If you’ve never heard of obsessive compulsive personality disorder (OCPD), you’re not alone. Most people are much more familiar with a similarly named mental health disorder known as obsessive compulsive disorder, commonly referred to as OCD. With such similar names, you might think that they are essentially the same condition. In fact, OCD and OCPD are very different.
Obsessive compulsive disorder (OCD) is a common anxiety disorder characterized by the presence of obsessions (repetitive, upsetting, and irrational thoughts or ideas) or compulsions (irrational behaviors performed repeatedly).
Obsessions and compulsions may both be present or may occur separately. The obsessions create a great deal of anxiety and the person will often resort to extreme actions (compulsions) to alleviate or avoid the thoughts. The lifetime prevalence of OCD is about 2.3%.
Obsessive compulsive personality disorder (OCPD) belongs to a group of disorders known as personality disorders and is not characterized by avoidance behaviors. Personality disorders are deeply ingrained patterns of thinking and behaving that deviate markedly from what is considered generally accepted behavior.
These disorders usually emerge during late adolescence and create long-term difficulties in interpersonal relationships and functioning across the board. The type of personality disorder a person may have depends on the associated thought and behavior patterns.
What Is Obsessive Compulsive Personality Disorder?
Obsessive compulsive personality disorder (OCPD) is a disorder characterized by a tendency toward extreme perfectionism and order. People with OCPD are very rigid in their thinking. They believe that their way is “the right way” and that everyone else is “wrong.”
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They have no sense that their ways of thinking and behaving are flawed and in fact, have an intense need to impose their standards on others. As a result, they tend to struggle with relationships and are often socially isolated.
Estimates are that OCPD occurs in about 2-7% of the population, making it one of the most prevalent personality disorders. It is diagnosed twice as often in men as in women.
What causes OCPD is not well understood. There is evidence to suggest that genetics plays a role in who may be predisposed to developing the condition. But genetics alone doesn’t seem to explain it all. Other research suggests that while someone may be genetically predisposed, environmental factors or certain life experiences seem to act as triggers for the development of OCPD.
Factors such as childhood trauma or overly involved or over-protective parenting styles have been linked to OCPD but the dynamics remain unclear.
What Does OCPD Look Like?
OCPD, unlike OCD, does not present with patterns of obsessions and compulsions. In fact, people with OCPD experience their thoughts and behavior as rational, practical, and intentional. Their symptoms tend to be stable across time.
According to the DSM-5, OCPD is characterized by a pervasive preoccupation with orderliness, perfectionism, and mental and interpersonal control. Symptoms generally emerge by early adulthood and are present in all areas of the person’s life. Additional symptoms can include:
- Rigidity and stubbornness
- Excessive fixation with lists, rules, order, or minor details to the extent that the major point of the activity is lost
- Perfectionism that interferes with task completion
- Excessive devotion to work and productivity to the exclusion of leisure activities and friendships (not due to economic needs)
- Rigid following of moral and ethical codes
- Hoarding behaviors
- Reluctance to delegate tasks or work with others unless things are done their way
- Reluctance to spend money and a belief that money should be hoarded for emergencies
People with OCPD often have difficulty expressing feelings and may be uncomfortable with others expressing emotion. They tend to struggle in relationships and with work and become easily frustrated when things are not as they think they should be. They may not realize how their actions and expectations negatively affect others.
Of course, one can have some of these symptoms but not meet the criteria for the diagnosis of OCPD. Personality disorders are diagnosed by a mental health professional using established criteria that consider both clinical presentation and level of functioning across the board.
How Is OCPD Treated?
If you or a loved one receive a diagnosis of OCPD, help is available. The first step is recognizing the problem.
People with personality disorders often see their actions as simply a way of life and don’t immediately recognize their behaviors as problematic. The same is true for people with OCPD. They are often not concerned by their behaviors and may even find some benefit to them. It’s often a family member who will encourage them to get help.
While there is no therapeutic “cure” for OCPD, there is treatment available. A specific form of therapy known as Cognitive Behavioral Therapy (CBT) has shown to be helpful for people with OCPD.
CBT addresses the person’s unhelpful thoughts and behaviors that impact functioning. CBT has been shown to reduce symptoms and improve functional levels.
Medication is also sometimes used to help alleviate symptoms. A class of medications known as SSRI’s (Selective Serotonin Reuptake Inhibitors) seems to help reduce the severity of some symptoms.
Treatment can help lead the person living with OCPD learn better ways of managing their symptoms and develop a greater insight into how their symptoms affect others.
The key is to start. When someone is motivated to change, there is help and hope for a healthy outcome.