When it comes to personality disorders, many think of challenging conditions, such as narcissism and borderline personality. Many do not know that there are 3 clusters and ten personality disorders in the DSM 5, and the most common personality disorder is obsessive-compulsive personality disorder (OCPD). An obsessive-compulsive personality disorder affects between 2-7% of the population and is more common in men, according to personality disorder specialist Gregory W. Lester, Ph.D. Like many diagnoses, comorbidities such as depression and substance use disorder are common.
A need for control and orderliness characterizes obsessive-compulsive personality disorder. It typically involves a grandiose sense of rigidity with a significant flexibility deficiency. This degree of perfectionism can cause those experiencing it to appear controlling, overly conscientious, cold, unemotional, and stubborn; it can interfere with daily life due to its effects on social relationships. Observable symptoms in those who have OCPD include:
- Restricted emotion and affect
- Inflexibility concerning morals, values, ethics, and rules
- Obsessive creation of lists and tasks
- Difficulty empathizing with others
- Struggle to maintain intimate relationships
- Struggle with the delegation of tasks
DSM- V Diagnosis
To meet the diagnosis of obsessive-compulsive personality disorder, a mental health professional must assess for persistent perfectionism present in early adulthood and a need for control of self and others as demonstrated by at least 4 of the following patterns:
- Preoccupation with rules
- Obsession with the execution of task completion (ultimately stopping the task from being completed)
- Excessive devotion to productivity and work at the cost of family and friends, not for financial reasons
- Inflexibility regarding ethics, values, and moral issues
- Hoarding
- Inability to delegate or work unless others agree to complete it “their way.”
- Rigidity and stubbornness
Obsessive-compulsive personality disorder can resemble many of the symptoms of obsessive-compulsive disorder. Still, it is essential to note that they are not the same or related. Those experiencing OCPD differ from those who experience OCD, with a few significant differences. Obsessive-compulsive disorder is caused by an anxiety disorder that causes unwanted intrusive thoughts that cause a person to exhibit the behavior; those with OCD often feel shame, embarrassment, and guilt over this behavior and demonstrate self-awareness around its impact. Conversely, those with obsessive-compulsive personality disorder fall under the personality disorder criteria and believe their way of doing things is “the right way.” They lack the social awareness to understand other perspectives and often become agitated by the idea that others think differently from them. Behaviors in OCD can affect every aspect of a person’s daily life, as a ritual may not allow them to move on, whereas OCPD predominantly affects interpersonal relationships. In OCD, behaviors can sometimes change and even subside, whereas those with OCPD exhibit persistent behavior across their lifespan.
Treatment
Therapy is a leading form of treatment for those who are struggling with OCPD. Mental health professionals utilize evidence-based practices such as Cognitive Behavioral Therapy and Dialectical Behavior Therapy to help soften and stretch the rigidity in behaviors and unhelpful thinking behind them. It is important to note that, like all personality disorders, medication is not used to treat the condition itself but rather symptoms such as depression and anxiety.
TIPS for loved ones
If someone you care about meets the criteria for OCPD, here are some tips for effective communication to help you both support them and your feelings:
- Be clear and concise about your boundaries around their way versus your way
- Practice Self-care
- Utilize “I statements” when expressing how their behavior is affecting you
- Utilize the SET technique when talking about their rigidity
- Support – accept their emotion, recognize that they are feeling uncomfortable
- Empathy – explain that it can be challenging to accept this information
- Truth – use connections and observations to explain that while the two above are true, their behavior isn’t working
