“Well…it’s one voice, really. And sometimes it’s more of a feeling than a voice. But sometimes I feel like I can actually hear it, you know, speaking. Telling me that I have to do things again even though I’ve already done them. Or that I have to do things a certain number of times or in a certain way.”

“And if you don’t?” Oliver prompts, his voice quiet. I can see the look on his face. He’s shocked at what this conversation is uncovering, probably more so than I am. I’m pretty sure just staying here at this table, he’s having to override all his instincts to just get up and leave. He doesn’t like going to dark places.

In other words, he’s trying.

Sam looks at us.

“Well…the voice says bad things will happen if I don’t do things just right. I don’t even know what bad things. I just know they’ll be bad…really bad.”

He looks at me, his face full of doubt. Is he waiting for us to backtrack; to agree that after all, there’s something really wrong with him, something unfixable that we don’t want to be part of?

“Sam…” I say. “We’re not doctors so we really don’t know. But it sounds like you might have a similar condition to one that a lot of other people have. A lot of people say they hear a kind of ‘voice’ that makes them jump through hoops like that, so that bad things won’t happen.”

It’s actually pretty much an exact reflection of what most of those websites were saying. These little rituals, they’re not just personality quirks, and they’re much more than regular perfectionism. What makes them so bad is that they come alongside this anxiety or dread that Sam’s describing. Performing the rituals is what gives the person relief from the dread—but it’s only temporary, of course. The dread comes back, and the cycle keeps going.

Sam looks at me, skeptical.

“What other people? You mean crazy people.”

I sigh.

“Sam, honey…” I try to tread carefully. “‘Crazy’ doesn’t actually mean anything, you know. It’s just a word. A mean word, that people tend to use for things that scare them. I’m going to let you in on a secret,” I say. “We all hear voices. Everybody on this planet. Okay? It’s just, the voice you’re hearing is louder and more unhelpful than most.”

Sam looks at me, narrows his eyes.

“So you hear voices?” His voice is skeptical. “You’re telling me…” I see him casting around for someone even more unlikely. “That—that the President hears voices?”

“Sam,” I say. “I guarantee you the President hears voices.”

He raises his eyebrows at me.

“Well, what about a conscience?” I say. “Isn’t that a voice?”

Sam looks irritable.