When I survey my past life, I discover nothing but a barren waste of time, with disorders of the mind very near to madness.
- Samuel Johnson
Having recently returned from a brief personal OCD pilgrimage while in London, I thought I would take the opportunity to share it with the OCD membership. Yes, there really are OCD shrines, if you care to look for them. This one is located in a small, well-hidden square in the heart of the City of London, just off Fleet Street. It is a place you have to really be looking for. It was the home of one of the great minds (perhaps the greatest) of the eighteenth century, a noted literary figure, and the author of the first comprehensive dictionary of the English language: Dr. Samuel Johnson. The good doctor was considered such an important figure, that the second half of the eighteenth century is referred to as "The Age of Johnson." Dr. Johnson, by the way, also happened to be a person who suffered from rather serious cases of both OCD and Tourette's Syndrome.
He was born in 1709 in Lichfield, England, just outside of Birmingham. His father, Michael Johnson, was a bookseller of modest means. He attended Oxford University, beginning in 1728, but after thirteen months, was forced to drop out because he was too poor to continue. Following this, he experienced a period of depression. This is not surprising, since as an academically brilliant man; he had to end his college career simply due to poverty, while less intelligent children of the wealthy were able to continue theirs.
Johnson went on to attempt a career as a schoolmaster, but was hampered in this by his lack of a college degree. Also, his numerous compulsions and tics, which were quite evident, made it difficult for him to keep up a dignified appearance and earn the respect of his students.
In 1737, Johnson set out for London to make a fresh start, accompanied by one of his students, David Garrick, who would later go on to become the best-known actor/director of his time. Johnson began a literary career that would continue until his death in 1784. During that time, he produced plays, biographies, political satires, reports on parliament, works of fiction, and most notably, the most important dictionary of the English language until that time. By the time of its publication in 1755, Johnson had personally crafted over 40,000 definitions, and until the creation of the Oxford English Dictionary 150 years later, it was to stand out as 'the' dictionary. One of his other more significant achievements was his eight-volume edition of the works of Shakespeare, which he published in 1765.
Much of what we know of Johnson is thanks to James Boswell, who published his famous biography, The Life of Samuel Johnson in 1791. Boswell met Johnson in London in 1763 and the two became friends, traveling to northern Britain together. Dr. Johnson's symptoms were well known to those acquainted with him, and were well documented, particularly by Boswell. In one instance, Boswell noted one of Johnson's movement rituals -
"He had another particularity, of which none of his friends ever mentioned to ask an explanation. It appeared to me some superstitious habit, which he had contracted early, and from which he had never called upon his reason to disentangle him. This was his anxious care to go out or in at a door or passage by a certain number of steps from a certain point, or at least so as that either his right or left foot, (I am not certain which) should constantly make the first actual movement when he came close to the door or passage. I have, upon innumerable occasions, observed him suddenly stop, and then seem to count his steps with a deep earnestness, and when he had neglected or gone wrong in this sort of magical movement, I have seen him go back again, put himself in a proper posture to begin the ceremony, and having gone through it, break from his abstraction, walk briskly on, and join his companion."
Nearly everyone with OCD and/or Tourette's has had the experience of saying about his or her symptoms, "I know this sounds crazy, but I have to do it anyway." It must have been especially maddening for a man as brilliant as Johnson to find himself trapped in a web of complex and illogical rituals and tics. In the eighteenth century, there were no diagnoses for these disorders, nor was there any form of real treatment. Neither was there any understanding of these disorders on the part of the public. Such behaviors were commonly referred to as bad habits, fits, or even madness. Sufferers were either ridiculed, shunned, or both. A Miss Frances Reynolds, the sister of the renowned English painter Sir Joshua Reynolds, and a friend of Dr. Johnson's, wondered as to the cause of his strange behaviors:
"What could have induced him to practise such extraordinary gestures who can divine: his head, his hands and his feet often in motion at the same time. Many people have supposed that they were the natural effects of a nervous disorder, but had that been the case he would not have sat still when he chose, which he did, and so still indeed when sitting for his picture, as often to have been complimented with being a pattern for sitters, no slight proof of his complaisance of his or his good nature."
Obviously, Miss Reynolds could not be aware of the fact that those with tics and compulsions can, at times, successfully resist them, at least for some period of time. Her brother, Sir Joshua, had his own views on the origins of Johnson's behaviors, theorizing that,
"It proceeded from a habit which he had indulged himself in, of accompanying his thoughts with certain untoward actions as if they were meant to reprobate some part of his past conduct The great business of his life (he said) was to escape from himself, this disposition he considered as the disease of his mind, which nothing cured but company."
Those with OCD know that distraction can sometimes help to temporarily relieve obsessions, and fortunately for Johnson, he was a frequent guest in many social circles. It was perhaps Johnson's brilliant wit and creativity that won him the acceptance of so many of those around him in an age where behaviors such as he displayed could easily have been labeled as insanity. Johnson, himself, lived in lifelong fear of going mad.
On the day I chose to visit Dr. Johnson's home (now a museum), I went late in the afternoon, when it was not very crowded, and soon found myself alone there. Walking through the three stories of the small townhouse, I tried to imagine the difficulties he had had to overcome, unaided by such things as therapy, medication, or even a personal understanding of what was happening to him, in order to do even the most minor everyday tasks. I thought of my own patients, and how much harder it can be for them to do the things most of us 'neurotypicals' take for granted. As I stood in the attic where the famous dictionary was composed, I reflected upon how much greater were Johnson's achievements because of the numerous obstacles he faced daily. Surrounded by pictures of Dr. Johnson, I could almost visualize this tortured, highly intelligent man vigorously hopping back-and-forth over the thresholds of the doors, repeatedly walking up and down the two flights of stairs while counting his steps, constantly touching the floor, and mumbling repetitive prayers to himself, as he walked to his upstairs to begin work on some of the most brilliant writings of his day.
In addition to what may have been compulsive ritualizations, Johnson appears to have also suffered from obsessions involving guilt, religion, and responsibility. Comments about mental problems can be found among his writings, and it would appear that he was, in reality, speaking from personal experience. In Rasselas, Prince of Abyssinia, published in 1759, he made the following revealing observations,
"Disorders of the intellect happen much more often than superficial observers will easily believe. Perhaps, if we speak with rigorous exactness, no human mind is in its right state. No man will be found in whose mind airy notions do not sometimes tyrannise, and force him to hope or fear beyond the limits of sober probability. It is not pronounced madness but when it [be]comes ungovernable, and apparently influences speech or action."
In this same work, he goes on to state,
"No disease of the imagination is so difficult of cure, as that which is complicated with the dread of guilt: fancy and conscience that act interchangeably upon us, and so often shift their places, that the illusions of one are not distinguishable from the other. If fancy presents images not moral or religious, the mind drives them away when they give it pain, but when melancholick notions take the form of duty, they lay hold on the faculties without opposition, because we are afraid to exclude or banish them. For this reason, the superstitious are often melancholy, and the melancholy are always superstitious."
He may have also have indulged in compulsive prayer rituals to deal with his religiously scrupulous or superstitious thoughts. Boswell wrote of him,
"Talking to himself was, indeed one of his singularities ever since I knew him. I was certain that he was frequently uttering pious ejaculations; for fragments of the Lord's Prayer have been distinctly overheard."
Johnson's numerous tics were also quite well known to his acquaintances, not to mention anyone who happened across him in public. Boswell provides a description of some of his vocal tics:
"In the intervals of articulating he made various sounds with his mouth, sometimes as if ruminating, or what is called chewing the cud, sometimes giving a half whistle, sometimes making his tongue play backwards from the roof of his mouth, as if clucking like a hen, and sometimes protruding it against his upper gums in front, as if pronouncing under his breath too, too, too: all this accompanied sometimes with a thoughtful look, but more frequently with a smile."
Miss Frances Reynolds also took note of some of his motor tics, reporting that
"His mouth is continually opening and shutting, as if he were chewing something; he has a singular method of twirling his fingers, and twisting his hands; his vast body is in constant agitation, see-sawing backwards and forwards; his feet never a moment quiet; and his whole great person looked often as if it were going to roll itself, quite voluntarily, from his chair to the floor."
Describing a walk she had taken with him one day, Miss Reynolds notes
"I well remember that they (his gestures) were so extraordinary, that men, women and children gathered around him laughing and they nearly dispersed when he pulled out of his pocket Grotius' De Veritate Religionis, over which he see-sawed at such a violent rate as to excite the curiosity of some people at a distance to come and see what was the matter with him."
One further observation by Miss Reynolds was that,
"The manoeuvre that used the most particularly to engage the attention of the company was his stretching out his arm with a full cup of tea in his hand, in every direction, often to the great annoyance of the person who sat next to him, indeed to the imminent danger of their cloaths sometimes he would twist himself round with his face close to the back of his chair, and finish his cup of tea, breathing very hard, as if making a laborious effort to accomplish it. "
Johnson's numerous witty quotes fill whole sections of books, and he appears to never have been at a loss for words. One anecdote that Boswell recounts indicates Johnson's ability to cope with the remarks and questions of others concerning his odd behaviors in public
"I am happy, however, to mention a pleasing instance of his enduring with great gentleness to hear one of his most striking peculiarities pointed out. A very young girl, struck by his extraordinary motions said to him, "Pray Dr. Johnson, why do you make such strange gestures?" "From bad habit," he replied. "Do you, my dear, take care to guard again bad habits."
In actuality, Johnson rarely spoke of his compulsive and ticcing behaviors, but was apparently able to speak up in his own defense. When, at a dinner, he accidentally knocked a fellow guest's shoe off her foot with one of his hand movements, he responded to the laughter that inevitably followed, saying
"I know not that I have justly incurred your rebuke. The motion was involuntary, and the action not intentionally rude."
From my nearly twenty years experience as a clinician, I can only imagine what this man endured, both in public and in private. Those with OCD and Tourette's have made great strides in the last twenty years in terms of gaining public understanding and the finding of more effective treatments. It is saddening to look back on those in the past who had no choice but to painfully face life each day in the face of the overwhelming odds their seemingly mysterious symptoms presented them with. No doubt, Dr. Johnson was having one of those symptom-filled days when he came up with the quote that opened this article. It is uplifting and inspiring, however, to also look back upon what some of them were able to accomplish in spite of their problems. They serve as great examples to all who suffer. Perhaps there really are patron saints of OCD, and if so, Dr. Samuel Johnson may have been one of them. I will leave you with one last quote of Dr. Johnson's, perhaps a thought that helped him to sustain himself (and one more optimistic than the quote this article began with)
"Great works are performed not by strength, but by perseverance."
Dr. Fred Penzel is a licensed psychologist who has specialized in the treatment of OCD and related disorders since 1982. He sits on the Science Advisory Board of the Obsessive-Compulsive Foundation, and is a frequent contributor to the newsletter. He is the author of the self-help book "Obsessive-Compulsive Disorders: A Complete Guide To Getting Well And Staying Well." You can find out more about this book at www.ocdbook.com, and can contact him at:
penzel@attglobal.net
