Simone Hoermann, Ph.D., is a Psychologist in private practice in New York City. She specializes in providing psychotherapy for Personality Disorders, Anxiety, and Depression
Last week, I wrote about Obsessive-Compulsive Disorder. There is a close relative of Obsessive Compulsive Disorder amongst the Personality Disorders, namely, as you may have guessed by now, Obsessive Compulsive Personality Disorder (OCPD). So, what is OCPD and how does it relate to OCD?
People with OCPD are perfectionists to the extreme. Now, a lot of people have perfectionist tendencies that may occasionally get in their way, but for someone with OCPD, perfectionism really interferes with completing important tasks. Things have to be just so, and just right. Therefore, instead of delegating tasks to other people, someone with OCPD will often end up doing everything themselves, because they feel that others just won’t do things correctly.
Perfectionism alone, however, is not enough to indicate that someone has OCPD. People with OCPD tend to be very thorough and detail oriented, so much so that they sometimes don’t see the forest for the trees and get lost in those details. Another characteristic of OCPD is difficulty in throwing out worthless or useless things, and a miserly spending style. Someone with OCPD tends to be preoccupied with rules, regulations, order and schedules, and so they get caught up in details, and can get quite stuck on questions of morals and ethics. Hence, they are very rigid and inflexible. They are often scrupulous and overly conscientious, feeling way too responsible for anything that may go wrong. Not surprisingly, they can be so devoted to their job and spend so much time at work, that they neglect their friendships and relationships.
According to the Diagnostic and Statistical Manual of Mental Disorders, if a person has four of the above characteristics to a degree that it interferes with their lives, they meet the criteria for OCPD. Research on prevalence of OCPD shows that roughly 1% of people in the general population can be diagnosed with OCPD.
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The basic idea in terms of a distinction between OCD and OCPD is that typically a person with OCD will feel that the obsessions and compulsions are symptoms that are unreasonable and bothersome. In contrast, OCPD is about longstanding personality characteristics, which the person with OCPD themselves does not experience as unreasonable.
Of note, I say this is a rough distinction, because there has been much debate about the relation between OCD and OCPD. Some experts believe that OCPD might be a precursor, or less severe form, of OCD, although research results on this topic remain mixed. Similarly, research findings on the prevalence of OCPD in people who have OCD shows a very wide range in different studies, from as low as 3% up to 60%.
As an aside, Sigmund Freud, the father of psychoanalysis, wrote about OCPD already in the early 1900s and referred to it as “anal retentive” character, defined by a preoccupation with orderliness and cleanliness, and a tendency to be frugal, defiant and angy. His idea was that children go through different developmental stages, and a conflict during the stage of toilet training, when children are supposed to learn to control bodily functions, results in the development of the anal personality. Freud’s theory about where OCPD comes from is nowadays controversial, and many experts would disagree with it. However, you can see remnants of his idea in today’s colloquial use of the word “anal’ for people who are overly thorough and uptight.
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