Не могу остановиться. Откуда берутся навязчивые состояния и как от них избавиться

by Sharon Begley

О навязчивых состояниях современный человек знает не понаслышке. Как часто мы буквально не можем остановиться, лихорадочно проверяя сообщения в смартфоне, пытаясь пройти уровень в видеоигре или покупая вещи, хотя их уже некуда девать. Но где грань между нормой и патологией, и главное, когда целеустремленность и одержимость — путь к творчеству и успеху, а когда — бесплодная и опасная трата усилий и времени? В книге автор рассказывает об истории изучения вопроса, о том, чем навязчивое поведение отличается от зависимости и как работает «компульсивный мозг». Актуальность проблемы, беседы с ведущими специалистами по навязчивому поведению, судьбы реальных пациентов делают эту книгу в равной мере содержательной и увлекательной.

Genres: Nonfiction, Psychology, Science, Mental Health, Self Help, Medical, Brain

334 pages, Hardcover

First published February 7, 2017

About the author

Sharon Begley was an American journalist who was the senior science writer for Stat, a publication from The Boston Globe that covers stories related to the life sciences. She regularly contributed articles to the Yale Scientific Magazine while at University. She published recurring columns and feature articles in several mainstream publications on a wide variety of scientific topics. Begley was also an author and spoke at professional and community organizations. Her topics included the neuroplasticity of the brain, issues affecting science journalism, and education. She appeared on radio and television to discuss topics covered in her articles and books. Begley attracted both praise and criticism as a writer.

Reviews

[Diane S ☔ · Rating 4 out of 5]

3.5 a mixed read for me, not that much of it wasn't interesting, just that some of it was difficult to understand. Had to reread sections to understand her explanation of brain science, what goes on in the brain in those with severe anxiety, OCD etc. Also the way they go about getting a scientific diagnosis, this part was quite lengthy. As I said extremely interesting but dense.

The case studies, actual people, were of course much easier to read but oh my, some of these people, what they go through just breaks my heart. How they manage at all, and some are quite successful is inspiring. Of course, we all have our little quirks, think we all have some things that must be just the right way for us to function, but unless it severely affects one's life, it is not really a problem.

I felt I really learned quite a bit by book's end. So many of us now suffer from some sort of anxiety, the numbers keep increasing, some people very close to me deal with this daily. Why I picked up this book and I hope to introduce it to a few other family members.

ARC from publisher.

[Elyse Walters · Rating 4 out of 5]

I actually feel a little empowered by Sharon Begley's non- fiction book.

According to Sharon Begley - me and many people have a few compulsions that seem like understandable responses to angst that might otherwise eat 'me/us' alive.
WE ARE NOT CRAZY....or even BROKEN.
In fact we may be keeping ourselves together - functioning better than if we had allowed the anxiety to swallow us. Sharon says: "just because you're compulsive about something doesn't mean your brain is broken".
"The mild compulsions of people who don't come close to meeting the diagnostic criteria for a mental pathology arise from the same sort of dread that drives severe ones".

"I bet you know many people who feel compelled to reach for their smartphone as soon as they wake up in the morning".

Sharon covers different topics such as different degrees of OCD, video games, compelled to do good, smartphones and the web, compulsive acquiring or I'll take two, hoarding, carrying consciousness too far, and the compulsive brain.
This book was really interesting - because it's not just about extreme situations.
Most people will relate to 'something' in this book.

I looked through my own life - through the years- and how little compulsive behaviors are still the same - others have shifted - none have been extreme - nor do I feel any have interfered as a hindrance to the quality of my life.
My little compulsive behaviors ( so minor) -- is that I have organized underwear drawers. I may wear schmata clothes on the outside - but I like my under clothes beautiful... and my undi drawers organized. I'm also one of those people who like the towels in the bathroom nice... ( I'm not too crazy about this for periods of time- but I prefer those towels 'neat'). I used to be more crazy about exercise- less so today....but it's still something I feel I must do.
I'm 'not' - believe it or not - very compulsive to HAVE to be on the computer. I've learned to make Goodreads a big part of my life - and enjoy the community ..
but even though I write many reviews- I honestly think I could walk away and be perfectly as happy. I do take full day breaks.

As I read this book - I thought deeper about my husband and two adult children. - Then looked at a couple of close friends. Every one of us has a little 'something'....
and yet I feel we are all pretty balanced - normal average people at the same time.

I'm glad this book was written -- because there are so many jokes about peoples behaviors. Read too much? Must have a problem. Walk too much. Must have a problem. Play too many video games? Another problem....
Yet .... maybe -- just maybe people are doing what they like to do - and many of our habits serve a purpose...( the brains way of fighting off anxiety etc.)

Great book - glad I read it! Good fit for my brain!

Thank You Simon and Schuster, and Sharon Begley

[Carlos · Rating 4 out of 5]

this was an eye opening book, it mostly gives examples of people who suffer from compulsive behavior (gambling, shoplifting, hoarding) and how the mental industry has treated them in the past, treats them today and the many nuances that goes on in the medical world to try to keep up with ever changing definitions of behaviors that have in the recent years been recognized as belonging to mental illness, this book mostly deals with anxiety and it states that it is anxiety that actually causes all symptoms usually associated with compulsive behavior. Im not going to try to explain something that is obviously beyond me (medical definitions of mental illnesses), but i do recommend you read this book and get your own conclusions , i didnt give it 5 stars because while the book was interesting , it never explained how to cure or treat said conditions, (maybe thats beyond current medical knowledge at the time) . Has its depressing and out lifting moments .

[Hunter McCleary · Rating 3 out of 5]

A little too much jargon in places. The big take-away message is that compulsions are more widespread than believed but there is such a wide range of what's normal that it's difficult to tag someone as having a serious problem.

Notes:
6 Compulsions are responses to anxiety.
16 Compulsions versus addictions.
21 Addiction is pleasure, tolerance, withdrawal.
22 Compulsions are all about avoiding unpleasant outcomes.
29 And role of perfectionism.
50 OCD often goes undiagnosed for many years,.
69 Scrupulosity is more or less religious fervor gone off the rails.
78 Is it just your problem or do you project it onto others.
69 Psych community is finding mental illness wherever they look.
110 The online gaming business model.
134 The fear of missing out or I don't exist.
137 Internet is a coping strategy.
144 Chapter on the history of compulsions laid largely on religion.
150 Compulsive checking.
160 Freud and the symbolism of compulsion.
165 Hoarding may be symptomatic of attachment disorder.
186 Hoarders sentimentalize things.
196 Hoarders versus collectors.
211 Shopping out of boredom or depression.
258 Multiple genes play a role.
266 Dopamine fueled circuits dysfunction.

[Karen · Rating 4 out of 5]

JUST CAN'T STOP BY SHARON BEGLEY

This digital copy was provided to me via Net Galley, Sharon Begley and Simon & Schuster for a fair and honest Review.

Sharon Begley's book is marketed to be the first of it's kind to describe Compulsions in all of it's different forms. Some compulsions are mild and some compulsions are stronger. "Mild and Extreme." The following behaviors are examined OCD, hoarding, acquiring, exercise and compulsions to do good things. Sharon Begley states although these compulsions are different, that they are responses to anxiety. In this book she includes people she has interviewed.

Sharon Begley begins with with the example of famous John Milton who blind used his three daughter's to help write down for him verse he had constructed for "Paradise Lost", had a need to unburden himself--to get out the verse as if a cow needs to be milked. The author states that compulsive behavior come from a need so desperate that it demands relief. They work as an outlet valve, a consequence of anxiety. But, while compulsion's bring relief they also bring little enjoyment. I agree with that wholeheartedly. Sharon Begley describes it as two different parts of our brain in conflict with one another. With one wish to stop them, with the other wish we are afraid of stopping them.

Acquiring more and more stuff, no matter how much we already have and how unfulfilled each hoard has left us--we feel compelled to engage in these behaviors more and more, if we are compulsive. If we don't we feel anxiety.

So we do what we can to control what we can, compulsive cleaning and hoarding or washing our hands too often or checking, or shopping, or playing video games. It could also be that we feel a need to check our smartphones. We hang on tight to our compulsions, according to Begley, by clinging to our compulsions as a lifeline for it is only in engaging in our compulsion's that we can let off some of our anxieties to function.

Sharon Begley mentions Carrie Arnold who began exercising regularly for fitness, an overachieving college freshman. She also exercised because she was stressed out off her mind. Whenever anxiety got too bad, she would exercise, her exercise habits were hardly extreme. For example four or five times a week for thirty minutes a day. But then her exercising increased more and more frequently where she would be exercising at night sometimes only allowing only four hours of sleep. I can see that as problematic.

Carrie wrote a book called "Running on Empty: A diary of anorexia and recovery", 2004. I am glad to read that having compulsions as long as they are not too excessive to release anxiety doesn't mean that your brain is broken.

At one time in my life I used to enjoy running. Now I am looking forward to the time when I can get back to doing it. It was a long time ago, so I would have to start from scratch. I don't know if I will ever find the time too do it. I used to run outside when my oldest son was a toddler. I pushed him in the jogging stroller and we would do it everyday in the summer. The more we ran, the more I increased my mileage. It brought me great joy. I feel a compulsion that I am not exercising at all in the past three years. I am married to my Net Galley deadlines. I excessively requested 75 titles by mistake, not realizing I had requested so many. They all came in around the sixteenth of December through December 19. Then in January 2017 the rest came through. I have been compulsive about working on them everyday. Every day I get down to 32 titles left and I have requested easily 15 more since I got bombarded. I can see where the author is coming from, because I can see my destructive behavior in having to keep staying at 32. I just want to be done with it. Because I requested the titles I feel committed to finishing them. I enjoyed this book but at times didn't feel it was easily accessible. Maybe it is a little too filled with too much detail.

[Jonathan Maas · Rating 5 out of 5]

Great non-fiction book that tackles the topic of compulsion. From phone-checking to hoarding, from moderately intrusive to debilitating – this one covers it all.

This is not a ‘one writer’s journey’ type of non-fiction tale. This is more of a ‘one writer covers it all’ type of books. File this under a ‘read it cover to cover, or keep it as a reference and read a chapter here and there.’

Either way it’s great, and Sharon Begley thoroughly covers a topic of the modern age – that of compulsion. Great writing as well - accessible and easy to get into.

[Katherine · Rating 4 out of 5]

This was a great book. Having experienced some scary periods of OCD rumination in my life—and, outside of those periods, having ridden out many smaller waves of obsessive thoughts—I'm very interested in why these thought patterns come about. I absolutely love reading case studies, and this book has a lot of good ones.

There are people who feel like they'll die if they don't exercise. People who can't throw away a single cardboard box, plastic bag or empty pill bottle. People who can't stop checking if their pet has gotten into the refrigerator, even if the pet just walked by. While I couldn't relate to the specifics of many of these stories, I could certainly relate to the feeling that one MUST do or think something in a certain way or something terrible will happen. And anyone, even the most well-adjusted and mentally stable, can relate to needing to check email/Facebook/texts just ONE more time, JUST to see if anything important came in in the last two minutes. Obsessive/compulsive/impulsive behavior is on a spectrum, and we're all somewhere on it.

My most interesting takeaway from this book was that there are many paths by which people come to being obsessive and compulsive. There is no one magic brain mechanism that we can target. That's a bummer in one way, because it means there will never be one cure-all, but it's also amazing. Our brains are so complex and we are each a unique product of our nature and our experiences. And no matter what you're feeling, you're not alone. Even if no one else has your exact obsession or compulsion, you can bet there's someone who's pretty close. That's comforting in a way.

[Tate Dixon · Rating 2 out of 5]

“I am afraid of being alone with my brain.”

Hmm I’m kinda disappointed with this one. I picked this up after looking into books that would touch on relatable topics in my life. I’ve struggled with OCD my entire life and have never found quite the right treatment/solution for me so I thought by understanding it more I could work on myself. However, after finishing this books I’m just left kind of disheartened by how much the science community still seems to lack in understanding of why some of our brains are wired this way. I also thought this book had a weird mix of complicated technical jargon and a laid-back, almost dismissive, tone that made my interest wane reading this

[Olivia · Rating 4 out of 5]

There's a ton of information in this book, almost to the point of being overwhelming, but it's so good and well-researched. I learned a lot about anxiety, OCD vs. OCPD, and compulsive behaviors. I also liked how Begley would compare different behaviors and explain more about them, differentiating between various labels and stereotypes. Highly recommend!

[Jeremy · Rating 2 out of 5]

Begley is a journalist and she did a ton of research on certain compulsion behaviors. Lots of focus on OCD, hoarding, and OCPD. She tried to drive home that these are disorders that cause people anxiety when they can't fulfill their compulsions. Too often people say they are OCD in a flippant way, but you are not OCD unless you have a little voice telling you to do certain things, or otherwise feel extreme anxiety unless these compulsions are acted on. Other "OCD" behaviors that people often refer to are really pretty normal human behaviors.

That was my main takeaway from this book. It was not very interesting and threw a lot of technical or "insider" information at us that the intended reading audience just doesn't really care about. I don't need a deep history of whether hoarding made the DSM5 vs the DSM4 or the intricate history of how psychiatrists referred to it. A little bit of stuff like that goes a long way.

[Sandra · Rating 5 out of 5]

Honestly, the reason I chose this book because of the cover. But now after reading the book, I really like the book also, I realized I have mild and a little bit extreme compulsive behaviors, like checking my smartphones for email or text messages, buying more stuff than I need, watching a lot of movies... In this book, Sharon Begley, the author writes that while compulsion 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. What she writes is so true. Yes! I'm afraid if I'm not checking my smartphones or watching a lot of movies, I'm afraid I'll miss something important. This book is very engaging and was a fascinating read. I also found the case studies interesting and informative.

I received this copy from Net Galley in exchange for my honest review

[Lucie Paris · Rating 3 out of 5]

I may like to clean when something is bothering me, feel lighter and free when I declutter ma home or thinking of sport too much when I want to enter my swimsuit, I don't really suffer of compulsion. But some of my friends do. Thta's why I've piqued up this book. I was curious to know more about these manifestations from a scientific point.

The read was dense and the examples interesting. Can't say it was a realxing fun moment but I've appreciated how Sharon Begley has put her book together. I believe it can help people to feel less alone and to understand their compulsive needs.

Interesting and dense.

Lucie
http://wp.me/p8ObN4-4F

[Lesa Parnham · Rating 3 out of 5]

This book was up and down. I went from being totally immersed in one chapter, and bored to death in the next. Ms. Begley combines interesting case studies along with her insights into compulsions.

[Stefanie · Rating 3 out of 5]

I was fascinated by this subject and this research!

[Joanie Driemeyer · Rating 4 out of 5]

Fascinating. Anyone close to someone with OCD should read this.

[Francesca · Rating 4 out of 5]

A few months back I was in a class where we learnt about operant conditioning, extinction etc. And only later it struck me that that's essentially what ERP leverages in the treatment of OCD...
I wish I could've asked the professor about that link but it was too late, course was already over :/

I guess I'll dig into some articles myself but I was super excited that I could relate a concept learned in the context of marketing to such an instinctual and subconscious aspect of my life!!

[Michelle · Rating 3 out of 5]

*3.5

I thought the first half was very interesting, probably because I could relate to the topics more. I found the second half less interesting and I skimmed most of those chapters.
Still very useful and insightful.

[Paul Anderson · Rating 4 out of 5]

“If every age gets the lunatics it deserves, then our age of anxiety deserves those who are in the grip of a compulsion.” Can’t Just Stop: An Investigation of Compulsions by Sharon Begley (Simon & Schuster, February 2017) hypothesizes that “compulsions are a response to anxiety, and modern life is filled with overwhelming anxiety.” Compulsions offer us an illusion of control in a world gone mad. “We cling to compulsions as if to a lifeline, for it is only by engaging in compulsions that we can drain enough of our anxiety to function.”

The idea behind Begley’s book was so compelling that I simply had to buy it. I’m a compulsive bookaholic who needs to know what’s inside every book (which may be an impossible task) or continuous wondering will drive me crazy.

That’s my excuse, anyway, for buying books, and I’m sticking to it. I’ve become a compulsive book hoarder. Books are more than a compulsion with me, they’re an obsession. And, as long as I have a book to read or a book to write, I don’t feel the need to kill anyone.

Is compulsion an anxiety disorder? Is it a personality disorder? An addiction? A syndrome? What’s the difference between Impulsive and Compulsive drives? Everyone feels anxious. Everyone is occasionally impulsive or compulsive. Should impulsive and compulsive behaviors be considered pathological only when they become so excessive they interfere with normal life functions?

Can we control our impulsive and compulsive behaviors? When do we know we need to?

Serial killers are addicts who get pleasure from risk-taking. They thrive on anxiety rather than feel a need to alleviate anxiety. They’re addicted to the pleasure they get from causing pain. They know their actions are wrong, but they can’t stop until they get caught. Seeing how long they can get away with doing something dangerous and forbidden is half the fun. They’re more concerned with what happens when they do something than when they don’t do something. They’re thrill addicts who need regular fixes or suffer the pains of withdrawal. Serial killing is addictive behavior, It isn’t compulsive.

Compulsive behavior, on the other hand, results from worries about what will happen if one does not possess something (knowledge, an object, followers on Facebook, love, money, drugs, bullets, soldiers, words in print, etc.) in sufficient quantity or quality to prevent disaster. It is the opposite of risk-taking. In one’s mind, possession is seen as the only thing that can prevent a future catastrophe from occurring.

Addictions can become compulsions only when worry about what may happen if you can’t continue the addictive (pleasurable) behavior takes over. You no longer get pleasure from risk-taking, but must take different risks to avoid pain caused by discontinuing the risky behavior. Like feeling compelled to kill in order to cover your tracks and not for pleasure. Like stockpiling books you’ll never have a chance to read.

When anxiety becomes fear, compulsions can become obsessive. You’re terrorized that unless you get things just right, absolutely perfect, calamity will happen. You, and only you can prevent bad things from happening, especially to ones you love. Only scrupulous adherence to a magical ritual (like buying certain books or writing them a certain way) will prevent disaster.

As a writer of crime-suspense thrillers, I enjoyed this book ‘s insights immensely. It was written in language a layman could understand, covered the gamut of compulsive behaviors, and tried to tie things together in a nice package. More importantly, though, this book taught me that when compulsions serve a useful function and contribute to a successful life rather than destroying it, being compulsive isn’t always bad.

Maybe that means I’m not as crazy as I thought.

[P K · Rating 1 out of 5]

This book was pretty novel to me in some ways. In general, I had not really read much about compulsion and associated disorders. I found the distinction Begley made between compulsion (something you have to do because it relieves anxiety, not because it’s pleasurable) and addiction (the behavior is at first intensely pleasurable) quite interesting, and I can see why that distinction would be really relevant for treating disorders like OCD and drug addiction differently. Additionally, I found the portion on hoarding pretty interesting because I didn’t realize that hoarding itself didn’t typically cause people distress, but rather treatment of the hoarding does. I also found it interesting that it may result from an impairment in decision making, thus manifesting in just keeping everything instead of deciding what to keep. However, the book overall was really tedious and had far too many extremely similar and drawn out anecdotes. The writing wasn’t super good either. It was like a good essay, if you had an assignment in school to thoroughly research compulsive disorders, this would have gotten good marks I suppose. But the writing comes with none of the overarching flow and panache you get with someone like Michael Pollan or Bill Bryson on non-fiction topics. Additionally, I’m not really crazy about journalists without strong education in the sciences writing about scientific topics. I always have an uneasy feeling like “Is this really what the latest literature indicates, or did you misunderstand it?” In some cases the writing is just so good and the research so thorough that I’ll happily make an exception, but this book wasn’t one of them. Also, Begley is really scathing throughout the book about various aspects of psychiatry as it pertains to the treatment of compulsive disorders. I get it if you disagree with the leading experts in the field, science is always evolving and there is room for growth. But it’s a bit much when someone with absolutely no professional training in a field takes such a condescending tone. Additionally, the format of the book was really weird in that the mechanistic neuroscience behind the disorders was all crammed into the very last chapter instead of being integrated throughout the book. Is that in case someone wants just the stories and none of the science? I’m not sure. But I kept reading through these fluffy story-only chapters waiting to get to the meat of the argument, and it just didn’t come for most of the book. Overall, I think this is an interesting and important topic, and more should be written about this in a popular science format. However, I wouldn’t recommend this particular book.

[Dove · Rating 5 out of 5]

I absolutely loved this book! I learned so much from it, and it really expanded my knowledge on this topic. I love books that are enjoyable to read, but also teach you things- which is exactly what this book is. This book explains the science and psychology behind compulsive disorders (most commonly OCD- overly compulsive disorder, which most people know about) and really breaks it down. She explains it from a neuroscience and biology perspective, but also a psychological perspective looking at childhood experiences and surrounding influences. She goes through literally every type of compulsive disorder you could think of- like cellphones, gambling, shopping, shop-lifting, etc. She explains key differences between things like addictions versus compulsions and how one could possibly lead to another. She also explains the root causation of these disorders- which is stress and anxiety and how this is just the way for the body to expel all the stress or anxiety it has. To illustrate these points, she uses real-life examples and gives us case studies of different people with different compulsions and explains the backstory of how this compulsion started and why. It's kind of like "My Strange Addiction" on TLC, which made me like it more. To take it to the next level, she supplements some real-life articles, studies, and experiments and includes statistics to help prove the point. I also really appreciate the fact that she quotes the DSM a lot (psychologist and psychiatrists bible for diagnosing) because that makes it more accurate and believable. She also brings in the history of the disorder and how to treat it. Moreover, she highlights the fact that most people suffer from this in one way or another, just varying levels of severity. For example, most people religiously and impulsively check their phones for text messages. Some of the stories are so unique and I could relate to them, which made it feel like the book was speaking to me. For example, there's hypergraphia which is the impulse to just write things down. She gives an example of a girl who wakes up in the middle of the night just to write down her thoughts, and emphasizes that the girl simply couldn't not write down her every thought. This is something I've suffered with for a long time, and I didn't know there was a term for it, so I appreciated the fact that I finally could explain what I was going through.

[Judy · Rating 3 out of 5]

Learned about this book 2/26/2017 from the Washington Post: When does all that tweeting, blogging, eating, Snapchatting veer into compulsion? my link text

Very detailed book about OCD and how it differs from addictions (OCD to quell anxiety; addictions to bring pleasure although there are overlaps). I got bogged down so started skimming, but I think it is a helpful book. I take the author's conclusion: "there is no bright line between mental illness and mental normality."

I found this true story in the book about Ethan Smith an important story about boundaries:

"He did get kicked out by the OCD Institute, which saw through his ruse and decided that tough love was the only hope for helping him. His parents went along; they told him if he showed up at their Florida home they’d have him arrested for trespassing. Reeling, Smith found a dingy apartment in a crack house in South Boston and lay in bed for six days.

I don’t mean he lay in bed except for going to the bathroom, to the kitchen for a snack, or even to the front door to pay the pizza guy. No. Smith lay in bed for six days without eating or drinking; he peed into the mattress. “Death seemed like my only way out, but I didn’t want to die,” he said. He figured the only way to not die was to get out of bed and go to the corner market. Somehow the will to live overcame the death grip that his illness had on him. Survival became more important than his compulsion. His doctors at McLean took him back, he endured ERP three days a week, and began to function again: he got a job at a guitar store, met a girl, and started living. In 2011 Smith went to Los Angeles, where he works as a writer, director, and producer. He was the 2014 keynote speaker at the International OCD Conference in Los Angeles.

He’s not cured, but he’s no longer paralyzed by the compulsion to get CT scans. Somehow what he learned at McLean, and on the streets, kicked in, and he learned to separate the being who is Smith from the pathology that was his CT compulsion, and he has held on to it for dear life."

I also found the sections on scrupulosity helpful.

[BOOKLOVER EB · Rating 3 out of 5]

"Can't Just Stop," by Sharon Begley, is an overview of obsessions and compulsions that includes a historical perspective and an exploration of possible causes and treatments. The author believes that most of us adhere to rituals that are relatively benign and help us cope with day-to-day living. However, when someone cannot function because crippling anxiety creates an uncontrollable urge to wash her hands, check again and again that she has locked her door and turned off the stove, or hoard large numbers of old newspapers, broken appliances, and other clutter, then she needs help. "Our compulsions arise from from a mortal ache that we will go...to the craziest extremes to soothe." Severe compulsions provide "an illusion of control" in a frightening world.

When people play video games for most of the day, glance at their phones constantly, shop until they drop, regularly work fourteen hours at a stretch, or clean their homes obsessively, there is something amiss in their mental circuitry. They may feel dread that gives them no peace. Perhaps they are lonely, insecure, or trying to deal with the effects of past traumas. It is likely that, in some cases, a genetic component plays a role in these abnormal behaviors.

Begley's informative and compassionate work of non-fiction defines obsessions and compulsions and explains how they differ from addictions and impulsiveness. In addition, she illustrates her concepts with heartbreaking examples of individuals who have spent torturous decades in thrall to their inner demons. At times, Begley repeats herself, uses overly technical jargon--especially in the chapter on MRIs and PET scans--and goes off on distracting tangents. The fact that great authors such as Milton, Dostoevsky, and Hemingway were driven to write is an interesting tidbit that would be more relevant in a book about the quirks of creative geniuses. More to the point are the passages that describe the excruciating suffering of ordinary people who are tragically out of step with their family, friends, and colleagues. Treating OCD patients with the most effective techniques known to medical science should be a top priority. In any event, most experts agree that we still have a long way to go in our analysis and understanding of the human brain's infinite complexity.

[Rt · Rating 4 out of 5]

A well-written book that argues that “mental illness” is a spectrum; none of us is “normal” but some of us are in severe distress and can benefit from particular interventions. As she explains, the discourse around impulse, addiction, and compulsion can get pretty confused, with various problems described in all three ways; some people’s behavior may be better described by one or another. Some compulsive shoppers are depressed or manic; others are anxious. I particularly liked one expert’s explanation of how our brains respond to unexpected dopamine hits: “It’s like, DUDE: UNEXPECTED HOT POCKET! KEEP DOING WHAT YOU’RE DOING UNTIL WE FIGURE OUT HOW TO MAKE IT HAPPEN AGAIN! So you keep playing.” I feel I know this expert, and that he would get along well with my son. What about compulsions? Acting on them relieves anxiety, at least for a bit, which teaches the brain that it makes sense to act on them.

Begley doesn’t like the language of “chemical imbalances” in the brain and argues that it’s more about conditioned responses in neural patterns of activity: wiring, not chemicals. Where OCD sufferers seem to have overactive responses to perceived danger, hoarders don’t get the “something is wrong” signal when non-hoarders would. Nonetheless, Begley has commendable caution about what we don’t know about brain activity yet, including differences among people. “The only safe thing to say about compulsive behaviors is that they probably involve dysfunction of the brain’s dopamine-fuled reward circuits.” I learned that a common treatment for Parkinson’s has as a known side effect in a subset of patients triggering compulsive behavior, from gambling to sex. I also learned that the story of Phineas Gage includes not just loss of decisionmaking capacity, but also a new fondness for souvenirs—frontal lobe damage made him a collector, apparently.

[Jane · Rating 3 out of 5]

This is an interesting look at compulsions - something many of us experience. However, I found the book a slog to read. I didn't understand the flow and then when the author crams in the science at the end I was overwhelmed and a bit disinterested. Perhaps I was a bit bothered by this paragraph toward the end of the book:

"The brain glitch responsible for OCD stands out for several reason, including that it was the first to be deciphered. But another reason is that it involves patterns of activity, 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. This isn't a book about what a train wreck that idea has been, leading to the proliferation of prescriptions for drugs that supposedly correct those imbalances but whose benefits are very, very slight or nonexistent, and turning most psychiatrists into just diagnosticians and drug dispensers more than therapists who seek to work through a patient's problems via psychotherapy. For our purposes, what matters is that it is empirically wrong: abnormalities in the brain's wiring, not neurochemical imbalances, underlie most mental illness. And OCD was the first to show that."

Wow, that paragraph packs a lot into it with little to support it. I believe that there needs to be better treatment with psychiatry/psychology/neuroscience combined. But I cannot discount the positive effects of medicines on so many people that I know. Furthermore, it can take years to find an effective therapist. There needs to be a lot more results-driven practices to better serve those with mental illnesses.

In the book's conclusion, the author has realized that compulsions can quiet anxieties and is one of the greatest gifts our brains can give us. I'm not so sure about that.

[Delia Turner · Rating 4 out of 5]

A diverting read, with many anecdotes and historical notes about the way that psychology has come to deal with various types of apparently obsessive behaviors. My main take-away is the distinction between addiction, impulsive behavior, and compulsion.

Addiction starts with pleasure seeking, develops habituation, and produces withdrawal symptoms.
Impulsive behaviors involve acting without planning, driven by pleasure seeking and the need for immediate gratification. Compulsions are about avoiding unpleasant outcomes, are driven by anxiety, and produce temporary relief from the anxiety.

She argues that Internet addiction is not a diagnosis; it's more of a compulsion, rather than a true addiction, because it's triggered by anxiety rather than the search for pleasure, and is merely a symptom of a wide variety of things, including response to the deliberate cultivation of compulsion, fear of missing out, and anxiety about being alone with oneself. She says that Internet addiction really doesn't qualify as mental illness, either; it's a reasonable response.

Favorite passage:

Without an a priori hypothesis about the brain activity behind a behavior, neuroimaging becomes a fishing expedition where you can't tell if the catch is a prized marlin or an old boot." (266)

[Kay · Rating 3 out of 5]

I'm sure this is not the definitive work on this topic, but it does show how difficult it is to pin down. What I learned reading this is that compulsions have varied over the years as well as science and society's perception of the seriousness of compulsions. Not that I'm an expert or anything, but some of this I could relate to and some I just couldn't. Perhaps it's dependent upon one's particular compulsion(s). I did find chapters informative and some I just didn't get. This book does offer insight on the nature of compulsions as serving the need to reduce anxiety. It also rightfully points out that there's a point when the compulsion becomes the problem and is no longer being successful at reducing anxiety and is instead creating more serious situations. Consider it a sliding scale that varies as to what interferes with life activities and society's perception. This is an interesting book if you're interested in video games, smart phone attachment, hoarding, shopaholics, etc. I did find historical compulsions such as mad travelers and bibliomania quite interesting. Because this book was hit and miss for me, I rated this at 3 stars.

[David · Rating 3 out of 5]

kind of interesting, with some research review and some case examples of people with OCD and various other compulsive behavior patterns [hoarding, hairpulling, shopping......]. Considers at some length whether disorders lie on continuum with normality [seemed to want this one both ways, saying most times they are on a continuum but also that people overpathologize normal eccentricities and that true OCD, for instance, feels massively different from just a neat freak noticing something out of place etc.

other, to me somewhat less interesting, theme was her wish to distinguish consistently compulsion from addiction and to bemoan that people don't use the terms consistently. Gist seemed to be that addictive behavior at least initially is pleasurable whereas compulsive behavior is providing more relief from anxiety than actual pleasure.

[Joseph Carrabis · Rating 2 out of 5]

Can't. Just. Stop. is about compulsions and the people who have them. All sorts of compulsions. Like the need to read lots of books. Or review them on Goodreads. Or write short sentences. Without subjects.
This is a good book for lay readers, not for people in the field. It might be a reasonable read for writers wanting to do background for a character.
What it was missing was a clear explanation of what to do when you have a compulsion such that writing short sentences without a subject becomes writing horribly run-on sentences with multiple subjects bound together by unrecognizable predicate clauses.
Seriously, probably good research but not for those in the field and not as a resource for those with compulsion challenges.

[Lydia · Rating 4 out of 5]

Ms. Begley is clearly passionate about this subject and cares deeply for people suffering from compulsions. I found Can't. Just. Stop. to be relatable, well-researched, and an enjoyable and informative read.

It hit a little too close to home in the chapter about hoarding - which I've found to be motivating in tackling my piles of stuff. I was fascinated by the chapters where the neuroscience of OCD was explained.

4 stars rather than 5 because so many times when listening to the audiobook, I found myself wishing she would stop rattling off lists of compulsions. I get it - there are lots. Keep with the book - I didn't come here for so many lists!

[Jelly · Rating 2 out of 5]

The subject of compulsions is, by itself, very interesting, but Begley turns the learning process into a bit of a chore. There's no rhyme or reason to the book's order: Begley follows up a brief introduction to the difficulty in defining compulsions and their connection to OCD with chapters focused on the various compulsions that permeate modern society. Halfway through the book, however, she completely reverses directions to discuss historical references to compulsive disorders, before concentrating once again on specific behaviors. Not to mention the fact that she omits information on several major compulsions like trichotillomania and excoriation disorder. So-so read.