Obsessive Compulsive Personality Disorder

Obsessive Compulsive Personality Disorder (OCPD) is a condition in which a person is preoccupied with rules, orderliness, and control.

It is a pervasive disturbance involving one's generalized style and beliefs in the way one relates to themselves and the world. Persons with OCPD are typically deeply entrenched in their dysfunctional beliefs and genuinely see their way of functioning as the "correct" way.

Their overall style of relating to the world around them is processed through their own strict standards. While generally their daily experience is such that "all is not well," they tend to be deeply committed to their own beliefs and patterns. The depth of ones belief that "my way is the correct way" makes them resistant to accepting the premise that it is in their best interest to let go of "truth owning."

Inevitably, OCPDs are perfectionists and rigidly orderly or organized. They lack flexibility, openness and efficiency.

It is easy to spot an Obsessive-Compulsive. They are constantly drawing up and dreaming up lists, rules, orders, rituals, and organizational schemes.  They demand from themselves and from others perfection. Actually, they place greater value on compiling and following rigid schedules and checklists than on the activity itself or its goals.

They are so excessively conscientious and scrupulous and so unempathically and inflexibly tyrannical that it is difficult to maintain a long-term relationship with them. They regard their impossibly high moral, work, and ethical standards as universal and binding. Hence, their inability to delegate tasks to others, unless they can micromanage the situation and control it, minutely to fit their expectations. Consequently, they trust no one and are difficult to deal with and stubborn.

People who suffer from the separate and unrelated condition obsessive compulsive personality disorder are not aware of anything abnormal with them; they will readily explain why their actions are rational, and it is usually impossible to convince them otherwise.

COMORBIDITY:
Obsessive-Compulsive Personality Disorder (OCPD) is often confused with Obsessive-Compulsive Disorder (OCD) though there are some overlapping symptoms that exist in both.

OCD is an anxiety disorder. OCD is characterized by bizarre and obsessive rituals, where an individual repeats an abnormal behavior over and over again. A common type of obsession is hand washing. The individual becomes so afraid of germs that he or she will run to wash his or her hands immediately upon touching something, and will wash for several minutes.

OCPD is not nearly as severe, and does not involve these strange rituals.

DIAGNOSIS:
Many people with this disorder are not seen as psychologically disturbed in any way. In our society, it is normal and even encouraged to be successful, and these people often are. However, this is not a healthy attitude towards life. Some of these people (after continuing this type of behavior for years) may end up with heart attacks or ulcers from stress they refused to admit they were under.

CAUSES:
1. This disorder tends to occur in families, so genes may be involved.  Very often, people who develop the disorder by adulthood have had parents who are rigid, overbearing, and faultfinding. The parents put pressure on these children to get control of themselves and to behave like little adults (or even like good little robots) rather than as independent, individual human beings. In order to be good and to gain their parents approval, the vulnerable children became trapped in an internal struggle to get control of the own "bad" or "dangerous" impulses, desires, and feelings. They develop into adults who are inwardly, perhaps unconsciously, angry, and outwardly very driven to achieve respect and approval.

2. Cultural influences may, however, play a part in the development of OCPD. That is, cultures that are highly authoritarian and rule-bound may encourage child-rearing practices that contribute to the development of OCPD.

3. Complex interplay of early life experience.

SYMPTOMS:
Some of the common signs of person with Obsessive-Compulsive Personality Disorder include:

1. Preoccupied with details, rules, lists, order, organization, or schedules.

2. Shows perfectionism that interferes with task completion (e.g., is unable to complete a project because his or her overly strict standards are not met).

3. Is excessively devoted to work and productivity to the exclusion of leisure activities and friendships.

4. Is over conscientious, scrupulous, and inflexible about matters of morality, ethics, or values.

5. Is unable to discard worn-out or worthless objects even when they have no sentimental value.

6. Is reluctant to delegate tasks or to work with others unless they submit to exactly his or her way of doing things.

7. Adopts a miserly spending style toward both self and others; money is viewed as something to be hoarded for future catastrophes.

8. Shows rigidity and stubbornness.

9. Jealousy.

10. Intrusion of insistent and unwelcome thoughts or impulses.

11. Attention seeking.

12. Restricted expression of affection.

13. Emotional distance, even from family members.

14. Feelings of excessive doubt and caution.

TREATMENT:
Treatment of OCPD patients addresses an issue of control. Before undergoing any treatment such individuals need to develop tolerance for:

1. Their own emotional vulnerability.

2. The presence of chance, uncertainty, and impermanence in their lives.

Treatment for OCPD normally involves:
1. Psychotherapy :
Psychotherapeutic approaches to the treatment of OCPD have found insight-oriented psychodynamic techniques to be helpful for many patients. Learning to find satisfaction in life through close relationships and recreational outlets, instead of only through work-related activities, can greatly enrich the OCPD patient's quality of life. Specific training in relaxation techniques may help patients diagnosed with OCPD.
It is difficult, however, for a psychotherapist to develop a therapeutic alliance with a person with OCPD. The patient comes into therapy with a powerful need to control the situation and the therapist; a reluctance to trust others; and a tendency to doubt or question almost everything about the therapy situation.

The therapist must be alert to the patient's defenses against genuine change and work to gain a level of commitment to the therapeutic process. Without this commitment, the therapist may be fooled into thinking that therapy has been successful when, in fact, the patient is simply being superficially compliant.

2. Medication:
In particular, the medications known as selective serotonin reuptake inhibitors (SSRIs) appear to help the OCPD patient with his or her rigidity and compulsiveness, even when the patient did not show signs of pre-existing depression. Medication can also help the patient to think more clearly and make decisions better and faster without being so distracted by minor details. While symptom control may not cure the underlying personality disorder, medication does enable some OCPD patients to function with less distress.

3. Cognitive Behavior Therapy (CBT):
CBT is based on the idea that cognitive errors based on long-standing beliefs influence the meaning attached to interpersonal events. In this therapy the patient is led away from describing situations, events, happenings and talking about how such situations, events and happenings made them feel. This approach entails describing the present condition and state of mind of the patient. This therapy focuses on coping skills learning how to take better control of behaviors and emotions with techniques such as mindfulness, which helps the patient in observing their feelings without reacting.  This type of CBT along with talk therapy can be very effective than either treatment alone.

DEMOGRAPHICS:
Obsessive–Compulsive Personality Disorder occurs in about 1% of the general population.

It is seen in 3%-10% of psychiatric outpatients.

It is twice as common in males as females.

OUTLOOK:
The outlook for people with Obsessive-Compulsive Personality Disorder tends to be better than that for other personality disorders. This may be because the self-imposed rigidness and control of obsessive-compulsive personality disorder may prevent many of the complications such as drug abuse, which are common in the other personality disorders. However, the social isolation common with this illness may lead to feelings of depression later in life.

If you think you or your dear ones are affected by this serious and disabling personality disorder it is highly recommended that you seek professional help from a licensed mental health care provider to determine a proper treatment plan.

With the proper treatment it may be possible to return to a somewhat normal semblance of life that will allow routine function in daily activities without serious complications.

Author’s Brief Bio- Latika Bhojwani, is a Post Graduate in Management with Major Specialization in Marketing and Minor in Finance, presently joined Family Business, also practicing as a Reiki Healer and Tarot Card Reader. Her favorite pastime activities include Crystal Healing/Readings, Hypnosis, Reading, Travelling, Exploring Gadgets.
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