Personality Disorders 102: Obsessive-Compulsive PD

Today’s post is number 10 in the Personality Disorders series, and the final disorder on the list is Obsessive-Compulsive Personality Disorder (OCPD).Now, before I go into this, the first thing that should be explained is the difference between OCPD and Obsessive- Compulsive Disorder (OCD).

The major difference between the two is their focus. For a person with OCD, obsessions and compulsions are entirely theirs. The person knows their obsessions/fears are irrational but feels forced to listen to them otherwise something bad will happen- either just to them, or to others as well. Therefore, their compulsions happen to prevent those bad things happening and to calm their anxiety about those consequences.

To go with a fairly stereotypical example, consider a person with OCD and an obsession/compulsion based on locking doors. The person may need to spend an hour checking that every door in their house is locked before leaving, but they will not think any differently of their partner for being able to go out after only checking once. Indeed, they may be envious of their partner for not having to worry in the same way.

Someone with OCPD would not consider their rules and beliefs as irrational and individual. Instead, they would see their way as the right way,  regardless of its complexity, rigidity or time consumption. For example, they may have specific rules to make sure everything in their house is in exactly the right place, and will apply those rules to whoever they live with, not allowing the other person to deviate from these rules. If their partner or housemate tried to do things differently, this would be seen as a functional or even moral failing.

The DSM-IV describes OCPD as : a pervasive pattern of preoccupation with orderliness, perfectionism, and mental and interpersonal control, at the expense of flexibility, openness, and efficiency, beginning by early adulthood and present in a variety of contexts, as indicated by four (or more) of the following:

  •  is preoccupied with details, rules, lists, order, organization, or schedules to the extent that the major point of the activity is lost
  • shows perfectionism that interferes with task completion (e.g., is unable to complete a project because his or her own overly strict standards are not met)
  • is excessively devoted to work and productivity to the exclusion of leisure activities and friendships (not accounted for by obvious economic necessity)
  • is overconscientious, scrupulous, and inflexible about matters of morality, ethics, or values (not accounted for by cultural or religious identification)
  • is unable to discard worn-out or worthless objects even when they have no sentimental value
  • is reluctant to delegate tasks or to work with others unless they submit to exactly his or her way of doing things
  • adopts a miserly spending style toward both self and others; money is viewed as something to be hoarded for future catastrophes
  • shows rigidity and stubbornness

OCPD is rarely deliberately written into a character. Generally, OCD is used to describe characters, even if their actions or personality better fit the controlling nature of OCPD rather than the anxious nature of OCD. An example of this is Sheldon Cooper from The Big Bang Theory. Sheldon is seen to have a very rigid structure in his life, and an inability to do anything which goes against this structure. For example, he throws away an untouched breakfast made for him because it was made on the wrong day of the week. He also applies this structure to his friends, especially to his room-mate Leonard, who has to sign and obey a large and incredibly specific “room-mate agreement” in order to stay with him.  He is not written as having OCPD (in fact, there is widespread internet debate as to what he could be diagnosed with), but he is a good demonstration of how someone with OCPD can be in life, and how they can impact their friends and family.

The lifetime prevalence of OCPD is estimated to be about 7.8% (meaning 7.8% of people will have it at some point during their life, but they won’t always have it once they’ve been diagnosed). As you would probably expect, it is correlated with having OCD- one study found 27% of people with OCD they interviewed also had OCPD.

The most-used treatment method for OCPD is typically long term counselling. CBT is often preferred, with the aim of getting the person to understand why they fear change and imperfection, and to help them deal with the fact that other people can not be expected to conform to the rules that the OCPD person needs to rigidly enforce.

Psychological Criticisms of OCPD

OCPD is another disorder where the main dysfunction is other-focused. It is usually identified only when it becomes a problem to others, rather than being something the person with it considers a problem. In that regard, a person with OCPD can rarely be said to be suffering from it. In cases like that, it is very hard to draw the line between something that is just uncommon or odd, or a disorder … in some schools of thought, the “line” wouldn’t even exist. It is conditions like OCPD that stretch the abilities and the control of the DSM and its school of thought most, and raise the most questions about the world of psychiatric diagnoses.

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