Free The Man Who Couldn’t Stop by David Adam Page B

performed a physical act like touching a wall or checking for blood on a rusty nail. Their response legitimizes the thought and gives it significance.
    For most people, the intrusive thoughts are what bother them and the compulsions are a relief, albeit a temporary one. The intrusive thoughts come first. But some people with OCD describe what sounds like a reversed flow of this cause and effect. The behaviour, the compulsion, is more like a tic. It comes first. They can’t explain why they need to tap their hand on their leg a set number of times. They are not doing it as a way to drive something from their mind. They just feel they need to do it, and if they resist the urge to do so then they get anxious.
    In these cases the intrusive thoughts follow the resisted compulsion – if these people don’t tap their leg then they worry something awful will happen, perhaps their parents will die in a car accident. That’s a form of OCD known as the just-not-right experience.
    It’s pretty difficult to track the true course of events in OCD, the sequence of obsession-compulsion-obsession and where it begins and ends. After all, a circle, even a vicious one, has no beginning or end. But there is evidence that some people with OCD find the unwanted compulsive behaviour distressing, rather than the unwanted obsessive thoughts. Other psychologists have taken this idea further. They have suggested that, even in cases where the compulsions appear to follow intrusive thoughts, it could be the behaviour and not the cognition that triggers the OCD event. The thought appears only as a way to justify the odd behaviour.
    The high-place phenomenon – the common urge to jump from a window or bridge – has been explained like this: Say you are standing near the edge of a cliff and enjoying the view. There is no safety barrier and part of your brain, the part that watches for hazards and instinctively avoids them, gets nervous and instructs the legs to take a step back, to minimize the risk. A different part of the brain registers this order to mobilize the legs and seeks to explain it, by comparing the imagined threat to the real threat. Yet there is no immediate threat. You are standing still. So why step back? What’s the problem? The brain – the intrusive thought generator – throws up an (irrational) suggestion: the problem must have been that you wanted to jump.
    That all happens in milliseconds, and the strongest signal, the one that breaks through from all of this subconscious activity, is the conclusion that comes as an intrusive thought: I want to jump.
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    OCD dissolves perspective. It magnifies small risks, warps probabilities and takes statistical chance as a prediction, not a sign of how unlikely things are. Example – someone once told me that to catch HIV from a kiss was a one in a million chance. But there are seven billion people in the world, right? And if they all kiss someone at some point in their life, then more than 7,000 of them are at risk. If we assume that only about one in 3,500 kissed people have HIV, then that still leaves two people who will catch the virus that way. Why shouldn’t one of them be me?
    That’s risk assessment by homeopathy. The hazard is so dilute that it is no longer present. Yet as Jim Carrey’s character in the film Dumb and Dumber replies with excitement when a woman says the odds of her agreeing to join him on a date are one in a million: ‘So, you’re telling me there’s a chance!’ Even when I accepted that it was OCD that made me feel this way, which took a while, there is still the fear of an ironic twist, that someone with an obsessive fear that they will catch HIV in a spectacularly unlikely way could be one of the unfortunate individuals who falls foul of the numbers, and actually does. People have contracted HIV in unusual circumstances – from their dentist, for example.
    That helps to