In this series, I dig a little deeper into the meaning of psychology-related terms. This week’s term is obsessive compulsive personality disorder.
When people say that someone is “a little OCD,” chances are, what they’re referring to has little, if anything, to do with obsessive compulsive disorder. What they’re talking about is far more like obsessive compulsive personality disorder (OCPD) than OCD. Granted, most people haven’t heard of OCPD, but it’s a lot closer to the popular OCD stereotype than OCD itself is.
Symptoms of OCPD
Obsessive compulsive personality disorder involves a pattern of persistent preoccupation with order and control, as well as perfectionism. While it’s called OCPD in the DSM-5, in the World Health Organization’s International Classification of Diseases (ICD-11), it’s called anankastic personaity disorder. The symptoms include:
- preoccupied with details, rules, schedules, organization, and lists
- perfectionism to the extent that it interferes with completing tasks
- leisure activities and friends are neglected in favour of excessive work and productivity
- unwillingness to get rid of worthless objects that don’t serve a purpose
- reluctant to delegate work to others because don’t trust them to do it the right way
- avoidance of spending money out of concern for future disasters
- rigidity and stubbornness
People with OCPD also tend to be very rigid, and have difficulty adapting to change. They tend to be deferential to authority, not accept any bending of rules, and have a rigid moral code. Their inflexibility and excessive amounts of time spent on details causes inefficiency and delays getting things done.
Like any personality disorder, symptoms have already begun by early adulthood. While there may be fluctuations in intensity of different symptoms over time, the symptoms are persistent over time.
OCPD occurs in between 2-8% of the population, and it’s more likely in males. Depressive disorders or alcohol use disorders are often co-occurring with OCPD.
Obsessive compulsive personality traits vs. disorder
It’s “normal” for people to have some on these traits, to some extent, some of the time. What sets the personality disorder apart is the number of symptoms, the severity, the pattern over time, and the degree of impairment in the person’s overall functioning. If, like me, you are all about the organization and lists, but that actually makes your life easier, that’s not what the OCPD experience is. OCPD gets so caught up in the controlling and organizing that whatever the task is probably doesn’t end up getting done.
People may be diagnosed with obsessive compulsive personality traits if they have some of the traits, which are somewhat disruptive, but not enough to meet the criteria for the full disorder. OCPD falls in the DSM-5’s cluster C personality disorders, along with avoidant and dependent personality disorders.
The difference between OCD and OCPD
Obsessive thoughts in OCD are often ego dystonic, meaning they’re intrusive, unwanted thoughts that have barged into their heads and are inconsistent with who they are. Someone with contamination OCD doesn’t develop those obsessions and compulsions because they’re hyper-preoccupied with cleanliness, and there is no possible clean that could ever be decontaminated enough to satisfy the OCD.
In obsessive compulsive personality disorder, thoughts tend to be ego syntonic, so they’re consistent with what the person actually wants and believes. Someone with OCPD might want their house cleaned in exactly a certain way because that’s the only “right” way to do it. Friction can develop in social relationships because of the need for control on the part of the person with OCPD.
Treatment options for obsessive compulsive personality disorder include CBT, psychodynamic psychotherapy, and SSRI antidepressants. Treatment can be difficult, especially since part of OCPD is believing that one is doing things the “right” way. As a result, people with the disorder may not have enough insight to see the need for treatment. Psychodynamic psychotherapy might be helpful for developing more insight, but therapy is unlikely to have much success if the individual doesn’t see a need for change.
During my nursing career, I don’t think I ever worked with any clients with OCPD. I can’t think of anyone I knew socially that seemed to have it, either. But the people I’ve known that were “a little OCD” were definitely far closer to OCPD than OCD.
Is this a disorder that you were familiar with? And does it sound to you like there’s a resemblance to the way “a little OCD” gets used inappropriately?