The Psychopathic Personality



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• Mental Disorders and Illness

Mood disorders, such as depression and bipolar disorder, which affect how one feels; schizophrenia, which affects how one perceives the world; anxiety disorders which affect how fearful one perceives places, events or situations to be; personality disorders, which affect how one sees oneself in relation to others; and eating disorders, such as anorexia or bulimia, which influence how one feels about food and one's body image effect a large population of our society.

Early Warning Signs

Inability to sleep, restlessness, social withdrawal or isolation, extremism in behaviors, indifference, deterioration in social relationships, hyperactivity or inactivity, inability to concentrate, noticeable difficulty in making decisions, unusual preoccupation with religion or the occult, hostility, suspicion and fearfulness.

Persons with OCPD often have a negative outlook on life (pessimism).

• Preoccupation with details, rules, lists, order, organization, or schedules to the extent that the major point of the activity is lost

• Showing 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)

• Excessive devotion to work and productivity to the exclusion of leisure activities and friendships (not accounted for by obvious economic necessity)

• Being over conscientious, scrupulous, and inflexible about matters of morality, ethics, or values (not accounted for by cultural or religious identification)

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

• Reluctance to delegate tasks or to work with others unless they submit to exactly his or her way of doing things

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

• Shows rigidity and stubbornness

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Obsessive-compulsive personality disorder

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Definition

Obsessive-compulsive personality disorder (OCPD) is a type of personality disorder marked by rigidity, control, perfectionism, and an over concern with work at the expense of close interpersonal relationships. Persons with this disorder often have trouble relaxing because they are preoccupied with details, rules, and productivity. They are often perceived by others as stubborn, stingy, self-righteous, and uncooperative.

The mental health professional's handbook, the Diagnostic and Statistical Manual of Mental Disorders, fourth edition, text revision (2000), which is also called DSM-IV-TR, groups obsessive-compulsive personality disorder together with the avoidant and dependent personality disorders in Cluster C. The disorders in this cluster are considered to have anxiety and fearfulness as common characteristics. The ICD-10, which is the European counterpart of DSM-IV-TR, refers to OCPD as "anankastic personality disorder."

It is important to distinguish between OCPD and obsessive-compulsive disorder(OCD), which is an anxiety disorder characterized by the presence of intrusive or disturbing thoughts, impulses, images or ideas (obsessions), accompanied by repeated attempts to suppress these thoughts through the performance of irrational and ritualistic behaviours or mental acts (compulsions). It is unusual but possible, however, for a patient to suffer from both disorders, especially in extreme cases of hoarding behaviour. In some reported cases of animal hoarding, the people involved appear to have symptoms of both OCD and OCPD.

Description

People suffering from OCPD have careful rules and procedures for conducting many aspects of their everyday lives. While their goal is to accomplish things in a careful, orderly manner, their desire for perfection and insistence on going "by the book" often overrides their ability to complete a task. For example, one patient with OCPD was so preoccupied with finding a mislaid shopping list that he took much more time searching for it than it would have taken him to rewrite the list from memory. This type of inflexibility typically extends to interpersonal relationships. People with OCPD are known for being highly controlling and bossy toward other people, especially subordinates. They will often insist that there is one and only one right way (their way) to fold laundry, cut grass, drive a car, or write a report. In addition, they are so insistent on following rules that they cannot allow for what most people would consider legitimate exceptions. Their attitudes toward their own superiors or supervisors depend on whether they respect these authorities. People with OCPD are often unusually courteous to superiors that they respect, but resistant to or contemptuous of those they do not respect.

While work environments may reward their conscientiousness and attention to detail, people with OCPD do not show much spontaneity or imagination. They may feel paralyzed when immediate action is necessary; they feel overwhelmed by trying to make decisions without concrete guidelines. They expect colleagues to stick to detailed rules and procedures, and often perform poorly in jobs that require flexibility and the ability to compromise. Even when people with OCPD are behind schedule, they are uncomfortable delegating work to others because the others may not do the job "properly." People with OCPD often get so lost in the finer points of a task that they cannot see the larger picture; they are frequently described as "unable to see the forest for the trees." They are often highly anxious in situations without clearly defined rules because such situations arouse their fears of making a mistake and being punished for it. An additional feature of this personality disorder is stinginess or miserliness, frequently combined with an inability to throw out worn-out or useless items. This characteristic has sometimes been described as "pack rat" behaviour.

People diagnosed with OCPD come across to others as difficult and demanding. Their rigid expectations of others are also applied to themselves, however; they tend to be intolerant of their own shortcomings. Such persons feel bound to present a consistent facade of propriety and control. They feel uncomfortable with expressions of tender feelings and tend to avoid relatives or colleagues who are more emotionally expressive. This strict and ungenerous approach to life limits their ability to relax; they are seldom if ever able to release their needs for control. Even recreational activities frequently become another form of work. A person with OCPD, for example, may turn a tennis game into an opportunity to perfect his or her backhand rather than simply enjoying the exercise, the weather, or the companionship of the other players. Many OCPD sufferers bring office work along on vacations in order to avoid "wasting time," and feel a sense of relief upon returning to the structure of their work environment. Not surprisingly, this combination of traits strains their interpersonal relationships and can lead to a lonely existence.

Causes and symptoms

Causes

No single specific cause of OCPD has been identified. Since the early days of Freudian psychoanalysis, however, faulty parenting has been viewed as a major factor in the development of personality disorders. Current studies have tended to support the importance of early life experiences, finding that healthy emotional development largely depends on two important variables: parental warmth and appropriate responsiveness to the child's needs. When these qualities are present, the child feels secure and appropriately valued. By contrast, many people with personality disorders did not have parents who were emotionally warm toward them. Patients with OCPD often recall their parents as being emotionally withholding and either overprotective or over controlling. One researcher has noted that people with OCPD appear to have been punished by their parents for every transgression of a rule, no matter how minor, and rewarded for almost nothing. As a result, the child is unable to safely develop or express a sense of joy, spontaneity, or independent thought, and begins to develop the symptoms of OCPD as a strategy for avoiding punishment. Children with this type of upbringing are also likely to choke down the anger they feel toward their parents; they may be outwardly obedient and polite to authority figures, but at the same time treat younger children or those they regard as their inferiors harshly.

Genetic contributions to OCPD have not been well documented. Cultural influences may, however, play a part in the development of OCPD. That is, cultures that are highly authoritarian and rule-bound may encourage child-rearing practices that contribute to the development of OCPD. On the other hand, simply because a culture is comparatively strict or has a strong work ethic does not mean it is necessarily unhealthful. In Japanese societies, for example, excessive devotion to work, restricted emotional expression, and moral scrupulosity are highly valued characteristics that are rewarded within that culture. Similarly, certain religions and professions require exactness and careful attention to rules in their members; the military is one example. OCPD is not diagnosed in persons who are simply behaving in accordance with such outside expectations as military regulations or the rule of a religious order. Appropriate evaluation of persons from other cultures requires close examination in order to differentiate people who are merely following culturally prescribed patterns from people whose behaviours are excessive even by the standards of their own culture.

Symptoms

The symptoms of OCPD include a pervasive over concern with mental, emotional, and behavioural control of the self and others. Excessive conscientiousness means that people with this disorder are generally poor problem-solvers and have trouble making decisions; as a result, they are frequently highly inefficient. Their need for control is easily upset by schedule changes or minor unexpected events.

While many people have some of the following characteristics, a person who meets the DSMIV-TRcriteria for OCPD must display at least four of them:

• Preoccupation with details, rules, lists, order, organization, or schedules to the point at which the major goal of the activity is lost.

• Excessive concern for perfection in small details that interferes with the completion of projects. Perfectionism that interferes with task completion.

• Dedication to work and productivity that shuts out friendships and leisure-time activities. Extremism in behaviour.

• Excessive moral rigidity and inflexibility in matters of ethics, morality, values and religion.

• Hoarding things, or saving worn-out or useless objects even when they have no sentimental or likely monetary value.

• Insistence that tasks be completed according to one's personal preferences and reluctance to delegate tasks or work unless people submit to exactly his or her standards of doing things.

• Stinginess with the self and others.

• Excessive rigidity, stubbornness and obstinacy.

The standards that those with OCPD set for themselves and others are impossibly high, and they are prone to damage personal relationships by being critical of those who don’t live up to their lofty ideals. There are few moral gray areas for someone with full-blown OCPD; actions and beliefs are either right or wrong, with no room for compromise. They can also be workaholics, preferring the control of working alone, as they are afraid that work completed by others will not be done correctly (Dobbert 2007).

Obsessions and Compulsions

Obsessions and compulsions are about control of self (mental) and others (interpersonal). People with the Obsessive-Compulsive Personality Disorder (OCPD) are concerned (worried and anxious) about maintaining control and about being seen to be maintaining it. In other words, they are also preoccupied with the symbolic aspects and representations (with the symbols) of control. Inevitably, OCPDs are perfectionists and rigidly orderly or organized. They lack flexibility, openness and efficiency. They tend to see the world and others as at best whimsical and arbitrary and at worst menacing and hostile. They are constantly worried that something is or may go wrong. In this respect, they share some traits with the paranoid and the schizotypal. It is easy to spot an Obsessive-Compulsive. They are constantly drawing up and dreaming up lists, rules, orders, rituals, and organizational schemes. They demand from themselves and from others perfection and an inordinate attention to minutia. Actually, they place greater value on compiling and following rigid schedules and checklists than on the activity itself or its goals. Simply put, Obsessive-Compulsives are unable to see the wood for the trees.This insistence on in-depth scrutiny of every detail frequently results in paralysis.OCPDs are workaholics, but not because they like to work. Ostensibly, they sacrifice family life, leisure, and friendships on the altar of productivity and output. Really, they are convinced that only they can get the job done in the right manner. Yet, they are not very efficacious or productive. Socially, OCPDs are sometimes resented and rejected. This is because some OCPDs are self-righteous to the point of bigotry. I described it in an article I wrote for the Open Site Encyclopedia: "They are so excessively conscientious and scrupulous and so unempathically and inflexibly tyrannical that it is difficult to maintain a long-term relationship with them. They regard their impossibly high moral, work, and ethical standards as universal and binding. Hence their inability to delegate tasks to others, unless they can micromanage the situation and control it minutely to fit their expectations. Consequently, they trust no one and are difficult to deal with and stubborn.

By Sam Vaknin

Power, Control and Abuse

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Abuse is about control and the fear of losing it. Ill-treatment is an absurd effort to maintain and enhance the abuser's hegemony - social, cultural, legal, and, above all, psychological. Abusers exploit, lie, insult, demean, ignore (the "silent treatment"), manipulate, and control. There are a million ways to abuse, directly and by proxy. To expect too much, to denigrate, to ignore - are all modes of abuse. There is physical abuse, verbal abuse, psychological abuse, sexual abuse, domestic abuse, substance abuse, spiritual abuse and so on. The list is long.

Most abusers abuse surreptitiously. They are "stealth abusers". You have to actually live with one in order to witness the mistreatment. It is important to understand that many of the symptoms and behaviours of physical, emotional or psychological abuse are similar in their basis.

God Forbid"

by Steven Phillipson, Ph.D.

Clinical Director

Center for Cognitive-Behavioural Psychotherapy

Scrupulosity: The over-concern for doing the correct thing both in God’s eyes, and that of the law.

Obsessive Compulsive Disorder is conceptualized as having three types or categories. The most traditional type is that of the observable ritualizer. In these people, rituals generally involve behaviours which are designed to undo or escape threats; such as contamination or checking rituals to prevent some disaster. In this type, the predominant concern is the protection of ones own well being and safety. The second most predominant form of OCD, which is just recently beginning to receive a modicum of attention, is the purely obsessional form of OCD, or technically the non-observable ritualizers, which I refer to as the Pure-O.

The 3rd category of OCD, which has received remarkably very little attention, is actually the one in which treatment is most difficult and convoluted. I refer to this type of OCD as the Responsibility OC, which encompasses two subtypes. One subtype is scrupulosity, while the other subtype is over-concern with the well being of others. Both subtypes essentially entail an exaggerated need to defend ones character from agreagious self deprication or disrespect from others.

Scrupulosity is a term given birth to in the 1600s amongst the religious monastic priests of the time. It was observed that certain priests never felt as if they engaged in their daily religious rigors to a satisfactory level. These people were preoccupied with the concern and fear that they were not satisfying God's need for them to display love and or reverence in an adequate way. Typical rituals that were observed in that time involved the need to pray in an exact way, or to pray achieving an exact level of emotional intensity. Four hundred years later scrupulosity is a well-documented form of OCD. It is typically evident in persons who have an overzealous concern that their behaviour or thoughts may in some way be displeasing, or disrespecting to God. Repetitive and excessive prayer continue to plague those persons with this type of OCD. Scrupulosity also can involve the need to adhere to a strict code of values or ridigidly follow the ethics of a law abiding citizen. This preoccupation involves not only the traditional experience of anxiety, which is a feature predominant in all forms of OCD, but the presence of guilt as an additive component further exacerbates the pain and complicates treatment success. OCD obviously is associated with a two part process. There is the upsetting or threatening thought and this thought is usually immediately followed by tremendous anxiety. Although this is the pervasive pairing of OCD there are occasions where the originating thought can produce guilt, anger and or depression. The Scrupulosity type of OCD takes on many different manifestations. There are those people who will experience an intrusive thought that involves some disrespect to God or to religious items or ideals. The spike involves the threat that an irreverent idea, or an incomplete prayer could create the risk of potential displeasure of God, and therefore that ones spiritual afterlife will be affected negatively.

Strict Moral Standards

"Premarital sex is wrong and it means that persons are tainted if they have ever engaged in it." "Girls who wear make up are loose and promiscuous." "Men who allow their wives to work are inadequate providers."

Moral righteousness and preaching morality as a dogmatic necessity is not an uncommon expression of OCPD. The avoidance of discussing religion or politics is certainly wise in the presence of the OCPD sufferer. Both of these realms are steeped in the potential for the OCPD sufferer's truth to override consideration and respect. In 1986 I flew with a client to Boston to aid him in his fear of flying. While at the airport in Boston we walked past a booth representing some very conservative organization (Linden LaRouch I believe). Out of nowhere, my 6'4" male client reached over the booth and grabbed the innocent fellow by the collar. My client proceeded to yell about the toxic ideology that this booth represented. In that moment this client graduated from fear of flying and commenced with a long year of work related to helping him let go of truth and anger. One of our agreed upon goals was for him to become more available to his friends, who had expressed that they were afraid to discuss any topic which he disagreed with. Our successful outcome boiled down to my client's willingness to replace "truth" with expressing his opinion in terms of degrees of confidence.

Excessive religious observance as in, strict adherence to ritualistic aspects of daily or weekly routines is a potential component of OCPD. If a child would ask for rationales for following through with certain age old traditions the OCPD parent may respond with "You just do it and never question the relevance". Often persons with this form of OCPD, believe in literal interpretations of the Bible or Koran. Adamantly endorsing the idea that the world was created some 5864 years ago, despite the existence of rocks carbon dated to over a million years ago, would not be unexpected. Using the Wrath of God as a means of modifying behaviour is often an unfortunate component of OCPD. Of course, religious intolerance is not surprisingly a derivative of this style of thinking. Finding fault with different views or creating fractions within divergent religious sects is not uncommon. The existence of hundreds of subsets amongst the Baptists and the ever-fractionalizing Hasidic (ultra-orthodox Jewish) community is evidence of religious leaders owning their interpretation of the Bible too rigidly. One of my favourite recollections of a female OCPD in discussing her spirituality was her reassurance that her observance of Eastern philosophy was the "True Buddhist" expression. The paradoxical humour is that letting go of truth is a spiritual goal of Buddhism (as I understand it).

Owning Truth (Spiritually Abusive groups)

We all periodically have such confidence in what we are saying that statements such as "I'm sure of it" or "The fact of the matter is..." play a natural part of our everyday vocabulary. For persons with OCPD, facts and confidence are all too often turned into "I'm RIGHT and your WRONG." "The way I see it represents the way it is, end of story". For others, refusing to yield to the "correct perspective" often entails encountering tension and discord. This manifestation of OCPD entails one's adamantly guarding his dogmatic beliefs to such a degree that casual conversation often converts minor disagreements into heated debates. The relative importance of any topic (i.e. comparing the effects of regular gas vs. high test on a particular car's performance) rarely is of consequence in determining the degree of the intensity expressed in the midst of the debate.

Perhaps there are a few variables on this planet, which are beyond debate in their apparent universal truthfulness. "Humans are a living organism when there is a heart beat and/or brain activity" or "Rocks eventually tend to drop in a downward direction when released into the air." For the person who experiences OCPD, abstract ideals and moral standards become rigidly held truths. An example belief would be that "The Mormon's practice of marrying more than one woman is illegal and absolutely wrong." The ideology that all-religious practices are subject to interpretation and not a matter of right or wrong is often overlooked and rarely considered. It is not unheard of for someone with OCPD to feel that he is flexible due to an occasional shift in his beliefs. If one listens carefully, the shift in position can be dramatic and equally dramatic is the degree to which the new truth is held as fact. The knowledge that abortion is "murder" can be converted to the fact that the freedom to choose represents every woman's "God Given" right to make decisions about her own body. Most examples of this particular cognitive shift would tend to go in the opposite direction.

It would not be unusual for an OCPD sufferer to literally take delight in being wronged, since it affords them, what they perceive, as the justified opportunity to deliver a steep punishment. The term "righteous indignation" was probably conceived with this perspective in mind. Crossing a person with OCPD provides her the license to hold a grudge and forever hold your mistake over your head.

In a conflict with someone who has OCPD, the non-OCPD person might be motivated to desperately seek closure. In the process of attempting conflict resolution, the non-OCPD might discover that every minute the quagmire becomes deeper and deeper. It is almost as if the mere effort to find resolution is a punishable offense. In a close relationship, encountering this zone of contempt is bewildering and frightening. All one wants to do is to bring this controversy to an end, and then, you are punished for not being willing to deal with the issue at hand. Within this zone, the person with OCPD feels a great need to bring about absolute clarity for the issue to be resolved. Once again this need for the perfect resolution creates a seemingly never ending tweaking of the issues. Agreeing to disagree is rarely a reasonable solution and often not in the scope of the OCPD's world.

Interpersonal Relationships

For many who have close contact with an OCPD sufferer there can be a pervasive experience of being ill at ease, while in the company of someone with OCPD. Often, being with persons who evidence this diagnosis, feels like walking in a field of land mines. One never knows when you’re going to step on one and pay a heavy emotional price for crossing the rigid standards. This ever present threat creates a tremendous amount of trepidation, resentment, and tension. These land mines can present themselves in association with seemingly random topics.

Within marital or familial relationships the divisiveness of this condition is most felt. Since ideology and correctness is placed before love and loyalty, divisiveness can break familial ties. Spouses can be subjected to daily scrutiny and given repeated feedback in a non-loving or supportive manner. The standard bearer must run his or her house like a tight ship -- from the children being kept in line (seen but not heard) to the outside appearance of the house, well manicured and tidy. The expression, both physically and emotionally, of tender feelings for "loved ones" is often painfully absent. Corporal punishment is not unusual since the mentality of "spare the rod and spoil the child" is even endorsed in the Bible. Wreaking humiliation seems to be just punishment since it closely approximates the inner experience of the OCPD sufferer's reaction to being wronged. In 1985 I was working in a university outpatient clinic with a child whose academic performance had lapsed far behind his intellectual capacity. Near the end our successful treatment I brought in the father of my client. My objective was to see if I might transfer the positive changes, which had occurred in the course of treatment, to the home. Near the end of the session I asked the father whether he was proud of his son for bringing up his grades so dramatically. I'll never forget the father's response in front of this child. "There's nothing to celebrate, these are the grades he SHOULD have gotten all along!"

In interpersonal relationships we all tend to hope for a little leeway in being given feedback for mistakes that we make. Persons with OCPD tend not to find it within themselves to provide a nurturing environment where being human and fallible is expected. Instead they feel put upon by others' mistakes and take license in extracting a heavy toll for even an initial infraction -- "Person's should know better and mistakes are just not to be tolerated." Often others in the presence of an OCPD sufferer find themselves embroiled in heated conflict over issues which pertain to seemingly trivial topics. It is not uncommon to become convinced that the OCPD sufferer actually takes delight in the heated nature of conflict. For those familiar with the OCPD's style, bailing out of a conversation and avoiding future areas of debate, is a pervasive response pattern. Not surprisingly this style of interaction has devastating effects on the great majority of relationships persons with OCPD have. Fault finding is the tendency for OCPD's to chronically pick out the flaws in others, especially those close enough to them to mention it. "You always misuse the word affect in stead of saying effect!" "Your hair is always so messy; don't you have any self respect?" It seems as if through criticism the receiver of the feedback will be inspired to get their act together.

For the OCPD sufferer, it is not uncommon for him to seek out the company of a significant other where his partner's personal disposition is that of being passive and non-conflictual. For a long-term significant relationship to survive with this diagnosis, it is almost essential for the partner to have great depths of resilience or dependency. Many OCPD relationships involve a clear distinction between the domineering and controlling spouse and the passive-dependent spouse. Mail order brides have sometimes provided an outlet for otherwise frustrated men who have found it difficult to cope with the ever-evolving power structure of women within today's western society.

Isolation due to rigidly held high standards is also a common result of OCPD. When perfectionistic standards are applied toward a partner's minute bodily defects or quirky personal style, the devastation wreaked within intimacy is astounding. I have all too often worked with clients who have legitimized ending relationships due to such minutiae as a significant others bad breath, small shoe size, or eyebrow thickness. An article written in New York Magazine, a few years ago, portrayed a satirical conversation which went something like this: "She's a Ph.D., expert skier, loves children and animals, and encourages me to spend as much time out with the guys as possible... it's just a shame she speaks French with a southern dialect". When this aspect of OCPD is manifested there is typically a pattern of failed relationships. The sufferer tends to consistently withdraw from a relationship soon after the development of intimacy. The awareness of the defect in one's partner as time goes on becomes so magnified, that after a while, the slight flaw which was not even noticed initially, becomes the only feature which is seen.

Poor social skills are often a consequence of a life-long pattern of rigid thinking. Being motivated to attend to subtle cues within one's social environment is lost due to the overriding perspective that "my way is the right way." Taking liberty to disclose radical opinions or facts, which are of an extreme nature, in the presence of a novel relationship or non-intimate acquaintances is a common characteristic. Whereas in a novel social setting, decorum pressures persons to withhold extreme positions, the OCPD sufferer feels that a lack of genuineness is wrong and being totally open, no matter what the consequence, is the only option. "If others are offended by what I say, too bad for them."

In professional relationships, subordinates of many OCPD's are often intimidated and frequently berated. Staff may experience tremendous inhibition in speaking freely about topics where there is not absolute certainty regarding the correctness of the statements. This environment facilitates the stifling of creativity and risk taking. Often the chain of command from above reinforces or ignores this style; since it appears that the manager is just being vigilant and instilling the company's commitment to excellence.

The RIGHT Stuff

Obsessive Compulsive Personality Disorder: A Defect of Philosophy, not Anxiety

by Steven Phillipson, Ph.D.

Center for Cognitive-Behavioural Psychotherapy

Obsessive Compulsive Personality Disorder (OCPD) is a pervasive characterological disturbance involving one's generalized style and beliefs in the way one relates to themselves and the world. Persons with OCPD are typically deeply entrenched in their dysfunctional beliefs and genuinely see their way of functioning as the "correct" way. Their overall style of relating to the world around them is processed through their own strict standards. While generally their daily experience is such that "all is not well," they tend to be deeply committed to their own beliefs and patterns. The depth of ones belief that "my way is the correct way" makes them resistant to accepting the premise that it is in their best interest to let go of "truth owning." Yet letting go of truth is paramount in their recovery. For the purposes of this article "truth" is defined as a person's rigidly held belief which s/he feels is universally applicable. Most often, blame for ones internal strife, is placed on external circumstances or the environment.

OCPD and Obsessive Compulsive Disorder (OCD) are often confused as they are thought of as being similar. There is, however, a great difference between the two conditions. Persons with OCD experience tremendous anxiety related to specific preoccupations, which are perceived as threatening. Within the condition of OCPD it is one's dysfunctional philosophy which produces anxiety, anguish and frustration. It has been well established that OCD is a condition in which people perform elaborate rituals to avoid or escape anxiety. Repetitive rituals are performed to undo the threat. Their overall genuine nature tends not to be affected by the condition and in the vast majority of the cases they recognize that the concerns are irrational. A person with washing rituals due to fears about contracting aids from a public door knob might still be very willing to sky dive or go white water rafting. This suggests that a person's inclination toward risk taking is not affected by their anxiety about germs.

This paper will attempt to convey a personality style that has devastating effects on one's emotional wellbeing, work productivity and interpersonal relationships. Although there is a moderate overlap between OCPD and OCD in regard to similarity of rituals, the pervasive differences might justify a relabeling (such as perfectionistic personality disorder) of this condition. OCPD wreaks havoc within a person's life due to a dysfunctional perspective. The movie "As Good as It Gets" unfortunately portrays a muddled combination of these two conditions, although it was touted as the OCD movie. The main character engages in a variety of OCD rituals, yet his overall demeanour is that of an angry, belligerent, intolerant loner who clearly has an exaggerated form of OCPD as his main handicap.

For those who have OCD, reading this paper will be very provocative. Not only are some of the characteristics similar to the population at large but there is going to be an unsettling degree of similarity between OCD and OCPD. If you have OCD, please do not read this paper and attempt to diagnosis yourself. It is not in the surface similarities that the distinction is made between the two conditions. Instead the distinction lies within the underlying rationale of these key elements. It requires vast training and clinical experience to distinguish the subtle but drastic contrast between the two conditions. Making an accurate diagnosis is therefore best left up to a qualified specialist. The purpose of this paper is to qualify aspects of this condition so that those who see glaring similarities to themselves or significant others may be better informed and possibly seek treatment. OCPD is a pervasive condition involving ones life philosophy where the characteristics are vast and complicated. To qualify for a diagnosis of OCPD one need not possess all of the following manifestations nor is one or two similarities sufficient. A combination of the following dispositions in an extreme form is generally grounds for a diagnosis.

Generally two hallmark thinking styles are pervasive for persons who suffer this condition. The primary manifestations of OCPD entail either a bent toward perfectionistic standards or righteous indignation. Along with perfectionism comes relentless anxiety about not getting things perfect. Getting things correct and avoiding at all costs the possibilities of making an error is of paramount importance. This perspective produces procrastination and indecisiveness. The second factor entails the rigid ownership of truth. This feature produces anger and conflict. Persons with OCPD generally lean toward one of these perspectives or another. In some cases both perspectives are of equal magnitude. Rituals, on the other hand, often play a relatively small part in this complex syndrome of perfectionistic mannerisms, intense anger and strict standards. Their way is the correct way and all other options are "WRONG". Anger and contempt are rarely held at bay for those who disagree.

The Diagnostic and Statistical Manual of Mental Disorders (DSM III-R, the bible for persons in the mental health profession)suggests that persons with OCPD display a pervasive pattern of orderliness, perfectionism, and/or mental and interpersonal control, at the expense of flexibility, openness, and efficiency. It is further suggested that persons with this condition tend to resist the authority of others while simultaneously demanding that others conform to their way of doing things. The DSM III-R's pervasive focus relates to the person's inability to attain completion of tasks due to the inordinately high standards, which are placed on almost all aspects of living.

Clients tend not to enter therapy for the express purpose of being treated for OCPD. Typically a diagnosis will be made by the clinician after other topics have been explored. Why seek out the help of others when one possesses ultimate knowledge. Perhaps this trend will now change due to an increasing awareness of the manifestations of this condition. Three pervasive rationales for entering therapy have entailed: seeking treatment for OCD rituals, which are becoming burdensome; a generalized dysphoric experience thought to be related to depression or social isolation; and/or marital discord where they have received an ultimatum from their spouse to "get help or get out."

Associated Features

Associated features, according to the DSM III-R, often entail, distress related to a tremendous amount of indecisiveness, difficulty expressing tender feelings and a depressed mood. From my own clinical observations it seems that emotional and cognitive rigidity are the hallmark indices suggesting the existence of OCPD. When events stray from what a person's sense of how things "should be," bouts of intense anger and emotional discord are characteristic.

Indecisiveness: When almost all decisions seem to take on the same paramount importance and being correct is imperative, making even simple choices can become a nightmare. Persons with OCPD can become stymied in life due to an inability to establish with certainty which choice is the correct one. Not unusual would be for someone to spend over ten minutes attempting to choose the correct pair of socks which best matches their tie. They tend to place a great deal of pressure on themselves and on others to not make mistakes. Within OCPD the driving force is to avoid being wrong. In contrast, the underlying rational for someone with OCD would typically be to make the correct decision so that nothing superstitiously bad would happen. Since continuously making the correct choices in life, seems to be an impossible task for us humans, there is a regular source of discontent available for OCPD sufferers.

The need for an occupational exact fit can also bring long term investment in a career choice to a screaming halt. Many aspects of any career can seem very appealing in their conceptualization. Things can always look great from afar. As one becomes more thoroughly educated about any school, career or person, through experience, the pitfalls become more apparent. Since perfection is often sought, the emerging defects of any career choice often deter a prolonged investment in any specific area of focus. Making a definitive choice and changing jobs can become stymied due to the endless pursuit of figuring out which of the available options is best. Aspirations for perfection can play themselves out in interpersonal relationships as well. Since all humans carry a significant amount of emotional baggage it typically doesn't take long in a dating or marital situation to discover our partners' flaws. For someone with OCPD choosing a partner who lives up to their unreasonably high standards is very difficult, if not impossible. Remaining invested in a relationship without bouts of volatility over the long haul is highly unlikely. For those who do remain in long term relationships chronic discord tends to be pervasive.

Emotional Rigidity: In a world where being in control is of paramount importance, dealing effectively with the volatility of emotions is extremely difficult. Since emotionality is associated with spontaneity and upheaval (i.e. loss of control), responding to emotions effectively and appropriately places an abundance of pressure on the OCPD to keep them constricted. Exerting effort to contain "out-bursts" of emotion is an everyday phenomenon. It seems however that there is one emotion which exists in abundance. The expression of anger tends to come out naturally and in excess. Anger, as an emotion, is one of the most basic and easily triggered of human reactions. Anger is only seconded by anxiety in its primitive nature. Vulnerability, (one of the most advanced of human emotions), as seen through the eyes of the OCPD sufferer, compels people to act in silly ways and expose themselves to the possibility of rejection. Emotional constraint is exerted to prevent the possibility that one may act in a regrettable way. The result of this emotional constraint is that all displays of emotion sometimes become compressed into an expression of flat affect. Anxiety and happiness can be perceived as the same on the receiving end. It is not uncommon for persons with OCPD to have their humour often mistaken for seriousness. Jokes or sarcasm (seen by the deliverer as obvious) are mistaken for insults and political incorrectness.

Depressed Mood: Although rarely observed by others, the experience of inner turmoil within this syndrome is immense. As much as others are often victimized by OCPD's oppressive and demanding style, the high standards often apply two fold within the OCPD sufferers' expectations directed toward themselves. It is not uncommon for a person with OCPD to feel deeply entrenched in the belief that they are a "Good Person." This belief can paradoxically often lead to feelings of depression and disappointment. The high standards which a "Good Person" is expected to live up to are often far beyond the capacity for any human being to consistently fulfill. A belief such as "I know that I'm a good person, but I hate myself for doing so many wrong things" is not uncommon. This self-hatred along with tremendous disappointment can easily lead to feeling of depression. Since ones humanness prevents an OCPD sufferer from living according his own high standards, a tremendous amount of self-hatred is imposed. Recent research has documented that as much as seventy percent of depression can be attributed to feelings of low self-esteem and inadequacy. In my work with helping persons manage the challenges of self-esteem I have found it much more difficult to have persons who are "Good" come to find acceptance in being "human" than helping those with low self-worth rise up to the possibilities of self-acceptance.

Another contributor to depression within the OCPD population is a cognitive style characterized by dichotomous thinking. Dichotomous thinking is the tendency to categorize all aspects of life into one of two perspectives -- "All good" or "All bad." The world is viewed predominantly through clearly defined black and white realms. All that is pure and wholesome is valued. It can take only one stain or blemish to have the person completely find justification in discarding anything which evidences a flaw. Within their own being these rigid standards can be devastating to one's self image. Fault finding in one's own world produces a regular source of conflict in maintaining the high standards of life.[pic][pic][pic][pic][pic][pic]

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