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Tuesday, April 27, 2010

Treatment Tuesday: OCD v. OCPD

This week's assessment is from Karissa. She wrote in wanting to know the difference between obsessive-compulsive personality disorder and obsessive-compulsive disorder (OCD).

How happy I am to oblige! I did a post not too long ago about Obsessive-Compulsive Personality Disorder (OCPD) here, so I won't go into that again. But the analogy I used on that post was that 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 OCD are trapped in a pattern of endless thoughts and behaviors that really don't make a lot of sense and can't be stopped. The obsessive thought drives the compulsive action in a vicious cycle.

Obsessions have 4 criteria that all have to be present:

1) Thoughts, impulses, or images that are experienced as intrusive and inappropriate. They usually case marked anxiety or distress.

2) The thoughts are not simply excessive worries about real-life problems (like checking the doorknob and windows locks in a run-down neighborhood where break-ins are common).

3) The person attempts to ignore/suppress these thoughts or neutralize them with some other thought or action (the compulsion part of the equation).

4) The person recognizes that the obsessive thoughts are a product of their own mind.

Compulsions have 2 criteria:

1) Repetitive behaviors (like hand washing, ordering, checking) or mental acts (like praying, counting, repeating words silently) that the person feelings driven to perform in response to an obsession (see above) or to be in accordance with some rigid set of rules they have in their life.

2) The behaviors or mental acts are aimed at preventing or reducing distress (like preventing some dreadful event---like a break-in), but they aren't connected in a realistic way or are clearly excessive.

So a person with OCD has to fit the above picture, but they also have to realize at some point that the obsessions and compulsions are excessive or unreasonable and they do the following:

1) cause marked distress

2) be time consuming (like more than 1 hour a day)

3) significantly interfere with the person's normal routine (occupation or academic fuctioning, as well as social activities or relationships

People with OCD don't want to be OCD. They don't relish it. Their mind is a mind that just won't quit. They have no peace, no calm. That's what it's an anxiety disorder.

So while people with OCPD might share similar characteristics with OCD sufferers, the biggest difference might be that people with the personality disorder aren't in as much mental anguish. Some might even enjoy being the way they are...perfectionistic, conscientious, detailed, devoted, overly productive.

Hopefully this clears it up. I'm glad Karissa asked, because I meant to clarify this more after that personality disorder post and forgot! So thanks for the reminder.

Q4U: Any OCD or OCPD people in your books? How do you/could you find a balance between showing the obsessions and the compulsions within the written page?

Wordle: signature


Talli Roland said...

Interesting! Thanks, Jeannie.

Jeannie Campbell, LMFT said...

you're welcome, talli. the two disorders truly are fascinating to compare.

Anonymous said...

really informational:) I have ocd also and it is just like a continous pattern to were my mind will focus on one thing (always has to be something)and I cant stop obsessing about it to the point to were I have trouble sleeping at night or where I'll dream about it. i'm also having a really hard time with it know because i'm 15 growing up and learning that everythings not as perfect like when I was five.
I found a prescription though called "zoloft" and I just started taking that after they finally took me off "respirdal" 12 pounds later cause I used to hear voices or obsess about what people said about me in the past which is so stupid to me know and I still heard voices even though I didn't want to. Part of them was from my dad,mom, n school. My parents are going through a 5 year divorce still. I had a really tough time going to a new private middle school were I knew nobody. My mom started drinking (depression) and would constantly fight with me when I came home slapped , pushed, hair pulled n lifted off ground by hair, n broke my stuff n my room n kept threatening for me to live with my dad. She also would get jealous of me having friends so I stopped inviting and playing with them. But I still live with her we get along now although sometimes i feel it wuz bipolar but I still cant forgive her I feel like its a spot in my heart I will never forget.I also stopped doing some of the chores i used to for her n buying stuff. I also have problems trusting anybody especially family and guys that remind or look like my dad I have a problem with since middle school which their were two and I secretly didnt like them. My dad also has told me she wuz bipolar but he's also borderline, a hoarder,a perv. and likes to make and see other people miserable because he is, probably called a narcasist to.
2 months ago my mom n me got n a fight and she slapped me n it was 2 much so I just pushed her back n she called the cops. The police officer was a woman and a bitch to me everybody believes my mom because she acts innocent and like I beat her somehow. So she ended up taking me barefooted n shoved me alot. I know lifes not fair but I hope itll get better and i can move out soon (3 years) n it feels like forever.
Oh and I just saw my sister after seven years also and she also said she had nightmares of my dad even three years after she moved out and he used to call her part black because she was tan and ugly which he also tried to call me but I don't have visitations with him anymore.
So im slowly getting a little better seeing help and hopefully get happier again. Everybody has their own story or skeleton in the closet. ;)

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