Clearer Thinking with Spencer Greenberg A conversation with a person with OCD (with David Adam)
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Dec 10, 2025 In this engaging discussion, David Adam, an acclaimed author and journalist, shares his journey with obsessive–compulsive disorder (OCD) and insights from his book, The Man Who Couldn't Stop. He delves into the intricate dynamics of obsessions and compulsions, and how intrusive thoughts can transform into debilitating OCD. David explains critical concepts like thought–action fusion and the impact of ego-dystonic thoughts. He also highlights effective treatment strategies such as exposure and response prevention (ERP) and the role of SSRIs, emphasizing the importance of resilience in managing the condition.
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Thoughts Drive The Disorder
- OCD is primarily a disorder of intrusive thoughts, with visible compulsions as secondary responses.
- Obsessions and compulsions form a reinforcing cycle where behaviors temporarily relieve fear but strengthen the loop.
HIV Fears Sparked Persistent Compulsions
- David developed intrusive HIV-related thoughts at 19 and performed compulsive reassurance behaviours like calling helplines repeatedly.
- He was diagnosed after seeking psychiatric help and realized his symptoms fit OCD.
Responding Matters More Than Content
- Learning that intrusive thoughts are common reframes OCD as a problem of response rather than thought content.
- Treatment focuses on changing how you process thoughts, not erasing them.
