Obsession: A History
- Lennard J. Davis
A battle for the public good has been waged for centuries between qualified doctors of medicine with formal training and their 'quack' counterparts. As scientific analysis has come to be accepted, we have demanded more evidence from our physicians. Despite a lingering love-affair with alternative medicines such as homeopathy, patient-consumers today expect more than snake oil and bedside charm. Into this market lands Lennard Davis's latest book, Obsession.
The stereotypical view of a scientist, which rings true of many, is of an obsessive individual working long hours, worrying about minutiae and trying to replicate experiments against an approaching deadline. Davis looks at this form of obsession and others. He discusses the mania of novel writing in the nineteenth century, when prolific authors such as Émile Zola would write for days and nights at a time. The obsessive Zola became a subject of obsessive study by his contemporaries, and Davis guides us through the sociocultural evolution of the disease now known as obsessive–compulsive disorder. There are fascinating examples throughout the book, not least in his discussion of obsessive love and sex.
Davis tries to untangle the central question of what constitutes obsession. If I check my car doors are locked a couple of times before I leave it parked each morning, am I being obsessive? What about washing my hands repeatedly? Where is the line between obsession as a harmless fact of life, and when it becomes a mental illness? It is far from normal to wash one's hands so often one develops skin diseases, or to be unable to leave the house because of fears one has left the doors unlocked.
Obsession provides an insightful and nuanced review of the history of this tragic illness by exposing obsessive behaviour and contrasting it with the common, mildly obsessive behaviours we all engage in. The question of difference, and thus definition, is a recurring motif. Davis is a professor at the University of Illinois in the departments of English, Medical Education, and Disability and Human Development, and has an interesting broad perspective. He insists that to treat an illness effectively, we must understand its history and evolution in a cultural context. Obsession has evolved from being subjacent to demonic possession into something to be almost proud of, to want even. Obsession is the hallmark of genius, of industry and perhaps of modern life, such as our need to regularly check e-mail.
Davis argues for the provision of a narrative framework to medicine, to understand both the disease entity itself and the illness that results from it. This raises the interesting question of whether we need a new type of clinician to help a patient understand their disease through such a narrative.
Davis also asks us to agree with a reclassification of obsession and thereby most, if not all, mental illness. But it is not clear into what. He asks us to assume that science and medical knowledge are responsible for the creation of obsessive culture because of their reductionist approach that observes too strictly the one gene, one disease schema. By this logic, it follows that scientists and physicians are themselves obsessive and unable to render any judgement. He addresses them in his introduction: “some clinicians and researchers who have miraculously persisted in reading my introduction up to this point will all the while have been shaking their heads at the ignorant insouciance of my project.” Unfortunately, he is right. His elegant approach to reclassifying obsession, and by extension obsessive–compulsive disorders, is clouded by a post-modernist demonization of science.
Many facts and statements in the book are misleading. For example, “We are in the very early days of understanding the neurochemical and electrical activity of the brain,” says Davis. But our current understanding of human physiology and disease follows centuries of study and analysis. The diagnoses we render now are based on an infinitely larger body of knowledge than those of our forebears who prescribed a good bleeding when one was feeling melancholic; hardly early days.
Davis gives us a witty and interesting historical tour of a fascinating subject. However, by presenting science as excessively reductionist and as responsible for the mis- or over-diagnosis of obsession, his arguments for reclassifying the disease remain incomplete and lack scientific rigour.
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Brooks, I. Our culture of obsession. Nature 457, 266–267 (2009). https://doi.org/10.1038/457266a