mental health | lived experiences

Living With Obsessive Compulsive Personality Disorder (OCPD)

And its difference from OCD (Obsessive Compulsive Disorder)

Table of Contents: − Introduction − What is a Personality Disorder? − What does OCPD look like? − How is it different from OCD? − What is a comorbidity? − My personal experience

Introduction

My recent article on the developments in the classification of mental health diagnoses aimed to be the prologue into talking about my experience with Obsessive Compulsive Personality Disorder (OCPD).

A main problem with such “labels” is that sometimes they’re not accurate. Other times, they can be a huge relief. But, the misconceptions about the diagnoses can make everyday life difficult.

I have talked in the past (mainly through poems and short life stories) about my other mental health struggles, for example with eating disorders, misophonia, developmental trauma, anxiety, OCD, etc.

I hope that talking about OCPD will help those who might have it, or help others who might know someone with those personality characteristics.

I wholeheartedly believe that we should be able to talk about mental health openly, to help ourselves and others.

What is a Personality Disorder?

Generally speaking, “personality” is the sum of all the traits we are born with and they are stable throughout our life. For example, personality traits can be extroversion, introversion, perfectionism, agression, analytical thinking, and so on.

All of these traits are also influenced by the environment we grow up in (the nature-nurture connection). However, our main personality traits are part of our genes. Whether they will be expressed or not depends on our experiences from the moment we are born. Recent studies have shown that what’s going on in the womb of the person who’s pregnant is also important.

A personality disorder is the sum of personality traits that (1) make the person deviate from what is culturally expected, (2) cause distress to the person or others, and (3) are stable over time and resistant to change.

There are some main categories of personality disorders (PDs) in the diagnostic systems. They are categorized by the way they make the person look in terms of behavior and relations. Here you can look at the descriptions of all the PDs, and below you’ll find a summary of the clusters.

• Cluster A PDs are those that cause eccentric or odd behavior (again, according to cultural expectations). In this category you’ll find Paranoid PD, Schizoid PD, and Schizotypal PD.
• Cluster B PDs are those that make the person more “dramatic” or overly expressive emotionally. In this category you’ll find Antisocial PD, Borderline PD, Histrionic PD, and Narcissistic PD.
• Cluster C PDs are those that are characterized by anxiety-induced behaviors. In this category you’ll find Avoidant PD, Dependent PD, and OCPD.

There are many criticisms in the scientific community about these classifications. A main argument against them is that it mostly depends on the clinician who makes the diagnosis to decide which cluster seems more fitting depending on the patient’s behavior and thoughts (you can read more about that in the article I linked in the beginning).

Presently, there are no medications that are effective enough for PDs. The medications that are usually given, target other symptoms (peripheral symptomatology), such as the anxiety or depression that might arise because of the PD. Of course, if a person with a PD is prescribed medications they should take them because the alleviation of those peripheral symptoms can benefit them a lot.

Also, brief psychotherapy models (such as CBT) are shown to not be effective in the long run for PDs. What mostly works is holistic and in-depth psychotherapy approaches like Psychodynamic Psychotherapy and Dialectical Behavior Therapy (DBT).

What does OCPD look like?

OCPD is characterized by the following traits:

• Extremely rigid patterns of thought
• Extreme preoccupation with rules, tracking, schedules, lists, and details
• Extreme urgency to be perfect
• Extreme conscientiousness and inflexibility
• Unusually strong adherence to ethics
• Prioritizing work over relationships and relaxation
• Extreme difficulty delegating tasks to others
• Difficulty in understanding the shortcomings of others

This is not an exhaustive list. In order to be diagnosed with OCPD other criteria need to be present, such as duration (how long have those patterns been present for), and interpersonal distress (are they causing distress to the person or others?).

Research on OCPD is limited. So far it is believed (based on research findings) that OCPD is a result of genetic predisposition with a combination of attachment-related trauma in early infancy.

What makes those traits a PD is the degree to which they exist and their persistence over time. A person who wants to perform well at work and finds it useful to keep a to-do list does not necessarily have OCPD.

Note how the traits are described as “extreme”. You may also find them as “intense”. A person with OCPD has those traits to the extreme 24/7 and began exhibiting them since early childhood.

How is it different from OCD?

OCPD is often mixed up with Obsessive Compulsive Disorder (OCD).

OCD is broadly classified as an anxiety disorder. It is characterized by Obsessions (intrusive thoughts that arise from anxiety), and Compulsions (repeated behaviors that aim to soothe the anxiety of obsessions).

OCD is time consuming and exhausting. It might have components of a need for order and perfection. But a main difference with OCPD is that when a compulsion is performed in OCD, the anxiety temporarily decreases.

Also, OCD is not stable through time. A person with OCD might have increase or decrease in the intensity of their symptoms. That’s in contrast to OCPD, where the traits are stable and the actions don’t appease the anxiety.

What is a comorbidity?

Generally speaking, in Psychology we use the word “comorbidity” to denote that a person has two or more conditions existing at the same time.

For example, a person can have a diagnosis of Major Depression with comorbid Generalized Anxiety Disorder. This may mean a number of things. It could mean that those disorders appear together at once, or that the one appears while the other is in remission.

OCPD can be comorbid with OCD, or any other disorder.

My personal experience

For me, living with OCPD is not too bad. That’s how I always was, so I haven’t known any other way of existing in this world.

Sometimes, my comorbidities with the disorders I mentioned earlier in the article as well as with my general personality traits, make things difficult.

For instance, my extreme need for perfectionism has been fueling my eating disorder in many different ways. My extreme conscientiousness in combination with generalized anxiety usually leaves me exhausted. My preoccupation with rules and order can make me appear too strict, which is further exacerbated by my introversion and “permanent resting bitch face” (i.e. not showing emotions) as some people have told me.

OCPD has led me to burnout several times, because I don’t stop until what I’m working on is perfect. If there’s any (perceived) indication that what I did was not “perfect”, it might affect me for days. Now I’m much better at handling it though.

Here’s a funny incident! Several years ago, I went to my therapy appointment and I started crying the moment I sat down on the couch. After a good 2–3 minutes of solid ugly crying, I was able to inform my therapist (who was looking at me in desperation probably) that I got an A- for an undergraduate class.

Now I can laugh about it, but in that moment I felt like my heart was ripped out. I felt that I was the worst person to have ever existed on this planet, and that I was so useless and stupid. I was deeply hurt. I was devastated and even considered dropping out of college. It wasn’t a self-esteem issue. My OCPD had complete control.

It helped that my therapist didn’t make fun of me in that moment, and he didn’t try to tell me things like “it’s just a grade”.

There are times that I fear that I won’t be able to control my fierceness if I’m given power. I’m a deeply empathetic person, and that makes it worse. Of course my hesitation with having power or being cruel once I have it stems from attachment issues and trauma in childhood. And, since I don’t want to be cruel to others I’m being cruel to myself.

The combination of these factors with my genetic predisposition gave rise to my OCPD. My older sister, for instance, has been through worse physical trauma as a child (from our mother) but she didn’t develop OCPD. She has other issues of her own but probably she didn’t have the genetic component for OCPD.

Personal therapy has helped me a lot. Also, working as a therapist and having the appropriate knowledge helps keep me on track. In older stories I have said that if I had only one wish, this would be to delete eating disorders from my brain.

Honestly, I can live with OCPD and I’m managing it to the best of my ability. I can also manage my anxiety and everything else. But, for me, OCPD is nothing compared to the mental anguish of eating disorders. Perhaps if I didn’t have OCPD my Eating Disorders would be more manageable. Unfortunately, I’ll never know.

To conclude, I’d like to point out an amazing comment by Annie Trevaskis in my article about the diagnostic systems. She said:

In my head, when I read ASD I don’t think Autism Spectrum Disorder, I think: Autism Spectrum Dynamic. I don’t like the word disorder!

I don’t like the word “disorder” either. I replied to Annie, telling her that I think of my OCPD as a personality difference. Since reading Annie’s comment, I incorporated “dynamic” into my definition.

So now, for me, a PD is a personality dynamic difference!

Thank you for reading!