Compulsive Acts is a short collection of clinical tales by Stanford psychiatrist Elias Aboujaoude. Each chapter is devoted to a different sort of compulsive act; the five chapters deal with a severe form of obsessive compulsive disorder where the patient could not let other objects come within a certain distance of his nose; a woman who compulsively pulled out the hair on her head; two different women who were both kleptomaniacs, a gambling addict, and a man addicted to an alternative reality video game. In each chapter, Aboujaoude intersperses the tale with information about the disorder, the different kinds of treatment available, ideas about how they might work, and the relative success rates of those treatments. His secretary Dawn also plays a major role in each story, with her comments on the patients, her accepting gifts from them, and her maternity leave.
The tales are certainly entertaining and informative. Aboujaoude explains in his preface that he has changed many details in order to protect patient privacy, and he also says that he has always wanted to write. The packaging of the stories is a little too neat, and I would guess that he has used a great deal of creative license in setting out the details. Strangely, he says very little about his own life, and we get very little sense of what motivates him to focus on these sorts of problems. He does occasionally summarize his research on topics relevant to the cases he discusses, but we get little sense of what drives him as a researcher and clinician. We also don't get a strong sense of why the patients do what they do: generally treatments focus on reducing the symptoms using behavioral therapy and medication. So the book mostly stays on the surface of the phenomena.
For those who don't know much about compulsive action, Compulsive Acts will be informative. It sets out some scientific and clinical knowledge in an easily digestible format. For those who are already familiar with books such as The Boy Who Could Not Stop Washing, Aboujaoude's collection of tales will not provide much new information. However, he does give a sense of the limitations of psychiatry both in its understanding of the compulsive action and its ability to treat, and he does show with compassion how difficult it is for people struggling with these disorders.
© 2008 Christian Perring
Christian Perring, Associate Professor of Philosophy, Dowling College, New York.
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