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Obsessive-Compulsive Personality Disorder


Neurotic Solution: Obsessive-Compulsive Type
Conscientious Personality Type
Values of the Conscientious Type New



Perspectives q.v.





The Disease Perspective

The Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition (American Psychiatric Association, 1994, pp. 672-673) describes Obsessive-Compulsive Personality Disorder as a pervasive pattern of preoccupation with orderliness, perfectionism, and mental and interpersonal control, at the expense or flexibility, openness, and efficiency, beginning by early adulthood and present in a variety of contexts, as indicated by four (or more) of the following:
  • is preoccupied with details, rules, lists, order, organization, or schedules to the extent that the major point of the activity is lost;

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

  • is excessively devoted to work and productivity to the exclusion of leisure activities and friendships (not accounted for by obvious economic necessity);

  • is overconscientious, scrupulous, and inflexible about matters of morality, ethics, or values (not accounted for by cultural or religious identification);

  • is unable to discard worn-out or worthless objects even when they have no sentimental value;

  • is reluctant to delegate tasks or to work with others unless they submit to exactly his or her way or doing things ;

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

  • shows rigidity and stubbornness.




The Dimensional Perspective

Here is a hypothetical profile, in terms of the five-factor model of personality, for Obsessive-Compulsive Personality Disorder (speculatively constructed from McCrae, 1994, pg. 306):



High Neuroticism
Chronic negative affects, including anxiety, fearfulness, tension, irritability, anger, dejection, hopelessness, guilt, shame; difficulty in inhibiting impulses: for example, to eat, drink, or spend money; irrational beliefs: for example, unrealistic expectations, perfectionistic demands on self, unwarranted pessimism; unfounded somatic concerns; helplessness and dependence on others for emotional support and decision making.

High Extraversion
Excessive talking, leading to inappropriate self-disclosure and social friction; inability to spend time alone; attention seeking and overly dramatic expression of emotions; reckless excitement seeking; inappropriate attempts to dominate and control others.

High Openness
Preoccupation with fantasy and daydreaming; lack of practicality; eccentric thinking (e.g., belief in ghosts, reincarnation, UFOs); diffuse identity and changing goals: for example, joining religious cult; susceptibility to nightmares and states of altered consciousness; social rebelliousness and nonconformity that can interfere with social or vocational advancement.

High Agreeableness
Gullibility: indiscriminate trust of others; excessive candor and generosity, to detriment of self-interest; inability to stand up to others and fight back; easily taken advantage of.

High Conscientiousness
Overachievement: workaholic absorption in job or cause to the exclusion of family, social, and personal interests; compulsiveness, including excessive cleanliness, tidiness, and attention to detail; rigid self-discipline and an inability to set tasks aside and relax; lack of spontaneity; overscrupulousness in moral behavior.





Too Conscientious


The Conscientious Personality Type, missing the mark in excess of its strengths and virtues, equals Obsessive-Compulsive Personality Disorder:

Too conscientious, too productive, too achieving (works righteousness, pride), too controlling, too perfectionistic, too correct, too meticulous, too orderly, too persevering, too pragmatic, too prudent, too accumulative.



Character Weaknesses and Vices*


Know Your Major Weaknesses


* Derived from Michael Stone's (pg. 23) list of the "personality traits" of DSM-III-R Obsessive-Compulsive Personality Disorder.





The Behavior Perspective


  • Preoccupation with details, rules, lists, order, organization, or schedules.

  • Perfectionism that interferes with task completion.

  • Excessive devotion to work and productivity.

  • Overconscientiousness, scrupulosity, and inflexibility about matters of morality, ethics, or values.

  • Hoarding

  • Excessive interpersonal control.

  • Miserliness toward both self and others.

  • Rigidity and stubbornness.






The Life Story Perspective



Childhood

"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" (Oldham & Morris, pg. 83).
 

Universal Character Disorder Basic Passions Avoidant


Stoic explanation

Obsessive-Compulsive personality disorder is a typological representation of bad character, of a vicious disposition formed by habitual passion. Passions are, or are the results of, erroneous value-judgments. The objects of passion listed below (derived mostly from Beck, Freeman, and associates, 1990, pp. 46-47) are external, indifferent things that the Obsessive-Compulsive personality incorrectly judges to be good or bad. (Evolutionary Psychology and Behavior Genetics provide adequate scientific explanations of the origins of these impulses.) The cure of Obsessive-Compulsive personality disorder will require correcting these habitual, erroneous value-judgments by making proper use of impressions.


Horneyan explanation

Obsessive-Compulsive personality disorder is a type of "solution" to the problem of anxiety; that is, it is a strategy to alleviate anxiety. The objects of desire and pleasure listed below (derived mostly from Beck, Freeman, and associates, 1990, pp. 46-47) are limited goods pridefully turned to for security when we fail to trust God. They are analogous to Karen Horney's "neurotic needs."

Karen Horney: Intrapsychic Strategies of Defense

The Expansive Solution

Perfectionistic type

"Even when we deeply value ourselves, the anxiety built into finitude will tempt us to find our source of security in some strategy rather than a trust in God" (Cooper, pg. 163).


Habitual Passions

Desires/ Pleasures

 Fears/ Distresses
  • achievement
  • respect of others
  • perfection
  • control
  • "shoulds"
  • orderliness
  • responsibility
  • systems
  • order
  • rules
  • high standards
  • doing things right
  • knowing what's best
  • doing things one's own way
  • details
  • doing better and trying harder
  • pushing oneself and others
  • criticalness
  • evaluating others' performances
  • directing
  • disapproving
  • punishing
  • perfectionistic standards
  • failure to achieve
  • disrespect
  • imperfection
  • lack of control
  • helplessness
  • of being overwhelmed
  • of being unable to function
  • of being casual
  • of being irresponsible
  • of being self-indulgent
  • of being incompetent
  • weaknesses
  • disorganization
  • disorientation
  • flaws or defects in performance
  • mistakes
  • imperfections
  • substandard performance
 



Cognitive Effects

Basic Belief: Errors are bad. I must not err. [Strategy]: Perfectionism (Beck, Freeman & associates, pg. 26).

The "idealized self is made up of beliefs about how we should feel, think, or act" (Tamney, pg. 32).

Compulsive beliefs and attitudes are idols, too.

In Cognitive Therapy of Personality Disorders, Aaron T. Beck, Arthur Freeman, and associates (1990) list typical beliefs associated with each specific personality disorder. According to my view, the beliefs and attitudes rationalize and reinforce the idealized image and the compulsive attachments and aversions. They are analogous to Karen Horney's "shoulds" and "neurotic claims." Here are the typical beliefs that they have listed (pg. 361) for Obsessive-Compulsive Personality Disorder:

  • I am fully responsible for myself and others.
  • I have to depend on myself to see that things get done.
  • Others tend to be too casual, often irresponsible, self-indulgent, or incompetent.
  • It is important to do a perfect job on everything.
  • I need order, systems, and rules in order to get the job done properly.
  • If I don't have systems, everything will fall apart.
  • Any flaw or defect of performance may lead to a catastrophe.
  • It is necessary to stick to the highest standards at all times, or things will fall apart.
  • I need to be in complete control of my emotions.
  • People should do things my way.
  • If I don't perform at the highest level, I will fail.
  • Flaws, defects, or mistakes are intolerable.
  • Details are extremely important.
  • My way of doing things is generally the best way (361).


Beck's Cognitive Therapy for Personality Disorders







American Psychiatric Association (1994). Diagnostic and Statistical Manual of Mental Disorders: DSM-IV. 4th ed. Washington: Author.

Beck, Aaron T. and Freeman, Arthur M. and Associates (1990). Cognitive Therapy of Personality Disorders. New York : Guilford Press.

Beck, Aaron T. and Freeman, Arthur M. and Associates (2003). Cognitive Therapy of Personality Disorders, 2nd ed. New York : Guilford Press.

Cooper, Terry D. (2003). Sin, Pride, and Self-Acceptance: The Problem of Identity in Theology and Psychology. Downers Grove, IL: InterVarsity Press.

McCrae, Robert R. (1994). "A Reformulation of Axis II: Personality and Personality-Related Problems." Costa, Paul T., Jr., Widiger, Thomas A., editors. Personality Disorders and the Five-Factor Model of Personality. Washington, D.C.: The American Psychological Association.

John M. Oldham and Lois B. Morris (1995). The New Personality Self-Portrait: Why You Think, Work, Love and Act the Way You Do. New York: Bantam.

(1989). Personality Disorders: Obsessive-Compulsive Personality Disorder. Treatments of Psychiatric Disorders, Vol. 3. American Psychiatric Association. Task Force on Treatments of Psychiatric Disorders. Washington, DC : American Psychiatric Association.

Stone, Michael H. (1993). Abnormalities of personality: within and beyond the realm of treatment. New York: W.W. Norton.

Tamney, Joseph B. (2002). The Resilience of Conservative Religion. New York: Cambridge UP.



Hypersensitivity

Theodore Millon (1981, pg. 220) identifies the compulsive personality as one of the "sensitive types" described by Ernst Kretschmer in Der sensitive Beziehungswahn:

Kretschmer described what we would consider to be the essential features of the compulsive personality under the designation of "sensitive types" (1918). By this term Kretschmer meant persons who are burdened by affect-laden complexes that they must deal with intrapsychically because of their inability to externalize or discharge them. Highly impressionable but deficient in powers of active expression, they engage in a "pent-up working over" of even minor and irrelevant daily experiences. Beset by their inability to take decisive action, they become uncertain over both large and small matters. In order to compensate for their indecisiveness and lack of self-confidence they hold fast to standards set with conviction by others, often becoming "men of conscience." Ethical and moral issues are prominent matters in their thinking, as are conflicts over sexuality. Experienced as especially humiliating and shameful are their sexual fantasies, which appear to lodge in their thoughts and resist all efforts at suppression. The contrast between their internalized standards and these persistent an intrusive ideas contribute to the affect-laden complexes and tension so characteristic of this personality.

Kretschmer, Ernst (1918). Der sensitive Beziehungswahn. Berlin: Springer.

Millon, Theodore (1981). Disorders of Personality. New York: Wiley.



Obsessive-Compulsive Personality Disorder: links

 Personality Disorders





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