What it’s like to be a prisoner of your own intrusive thoughts

Reuters/Wolfgang Rattay

David Adam is an editor at Nature and an accomplished science writer who has suffered from obsessive-compulsive disorder for twenty years. Below is a story from his book, The Man Who Couldn't Stop.

An average person can have four thousand thoughts a day, and not all of them are useful or rational. Mental flotsam comes in many forms.

There are the irrelevant words, phrases, names and images that flash unprompted into our minds, often as we perform some mundane task. There are earworms: tunes that wedge themselves in our heads, more prosaically called stuck-song syndrome.

And there are negative thoughts — 'I cannot do this,' 'I must quit' — the sworn enemy of sports psychologists everywhere.

Then there are the very strange thoughts: those occasional, random and unprompted ideas that seem to emerge from nowhere and stun because they are vile, immoral, disgusting, sickening — and just plain weird. The seductive question 'What if?' What if I was to jump in front of that bus? What if I was to punch that woman?

These kinds of thoughts are more common than most people realize. Ask around. A friend of mine has a need to check the toilet bowl for rats before he sits. Another unplugs the iron and places it in an unusual place when he finishes with it, so he knows for certain the answer when his mind demands later: Are you sure, really sure, that you turned it off?

One tortured soul spent an evening unable to ignore the repetitive thought that he may have scrawled across an application form for his dream job the word 'c---.'Most people have these kinds of strange thoughts. Most shake them off. Some people don't.

When we cannot make our strange thoughts go away they can lead to misery and mental illness. The friends I mention above did not convert their strange thoughts in this way. But I did.

I turned mine into obsessive-compulsive disorder.

The day that the Brazilian racing driver Ayrton Senna died in a crash during a Grand Prix in Italy, I was stuck in the bathroom of a Manchester swimming pool. The door was open but my thoughts blocked the way out.

It was May 1994. I was 22 and hungry. After swimming a few lengths of the pool, I lifted myself from the water and headed for the locker rooms.

Down the steps – one, two, three – ouch! I had scraped the back of my heel down the sharp edge of the final step. It left a small graze, through which blood bulged into a blob that hung from my broken skin.

I transferred the drop to my finger and a second swelled to take its place. I pulled a paper towel from above the sink to press to my wet heel. The blood on my finger ran with the water as it dripped down my arm. My eyes, of course, followed the blood.

And the anxiety, of course, rushed back, ahead even of the memory. My shoulders sagged. My stomach tightened. It had been four weeks since the incident at the bus stop, and, as much as I told myself that it no longer bothered me, I was lying.

I had pricked my finger on a screw that stuck out from the bus shelter's corrugated metal. It was a busy Saturday afternoon and there had been lots of people around. Any one of them, I thought, could easily have injured themselves in the way I had. What if one had been HIV-positive? They could have left infected blood on the screw, which then pierced my skin. That would put the virus into my bloodstream.

Oh, I knew the official line was that transmission that way was impossible. The virus couldn't survive outside the body. But I also knew that, when pressed for long enough, those in the know would weaken that to virtually impossible. They couldn't be absolutely sure. In fact, several had admitted to me there was a theoretical risk.

Standing quietly in the toilets of the changing rooms, still dripping wet, my swimming goggles in one hand and the bloodstained paper towel in the other, I ran through the sequence of events at the bus stop once again. I told myself how there hadn't been any blood on the screw when I had checked it, or at least I didn't think there had been. Oh, why hadn't I made absolutely sure?

Someone else banged through the door into the swimming pool changing rooms.

They whistled. I looked at my finger. Wait a minute. WHAT THE HELL HAD I DONE? I had put a paper towel on a fresh cut. OH JESUS CHRIST. There could have been anything on that paper towel. YOU STUPID B------. I looked at the paper towel, now soggy. THERE IS BLOOD ON IT. Well, of course, it's my blood. HOW CAN YOU BE SURE? Someone with AIDS and a bleeding hand could have touched it before me. OH JESUS. I threw it into the bin, pulled a second from the dispenser and inspected it. No blood. That helped, a little. No blood on the next one either. BUT THEY COULD HAVE DONE. I pulled the original paper towel back from the bin. It was bloody. IF THIS IS SOMEONE ELSE'S BLOOD THEN WHY ARE YOU PICKING IT UP? I quickly washed my hands. AND WHAT IF THEY BLED INTO THE SINK TOO? DON'T TOUCH YOUR F---ING HEEL. DON'T TOUCH YOUR F---ING HEEL. No chance of that. WHAT IF THAT ISN'T EVEN THE PAPER TOWEL YOU THREW IN THE BIN? It could be someone else's paper towel that I was handling, someone else's blood. I looked in the bin. I couldn't see any other paper towels with blood on them. WHAT ABOUT THAT ONE?

The whistling man was ready to swim. He came to the sink, grabbed a paper towel, blew his nose and threw it into the bin. I did the same. He looked at me. I smiled. He didn't. He walked away. I didn't. He finished his swim and left. I couldn't.

Excerpted from THE MAN WHO COULDN’T STOP by David Adam, published in January 2015 by Sarah Crichton Books, an imprint of Farrar, Straus and Giroux, LLC. Copyright © 2014 by David Adam. All rights reserved.