The Boy Who Couldn’t Stop Washing: The Experience & Treatment of Obsessive-Compulsive Disorder by Judith L. Rapoport was a gift I received over twenty years ago. It was one of many books that I had kept on my bookshelves, unread. A resolution I made midway through 2012 was that for the rest of the year I would read only these old-timers and clear them off my shelves. I would alternate reading an old book with a library book. Although I have well over a dozen new books on North Korea, to say nothing for the dozens (yes, dozens, plural) of books that I bought when I was over there, and all of the books I bought while in Newfoundland, I want to read all the old stuff that has been occupying valuable shelf space. I have no sentimental ties to keep these books after I read them, so once they’re read and reviewed, they’re gone.
Twenty years have passed since a friend gave me The Boy Who Couldn’t Stop Washing, and I cannot remember the circumstances behind his choice for giving it to me. In the late eighties, and in 1991 when this paperback edition came out, Obsessive-compulsive Disorder (OCD) was all the rage as the talk-show topic du jour. I probably talked about an episode or expressed an interest in this psychiatric phenomenon. OCD must have interested my friend as well, as when I opened the present he told me that he had bought a copy of the same book for himself.
Rapoport is an M.D. who had studied OCD for thirty years. She was one of the first doctors to take the disorder seriously and not pass it off as merely symptomatic of depression, its common misdiagnosis. Those who suffer from OCD are first of all aware that they are suffering: they cannot stop doing the same rituals over and over again. Their lives, jobs and personal relationships are ruined as these rituals take over. In The Boy Who Couldn’t Stop Washing, Rapoport shares her own experiences in treating OCD patients and has included testimonials from her patients who had both recovered and in some cases, still suffer from their possession of ritual.
As the title of the book suggests, washing is a common obsessive-compulsive disorder, as is grooming, hair-plucking and checking doors to make sure they are locked. Other examples of OCD include counting in patterns, choreographing specific movements when entering a room or in anticipation of or following any other specific task. People with this disorder are compelled to do these activities; telling them “Stop it!” or threatening them with punishment will be of no use.
Rapoport shares her expert opinion on drug therapies and how clomipramine (trade name Anafranil) has been successful in the majority of her cases. At the time of the paperback’s printing in 1991, clomipramine was not yet approved for use within the USA (although it was approved in Canada) so a twenty-year-old book such as this has definitely had its day, since a portion of the book’s final section on drug treatment deals with ways one may legally obtain a prescription.
Some of the rituals most commonly exhibited by those with OCD are washing and grooming. Rapoport wonders if perhaps these are primordial human instinctual behaviours that are somehow miswired in the brain. Like a dog that kicks up dirt after it defecates, or a dog that runs around in circles before it lies down to rest, these are vestigial behaviours that have carried on through the millennia of canine evolution. Rapoport wonders if human washing and grooming–rituals that have always preoccupied homo sapiens–remain “stuck” in the brain of an obsessive-compulsive and they can’t stop themselves from doing anything else. Without treatment, does an obsessive-compulsive remain forever locked in human prehistory?
Rapoport provides an informative chapter entitled “Do You Have Obsessive-Compulsive Disorder?” at the end of the book and the reader can go through an obsessions and compulsions checklist in an attempt to self-diagnose. Because of its age I cannot recommend The Boy Who Couldn’t Stop Washing as there is a lot more up-to-date information about this disorder. My own library system has withdrawn its copies of this book and they were not interested in adding my pristine copy to the collection. I would recommend the book however for its patient testimonials. By reading these first-hand accounts one can see what living in an enclosed world is like, where one is preoccupied with doing only one thing for hours on end.