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) ( )

1st incident: A week ago, I went on a short trip in a lovely town not too far from Athens for three days. We ended up leaving 15 minutes later than planned, because I just HAD to make sure that the door and the windows were locked. And then, I HAD to go back and check whether the boiler and all appliances were switched off. But then, I thought ‘’did I lock properly?’’ Needless to say, I was almost thrown in the car by the other member of the household…

2nd incident: In my class, there are three rows of desks. Each desk has a set of two chairs,one painted in pistachio green and a second in canary yellow. They’re so beautiful, they make me happy just by looking at them. One evening, I noticed that three chairs were out of place. I just couldn’t leave until the colour coordination was properly restored.

3rd incident: Possibly the weirdest of all. When we travelled to beautiful Moscow,I insisted that we had to return to the hotel from the same route each night, no matter the spot of the city where we had found ourselves in. If we hadn’t, I was convinced that something would have happened to us.

If you made it through these crazy moments, first of all, congratulations! Secondly, you're probably thinking this is OCD to the core.I thought so too, I even declared so in a half-ironic, half-serious manner, but after reading this book, I realised how wrong I was.

Sharon Begley’s book attempts to shed light in the disorder that becomes more and more notorious and relevant to our age. There are facts and personal confessions that shocked me. I’m not exaggerating. They shocked me and frightened me. It can start harmlessly. Let’s check the mobile phone one more time, let’s check the e-mails even though we checked ten minutes ago, let’s try to pass the level of this addictive video game. And what about all the buttons and the clippings and the clothes we don't need anymore? And the problems mount in frightening progress and the impact on the patients and their close relationships becomes almost irreversible.

What really made me sad was the bottom line in many of the cases referred to in the book. Loneliness, disappointment and a deep feeling of failure. People clinging onto things that they regard as their anchor to a past,happier life or to a life they wanted to live,but fate had other decisions in store for them.

I’ve always considered my mother to be a hoarder. Let’s keep this jar, let's keep this lamp, keep this, keep that...when my grandmother passed away, she simply had to throw away and donate things, it couldn't have been otherwise. And she did so, but I could see the pain in her eyes while she was carrying out the task,and I remember I thought that was such an unhealthy clinging to the past. Now I know I was cruel. You see, I've learnt not to cling onto things. The teaching profession requires us to have almost no basis at all. This year we’re in this school , next year we may found ourselves miles and miles away. But I understand now that my mother has no disorder,nor is she a victim of the past, and I will never call her ‘’a hoarder’’ again.

I appreciated the fact that the writer provides no personal opinions and answers, She states the facts and let us decide and learn. She informs without imposing any explanations on such a delicate subject,and thus, this book does worth your time.

And as for me,next time we travel anywhere, I am determined to change routes to the hotel each and every day.Well, perhaps...

( )

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. ( )

3.5 a mixed read for me, not that all, 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, was 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. ( )