This essay appears in today’s edition of the Fortune Brainstorm Health Daily. Get it delivered straight to your inbox.
There are any number of things that drive human behavior, from the basic craving of hunger to more complex feelings like anger and compassion to ethical or spiritual motivations such as a sense of duty or altruism. But none of these drivers is as psychologically mystifying—and, to many people, as unsettling—as compulsion.
“Compulsions come from a need so desperate, burning and tortured it makes us feel like a vessel filling with steam, saturating us with a hot urgency that demands relief…But while compulsions bring relief, they bring little enjoyment, and while with one part of our brain we desperately wish to stop them, with another we are desperately afraid of stopping.”
That striking and lovely passage—and I wish I didn’t have to abridge it—is from the introduction to Can’t. Just. Stop. An Investigation of Compulsions, by Sharon Begley, the senior science writer at STAT, former correspondent at the Wall Street Journal and Newsweek, and one of my favorite science writers hands down. While the book doesn’t hit shelves until February, I began reading an early copy last night and, with some degree of compulsion, couldn’t put it down.
As compelling a read as it is, the book is equally timely. The U.S. seems to be going through an epidemic of anxiety. In any 12-month period, according to the National Institute of Mental Health, just over 18% of adults suffer from an “anxiety disorder”—of which nearly 23% of these cases (representing 4.1% of U.S. adults overall) are considered “severe.” And according to a growing body of evidence, Begley reports, one response to such anxiety can be a compulsion.
It’s no secret we’ve become a nation of obsessive Facebook-checkers, Candy Crush’ers, Pokemon Go-ers, and Tweeters—with one fellow about to hold the highest office in the land compulsively, it would seem, sending message bursts in the wee hours of the morning. But for some—the hidden checkers, repeaters, hoarders, and “just-right’ers” (those who have to adjust picture frames or books on a shelf to make sure they’re perfectly aligned)—the compulsion is a never-ending antagonism to normal life.
Begley expertly escorts us across the psychological boundary between OCD (obsessive-compulsive disorder) and OCPD (obsessive-compulsive personality disorder), shows us how a game like Candy Crush or Angry Birds can pull deep levers in the human psyche, and with great humanity helps us experience what it’s like to know with near certainty that your cat Fred is not in the refrigerator but feel a tug of urgency to check nonetheless.
If there is a light at the end of the seemingly endless tunnel that is OCD, it emanates from the science that’s helping us understand the connection between this psychiatric disorder and its neurological basis. Every so often, it appears, a glitch develops in an “error-detection” message router between the brain’s orbitofrontal cortex, anterior cingulate, and caudate nucleus.
It’s a wiring problem, Begley explains, “not the ‘chemical imbalances’ that the public—thank you, direct-to-consumer pharmaceutical ads—has been brainwashed into believing are the cause of mental disorders.” Somehow, the “worry circuit” that exists in healthy brains turns into the “OCD circuit.” And that “somehow” is related to both nature and nurture, she says.
No, Begley’s book isn’t likely to stop you from playing Candy Crush—but it will make you more forgiving of yourself when you can’t seem to stop.
