Each one of us can experience bizarre or distressing thoughts - speaking for myself, (and probably by now, hundreds of clients I've worked with), it's not unusual to think of say punching a stranger or jumping off a ledge. I had one the other day - walking past a waitress carrying a large tray of dirty crockery, I thought about kicking it out of her hands. Fortunately, the thought evaporated (although now nestles in my mind again of course) and I swiftly dampened the tiny urge sparked up by my seemingly un-thought thought. I'd very confidently describe myself as a non-violent non-tray kicker upper, which helped in the evaporation process, but for some - such as David Adam - bizarre thoughts become too sticky to let go of, and coupled with the distress of their content, make for a recipe of potentially extreme mental torment. OCD - as explored in The Man Who Couldn't Stop is a potentially life-threatening condition. It can drive people to end their lives or to life-threatening behaviours. His book is a very valuable addition to writings about the distress our minds can cause us - and his effort to educate us further on the subject is important for us all - not just those who suffer.
Having made the brave decision to write about his illness, Adam offers an ambitious look at how it affects (in varying degrees) many more of us than we'd probably imagined. He travels far and wide with his research and case studies, weaving his own battle with a pernicious fear (driven by relentless thoughts and behaviours) of an AIDS infection. He explores therapies that help and those that don't - a drug and CBT have helped him, while he sighs with relief at the trepanning-type interventions that have died out. The book generally reflects upon how we/the psychiatric community think about mental illnesses. The age-old debate about labels comes up of course - they are useful but can also be too clunky to capture the nuances of our human minds. 'Where nature draws a line, she also blurs it' someone clever once said. The latest psychiatric bible, the DSM-V made this clear to many.
I like the idea of 'dimensionality' which he introduces toward the end - where classes of mental disorder are arranged on a single axis and people would be scaled by assessing the severity of a series of traits that are affected by these conditions, such as cognitive impairment or mood disruption. It's the route I like to take in my work - I'm more interested in alleviating the distressing experiences rather than being guided by a pre-ordained route.