Judith L. Rapoport - The Boy Who Couldn't Stop Washing: The Experience and Treatment of Obsessive Compulsive Disorder

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The Boy Who Couldn't Stop Washing, by Judith L. Rapoport, M.D.

Feb 9, 2006 (Updated Feb 9, 2006)
Review by  
Rated a Very Helpful Review

Pros:Well-written, well-organized, very informative.

Cons:Not many I could see.

The Bottom Line: There's a lot more to OCD than what you see on MONK.


You can call them whatever you want, silly habits is probably the most popular, but for the people who suffer from Obsessive-Compulsive Disorder, their rituals are anything but silly. Paul says he was seven “and the school bus would drop me in front of my door. We have a little white fence in front of our house. I couldn’t get through it. SOMETHING made me go back and do it again. My sister was behind me, and pushed me through. It was okay until I had to go through it again.” He tells a story of getting “stuck in doorways” and not being able to pass from one room to another until he “did it right”. And to get from the gate to the front door took Paul seventy-four steps. It wasn’t a long walk, but Paul felt compelled to make the trip in seventy-four steps, even if it took him over an hour of weaving back and forth across his front yard to get it right.

For a long time not a lot was known about Obsessive-Compulsive Disorder (OCD), how to properly diagnose it, what caused it, and especially how to treat it. Now, thankfully, the disease is better understood than it was, and there are even medications that can calm, sometimes even wipe out completely, those compulsions, the need to “ritualize”.

THE BOY WHO COULDN’T STOP WASHING by Judith L. Rapoport, M.D. is probably just about as comprehensive a study on OCD as you can get. She’s studied the disease and its causes and treatments since the 80s (possibly the 70s, sometimes the timeline wasn’t always that clear) and has seen and “cured” probably hundreds of patients. In this book she really goes into some detail and tries to help those without OCD better understand the disease and the effect it has, not only on those who suffer from it, but also those who have to watch them suffer from it.

THE BOY WHO COULDN’T STOP WASHING is well-organized and well-written, easy to understand, and very enlightening. Letting the patients put their compulsions in their own words, also, helped a great deal in getting to the heart of what this disease does to people. For example, Sam, a thirty-eight-year-old husband and father:

I am very careful as I read a book or newspaper or magazine. I never know what terrible things lie on the next page or the next paragraph of the next sentence. I read slowly. i concentrate on the mantra.

Damn! “Death.” There’s that awful word. all right, start to offset it. Be careful. Better to go backwards over what you’ve already read. Try to remember where the words are. You can’t go forwards anyway, because forwards is the future and you don’t want to contaminate the future with eyes that have just beheld a word of such terrible consequence. Go back over what you’ve read. Go to the past. You can’t really harm the past (you don’t really believe that)--use it to your advantage. Would anyone in my office believe this if they saw it? Of course not.

I saw the word “Death”? Yes. All right, careful. “Life” must be here somewhere. Go back more pages. Where did I see it? “Life”, where are you? There’s “living.” No, that won’t do. It would work for “dying,” but not “death.” “Death” is the most terrible word. It can only be appeased with “life” And if “death” was capitalized, try to find “life” capitalized also, or find two of three “lifes” to even things out.

Careful.

No-ooo. Damn! “Died.” Now I’ve got to find “living” or “Alive” or “lives” or some such word to offset “died” before I can go back to the first problem. What about “lived”? It’s not much better than “died.” Implicit in “lived” is that what was alive is now dead. No, it must be one of the others.


And it goes on and on. To someone from the outside this can sound like the craziest thing in the world, searching endlessly for that one perfect word that will balance out the bad word you just read. But to Sam and a million others like him, it just has to be done. They know, while they’re doing it, that there’s absolutely no rational justification for these things they do, but the compulsion is just so strong that logic isn’t even part of the equation. It’s not a conscious choice they make--and this is where the distinction between OCD and crazy comes in, Dr. Rapoport says. A “crazy” person may say, “My arm moves on its own like this,” and then demonstrate the patterns their arm makes. A person with OCD will say, “I have to move my arm like this. I can’t NOT do it.” They know that the arm doesn’t move on its own, they’re moving it consciously. But they’re doing it because they HAVE to.

And to resist these urges causes honest, physical anxiety. The only thing to relieve this anxiety is to perform their rituals.

I’ve always been fascinated by OCD and until reading THE BOY WHO COULDN’T STOP WASHING, I would have recognized a million different variations on the theme--constant hand-washing, the paper route that takes 3 hours because the paperboy double- and triple-checks each house to make sure everyone got their paper (OCD is sometimes called the “doubting disease” because some sufferers are “checkers”, the people who check to make sure the stove is off, not just once or twice, but up to thirty times because, as Dr. Rapoport explains, the connection in the brain necessary for most people to see something and trust their own senses that what they just saw is the true reality, this connection isn’t being made for most people with OCD, so they can see that, yes, the stove is off, but immediately again they’ll doubt their own senses and recollection and must check again)--but there were still so many things that took me by surprise. For example, the constant grooming of a lot of OCD sufferers is actually a common thing among many animals. Does this mean that a person’s constant hand-washing can be seen as just another inbred trait? Possibly. But when this compulsion reaches a certain state--one man once spent 12 hours in the shower--then it goes beyond instinct and you’ve got a real problem.

And believe it or not, some sufferers have attacks where they believe they've killed someone. They don't remember the details, couldn't tell you what happened, but they're constantly overcome by the feeling that they've committed murder.

I’d always thought if you had OCD you learned to live with it. You try to control your rituals as well as you can and don’t let them ruin your life. But Dr. Rapoport says there are now drugs on the market--most unavailable in the US at the time this book was written, the late 80s--like Anafranil, that can greatly reduce the urges and help those with severe cases get on with their lives. These treatments can also improve the lives of those the OCD sufferers love. Sam, the man who had such trouble reading earlier, found his marriage much improved after he started taking Anafranil. When in the grip of one of his attacks, he would become so distracted and so focused on easing this anxiety in him that his wife, who didn’t know about his urges, would misunderstand and think he was angry, possibly with HER. But once Sam got treatment and these attacks went away, she was better able to understand what he was going through.

OCD can be crippling if not properly diagnosed and treated, and THE BOY WHO COULDN’T STOP WASHING goes a long way in attempting to educate the public on this condition. If you or someone you know has these rituals, these urges (try explaining to someone that the patterns you make with your fingers or the way you have to touch something, you have to keep doing it until it “feels right” . . . you just can’t explain how you know it feels right to someone who’s never been there) this book shows you you’re far from alone, and these things you never thought you could explain or understand, millions of people know exactly what you mean.


Recommend this product? Yes

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