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Thursday, December 17, 2009

T3 - Obsessive-Compulsive Personality Disorder

For our last installment in the Personality Disorder series, I've picked one of my favorites. OCPD shares many features of OCD (Obsessive-Compulsive Disorder), but it's deeper, heavier. For example, if neurosis was water and a person was a sponge, a person with OCPD would be completely saturated while a person with OCD would just be wet.

People with OCPD are preoccupied with three things: 1) orderliness, 2) perfectionism, and 3) mental/interpersonal control. They obsess over these things at the expense of flexibility and efficiency. In other words, they get so tied down to washing the deck that they never set sail. In layman's terms, this person is "anal," or "Type A."

There are 8 diagnostic criteria for this disorder, and a person only has to have 4 of them to qualify. So let's get started.

1) They attempt to maintain a sense of control through painstaking attention to rules, trivial details, procedures, lists, schedules or form to the extent that the point of the major activity is lost. They can be repetitive and repeatedly check for mistakes, completely oblivious to how they are holding everyone up in the ATM line behind them. They often don't allocate their time well, and the self-imposed high standards of performance cause significant distress in these people.

2) They may become so involved in making every detail of a project perfect that they often don't finish the project. An OCPD novelist would just never make it. They'd always want to go back and re-write scenes over and over, to the point that they never finish a book. While they are obsessing over one area in their life like this, the other areas most definitely suffer.

3) They display excessive devotion to work and productivity, to the exclusion of friends and leisure activities. And this isn't because they can't pay their rent and need the money. They may put off vacations for years, and when they do take one, they might be extremely uncomfortable unless they took something along to work on. Often, household chores are concentrated on, like excessive cleaning and squeaky clean floors. If they do spend time with friends, likely it's in group activities (i.e. sports). Hobbies and recreational activities are approached just as seriously as work. The emphasis is on performance. They also turn play into a structured (and sometimes unhealthy) forcing an infant to put the graduated rings on the post in the right order.

4) They may be excessively conscientious, scrupulous and inflexible about matters of morality, ethics or values. Many insist on complete and literal rule compliance, with absolutely no "rule bending" for any reason. They may rigidly defer to any authority figure. This is the "no exceptions" person.

5) They may be unable to discard worn-out or worthless objects, even when they have no sentimental value. This is your pack rat. They don't want to throw anything away because it might be wasteful, or worse, they think they might need it later.

6) They are reluctant to delegate tasks or to work with others. Their belief is that no one can do it as right as they can. They often give very detailed instructions on how things should be done if they are forced to work with people (i.e., like there's only one way to wash dishes or fold towels). They will be surprised or irritated if someone were to challenge them or suggest an alternative way. They might even reject offers of help when they are behind, preferring to do it themselves to make sure it's done right.

7) They may be miserly and stingy, maintaining a standard of living well below what they can afford, because they want to control their spending to provide for future catastrophes. While this might not sound bad--everyone should save up money, right?--these people take it to the extreme.

8) They may be rigid and stubborn. They might plan ahead in meticulous detail and be unwilling to consider any changes. They may not go along with anyone else's ideas because things have to be done their way. They might even be able to realize that compromise might be in their best interest (as far as getting along with others), but they may simply refuse "out of principal."

For fun, I'll give you an example of an OCPD in action, to show you how extreme this disorder can be. Say a guy with OCPD picks up a date at her house even though he thinks he should be at the office finishing that proposal. When they get to the car, she opens her door and gets in, and he's irritated because clearly, the man is supposed to open the door for the female. It's an unspoken rule. Once inside the car, maybe he notices that she smells faintly of cigarettes. His first thought is that she's underaged and he might should call the cops. Then he wonders at the tar coating her lungs and whether the smell will infiltrate is newly-cleaned upholstery.

Once inside the restaurant, they are seated and given a few seconds to look over the menu. He notices a speck of dried food on his and begins to pick at it. After a few minutes, the waitress comes back for their orders, but he's forgotten to actually look at the menu while he's been picking at the food. He noticed several more water spots on his silverware by then, too, and took his napkin to buff them off. He orders his food, and when it comes out, it's not as he asked. The salad dressing isn't on the side, the bread clearly is sourdough, not French, and his steak is medium rare, not medium. The waitress only comes back once to ask if they needed refills, and at the time, he didn't. But when he does, he never sees her. He flecks off the chives on his bake potato that he'd asked to be left off, and he lines them up along the perimeter of his plate.

Instead of getting angry at the poor service, he mulls over how much of a tip to leave. He misses just about everything his date said while he figures this amount up in his mind. Then he goes through his list of credit cards, determining which he needs to utilize. Back in the car, he persists in going 55 miles an hour even though they are running a tad late and will likely miss the beginning of the movie if he doesn't step on it a tad. At the theater, he insists on tearing his own ticket stub, because clearly the attendant on duty will rip it too fast and cause it to tear unevenly. He disdainfully picks the only row that doesn't have leftover trash in it, irritated at how people can't follow instructions to throw trash in properly marked receptacles. During the movie, a person's phone goes off and he nearly gets up to report it to the theater officials.

Do you get an idea of the neurosis this individual has? I mean, WAY over the top.

This disorder is diagnosed about twice as often in males as it is in females and it's only found in about 1% of the general population. However, around 3-10% of inpatient individuals have this personality disorder. It's important to realize that some OCPD traits--in moderation--might be adaptive, especially in situations where high performance is rewarded. The traits have to be inflexible, maladaptive, persisting and causing significant functional impairment for them to constitute OCPD. In my above example, the guy would have to be aware of how he puts off his date and everyone else, and not really sure what to do to stop it. I'm trying to say that they don't enjoy their lives this way.

Q4U: Now for truth-telling time. Anyone out there have even one or two of these symptoms? I know I do (like the ticket stub tearing thing...I didn't just make that up). :) Want to share your Type A neurosis?

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Eileen Astels Watson said...

You know what, this is actually one I WISH I had at least a little of in regard to keeping my house clean, but sadly, I'm way too relaxed about it.

I think I might actually be jealous of those who do possess this, they don't hide from the door bell when it rings I'm sure! LOL Seriously, I need to spend some time with God on the jealousy issue.

Jessica Nelson said...

Hmmm, I'm not sure I do. I like to clean, but I figured out that it's because I'm a SAHM and goal-oriented. (not detail though, lol) I'm not sure I have any of these, but guess who does? MY HUBBY!!! LOL When I met him, his closet was color-coded. I think he's loosening up as he gets older. Also, he has a good sense of humor, so that helps buffer some of his more anal traits. LOL

Lynnette Labelle said...

Love it. Love it. Love it. Thanks for this great post.

Lynnette Labelle

Katie Ganshert said...

Jeannie - email me, or call me, or somethin! I'm dying to hear about this CFOM columnist deal. You are on a ROLL, sister! was your reunion with Alan? Very smoochy?

Andrew Rosenberg said...

I got a couple of those. Some of those seem contradictory.
I don't know if OCD and novelling go together. There's a certain amount of relaxation that goes with it. An OCD person would be better off writing manuals ;)

Jeannie Campbell, LMFT said...

very good point, Iapetus. i'm of the opinion that everyone has a few traits of some disorder. that doesn't mean you qualify for the diagnosis, but it's on a continuum of sorts. i've definitely got some of these myself. :)

Jill Kemerer said...

This is so interesting. Thanks for clarifying the difference between this and OCD. Very helpful!

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Both comments and questions are welcome. I hope you enjoyed your time on the couch today.