OCD versus OCPD
Obsessive-Compulsive Personality Disorder
I, for one, feel uncomfortable walking anywhere, except sometimes on the beach, without slippers. Or shoes. Or sandals. You know what I mean. And I really like socks on the inside of these foot coverings, too. If at all possible.
Does that make me O-C?
When I posted on bi-polar disorder I told you that none of the disorders are romantic. You don't WANT these disorders. No matter what you see on television or in the movies, having a real diagnosable mental disorder is a serious drag.
No question we like our symptoms, and many of you may even claim you're "married" to a symptom, say, depression. But what you really mean is that you like that nice little lull you get when your attention focuses inward and your body says, Stop. Oh why on earth would you want to treat that? (I can think of a few reasons, actually)
ALL of us have suffered from the symptoms of multiple mental or behavioral disorders. You know I don't use the word "ALL" all that lightly. But it's an "ALL." This one's an absolute. You can't live and not feel anxious. You can't live and not get depressed. Find me one person without an "addiction" of some kind.
These people are lying.
But to be diagnosed with a disorder is a whole other level of dis-order. It means that you have a cluster of symptoms that meet a cluster determined by real social scientists who have done research to find that indeed, symptoms cluster together and define recognizable syndromes, or disorders.
A list of symptom clusters helps therapydocs explain to people who don't believe in mental illness that if one has that particular cluster of symptoms, then that person has what we believe to be a particular mental disorder.
Even your grandfather, who doesn't believe in all this therapy nonsense gets it when he can read the symptoms on a list.
What's the difference between Obsessive-Compulsive Disorder and Obsessive-Compulsive Personality Disorder?
The first, OCD, is an Axis I disorder, meaning the symptoms of the disorder can make the person who has them feel sick. The second, OCPD, is an Axis II disorder, a Personality Disorder, meaning the symptoms make EVERYONE ELSE sick, especially the people who live with the person who has the symptoms. But the symptom bearer can be relatively comfortable. Not always. Perhaps not usually.
Obsessive-Compulsive Disorder, 300.3, belongs to a family of anxiety disorders that are classified in the American Psychiatric Association's Diagnostic and Statistical Manual of Mental Disorders.
Sufferers are sick with many of the following symptoms. This is almost straight out of the book. For a better explanation go to the library or Google OCD. The "bold" in the descriptions below is my attempt to get you to pay attention. If words are in bold then you should stop for a second, and think. Here are the symptoms of OCD. All of the categories, A through E, have to apply.
A) Either obsessions or compulsions:
1) recurrent and persistent thoughts, impulses, or images that are intrusive and cause marked anxiety and distress
2) the thoughts, impulses, or images are not simply excessive worries about real-life problems
3) the person attempts to ignore, suppress, or neutralize them with some other thought or action
4) the person recognizes that they are a product of his or her own mind (not imposed from without as in thought insertion*)
1) repetitive behaviors (hand washing, ordering, checking) or mental acts (praying, counting, repeating words silently) that the person feels driven to perform in response to an obsession, or according to rules that must be applied rigidlyB. At some point the individual recognizes that the obsessions or compulsions are excessive or unreasonable. Note: This does not apply to children.
2) the behaviors or mental acts are aimed at preventing or reducing the distress or preventing some dreaded event or situation; however, these behaviors or mental acts either are not connected in a realistic way with what they are designed to neutralize or prevent or are clearly excessive.
C. The obsessions or compulsions cause marked distress, are time consuming (1 hour or more a day) or significantly interfere with normal routine, work, academics, social life or relationships.
D. If another Axis I disorder, the content of the obsessions or compulsions is not limited to that (i.e., preoccupation with drugs in the presence of substances, food for anorexics)
E. The disturbance is not due to the physiological effects of a substance or general medical condition.
That's a lot to remember, right? Now don't you have more respect for your therapists? They know (or should know) ALL of the DSM-IV-TR.
There's more to say on OCD, but let's move along to OCPD.
Obsessive-Compulsive Personality Disorder, 301.4
A pervasive (doesn't go away) pattern of preoccupation with orderliness, perfectionism, and mental and interpersonal control, at the expense of flexibility, openness, and efficiency, beginning by early adulthood and present in a variety of contexts, as indicated by FOUR or more of the following:
1) is preoccupied with details, rules, lists, order, organization, or schedules to the extent that the major point of the activity is lost
2) shows perfectionism that interferes with task completion (unable to complete a project because his or her own overly strict standards are not met)
3) is excessively devoted to work and productivity to the exclusion of leisure activities and friendships (not accounted for by obvious economic necessity)
4) is overconscientious, scrupulous, and inflexible about matters of morality, ethics, or values (not accounted for by cultural or religious identification)
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
If you have either of these disorders you might consider getting therapy. Usually we see people with 300.3, the Axis I anxiety disorder in therapy because they're miserable.
Those of you with the Axis II disorder 301. 4 might be unhappy, and for sure your behavior is causing others more stress and discomfort than you realize. But you're not going to part with those moldy National Geographics form 1945 that are stacked up in the basement. You'll be yanked (against your will) into marriage or relationship therapy at some point or you'll lose the best thing you ever had. But you generally won't volunteer for it.
That's it for now. Any questions?
This obsessive blogging has GOT to stop, by the way, don't you agree?
*Thought insertion is a symptom of schizophrenia. One who suffers from this disorder actually hears a voice that does not exist that is inserting thoughts into his or her mind, i.e., the FBI is listening to this phone call, watch what you say.
Copyright 2007, TherapyDoc