the street with a grin on his face to avoid cracks in the pavement.
Fed up with having to watch Nicholson play OCD for laughs, the Welsh actor and writer Ian Puleston-Davies co-wrote what he hoped would be a more realistic portrayal. Called Dirty Filthy Love, and with Michael Sheen in the lead role as an architect with both OCD and Tourette’s, the 2004 ITV film won a Royal Television Society award the following year. In the two hours after it was screened, OCD-UK received 2,000 phone calls.
Puleston-Davies, who as I write this stars in the long-running British soap opera Coronation Street, has severe OCD and has described how intrusive thoughts can join him on stage – forcing him to think about when he last went to the toilet rather than his lines in a play. He based the script of Dirty Filthy Love on his own experiences. But even he admits that some scenes are unrealistic, particularly those when the lead character goes to a self-help group. Puleston-Davies had originally written the group as they appear – like a class sat around to learn how to speak Spanish. This was too dull for the producers. The final screened version, to his despair, looked more like something from One Flew Over the Cuckoo’s Nest – all white clinical walls and intense oddballs who rock in their chairs.
OCD gets a raw deal in the media, especially film and television. It’s pretty clear why: obsessive thoughts are internal and hard to film, so the focus tends to fall on the compulsions. The distress is invisible, but the checks, the hand-washing and the lining up of shirts in a wardrobe can appear sinister and funny, sometimes both at the same time.
In 2009, Paul Cefalu, an English professor at Lafayette College in Pennsylvania, investigated this media misrepresentation further. He published an article in PMLA, the house journal of the Modern Language Association of America, called ‘What’s So Funny About Obsessive-Compulsive Disorder?’ ‘What distinguishes representations of OCD from depictions of other mental disorders’, he wrote, ‘is the frequency with which OCD is treated with humour and levity.’
Earlier incarnations of obsession were portrayed – by Edgar Allan Poe and others – in melodrama, tragedies and Gothic literature, Cefalu said. Yet more recent books and films suggest that sufferers of OCD ‘can always be counted on to make us laugh’. The reason, and the answer to the question in the title of his essay, he decided, is irony. ‘Not only is there something fundamentally ironic about the extent to which obsessives with OCD concentrate on tasks that they believe ridiculous, but compulsions, usually orchestrated to relieve underlying obsessions, tend to worsen the motivating obsession.’
OCD is funny, he says, because it is based on incongruity, and incongruity is funny. The action makes no sense, but even after it acknowledges its own senselessness, it carries on regardless. That makes OCD postmodern irony; slapstick misery.
Funny or not, some psychologists have suggested that peer pressure and societal expectations are crucial to the perception of obsession. People with OCD, they suggest, might experience less distress if they live in cultures where commonplace superstition makes their mental and behavioural rituals more acceptable. (If everyone around you touches wood for luck, you might feel less bothered about having to touch it compulsively to see off intrusive thoughts.)
Such acceptable and unacceptable cultural context for obsessions has been highlighted by the US academic Lennard Davis to explain the rise in the visibility and apparent prevalence of clinical OCD in the last few decades. In his 2008 book Obsession: A History, Davis writes:
In the requirement that the behaviours produce marked distress in the person, how one arrives at distress is crucial. The same behaviour in different cultures might produce different results. In other words, it takes a community, a culture, a family to make an obsessive. If your behaviour, say the meticulous lining up of objects, is seen as an oddity, you will be distressed that you do it. If it is seen as the useful quality of a master bricklayer, then you will not be distressed.
Davis, a professor in the Departments of English, Disability and Human Development and Medical Education at the University of Chicago, argues that obsession – and OCD – is better framed as a disease entity, a temporary and fluid definition that shifts with culture and history; sometimes useful and valued, but sometimes malevolent and feared. Dickens’s huge output, he says, shows he was an obsessive writer. We demand that lovers are infatuated with each other in films. We respond to driven athletes and single-minded musicians.
Plenty of psychologists and psychiatrists have taken issue with his argument already. It misleads to bundle all these different types of obsessive behaviour together, they say. It conflates the general definition of obsession and the clinical term, and in doing so it dilutes the significance of the latter. Here’s my objection: when Davis writes that the distress caused by repetitive behaviour, to line up objects say, is subjective, he misses a crucial point. In my experience, and that of most people with OCD I’ve met, the compulsive behaviour does not cause distress, it lessens it. That is why we do it. As the character Mark Renton in Irvine Welsh’s 1994 novel Trainspotting puts it to explain why he and his friends take heroin: it feels good. ‘Otherwise we wouldn’t do it. After all, we’re not fucking stupid. At least, we’re not that fucking stupid.’
My paternal great-grandmother’s temper was legendary. It was said she could start a fight in an empty room. My OCD can cause me distress in an empty room. It doesn’t need a community or a culture or a family to disapprove. I’m not that fucking stupid.
Davis is not alone in the quest for possible benefits to OCD. Plenty of writers on the subject, including some who should know better, are keen to point out the upside of a personality that repetitively focuses on detail. Armed with little more than some vague references in his diaries to how his mind would fix on an object and would sometimes be taken by insane feelings of anger, some websites dedicated to mental illness claim that Charles Darwin had OCD. Others, in an apparent effort to challenge the view of OCD as a handicap, have credited Winston Churchill’s obsessional nature for giving him the strength of character to see through the dark days of the Second World War. OCD helps defeat global fascism! Way to go Winston.
I can’t think of a single positive thing about OCD. And I’ve thought about OCD a lot. In 1785, after a particularly rough Atlantic crossing to Southampton, the US inventor Benjamin Franklin designed a sea anchor – a submerged sail a ship could tow behind itself in the water to slow and stabilize itself in heavy seas.
People who live with OCD drag a mental sea anchor around. Obsession is a brake, a source of drag, not a badge of creativity, a mark of genius or an inconvenient side effect of some greater function. That’s not to say that some people with OCD don’t achieve great things. But – given what we have seen of how OCD might develop – that’s only what you would expect, just as some people with OCD are criminals, teachers, politicians and writers. Some have it worse than others and some perform better than others. Certainly, some people with severe OCD are quite brilliant.
* * *
At Christmas 2009, a plaque was unveiled on the door of room 3327 on the 33rd floor of the New Yorker Hotel in Manhattan. It commemorates the life of electricity pioneer Nikola Tesla, who lived in the room for the last ten years of his life, and the confluence of numbers is no coincidence. Tesla was obsessed by the number three, one of a series of intrusive thoughts and compulsive behaviours that affected him his whole life.
Tesla wasn’t diagnosed with OCD, but his experiences fit the model. Aged 5, he suffered a terrible trauma when his older brother Daniel was killed. Tesla always maintained Daniel died of injuries inflicted by a horse, but another account says Daniel fell down the cellar stairs and banged his head. Drifting in and out of consciousness before he died, he accused his younger brother of pushing him. In her 1981 biography of Tesla, US writer Margaret Cheney says:
We can only speculate about the degree to which Daniel’s death may have been responsible for the fantastic array of phobias and obsessions that Nikola subsequently developed. All we can say for certain is that some manifestations of his extreme eccentricity seem to have appeared at an early age.
As a teenager in the 1870s in what is now Croatia, Tesla indulged in what sounds like maladaptive daydreaming (see page 94). He would invent complex and detailed places and live there in his head, where he would meet people and make friends. As a student he opened a book by Voltaire and then felt compelled to read his entire works, close, he discovered with dismay, to one hundred volumes. As an adult he counted steps when he walked and had to calculate the cubic volume of his food and drink to enjoy it. He tended to dine alone. He had issues with touch and tactility and said he could not bear to feel other people’s hair, ‘except perhaps at the point of a revolver’.
Tesla’s greatest invention was the alternating-current (the AC in AC/DC) motor. It revolutionized the supply and distribution of electricity and remains the basis for power in the modern world. Like many of his creations, he designed the motor in his head. ‘Ideas came in an uninterrupted stream,’ he said. ‘The only difficulty I had was to hold them fast.’
As his fame and wealth grew, so did the impact of his obsessions and compulsions. He would dine each evening at exactly eight o’clock and needed a stack of eighteen clean linen napkins to wipe his cutlery. Walking the Manhattan streets to his laboratory, if he took a certain route he felt forced to circle the block three times before he could continue on his way.
By the Second World War, just as Walter Freeman was descending to his lobotomizing pomp and the hoarding Collyer brothers were at the height of their unwanted fame, Tesla’s obsessions and compulsions ruled his life. His fear of germs meant even close friends could not approach him; he preferred the company of pigeons. He died alone in his hotel room in January 1943.