How to Recognize Obsessive Compulsive Personality Disorder

Recognizing Common Features of OCPD

Look for an emphasis on efficiency, perfectionism, and rigidity. People with OCPD are perfectionists. They are overly disciplined and preoccupied with processes, procedures and rules. They spend a great deal of time and energy in planning, but their perfectionism may keep them from actually accomplishing tasks. People with OCPD have an eye for detail and their need to be perfect in each and every aspect pushes them to control every facet of their environment. They can micromanage people despite resistance. They strongly believe in going by the book and also that rules, processes and procedures are meant to be followed and any deviation from them would result in producing imperfect work. This behavior is diagnostic Criterion 1 for OCPD in the Diagnostic and Statistical Manual of Mental Disorders, 5th edition (DSM-V).

Observe how the person makes decisions and completes tasks. Indecisiveness and an inability to complete tasks are hallmarks of people with OCPD. Because of their perfectionism, a person with OCPD has a strong urge to exercise caution in trying to decide what, when, and how things need to be done. They will often research the most minute of the details irrespective of relevance to the decisions at hand. People with OCPD are extremely averse to impulsivity or risk-taking. This difficulty with decisions and tasks extends even to very small things. Precious time is lost in weighing the pros and cons of each proposition, no matter how minor. The emphasis on perfection also causes people with OCPD to perform tasks repetitively; for example, a person might proofread a document for work 30 times and thus fail to get it in on time. This repetition and the person’s unreasonably high standards often cause dysfunction for them in the workplace. This behavior is diagnostic Criterion 2 for OCPD in the Diagnostic and Statistical Manual of Mental Disorders, 5th edition (DSM-V).

Consider how the person interacts in social situations. People with OCPD can often come across to others as “cold” or “heartless” because of their focus on productivity and perfection, to the exclusion of things like social and romantic relationships. When a person with OCPD does go on a social outing, they will generally not appear to enjoy it, instead worrying about how it could be done better or that they are “wasting time” having fun People with OCPD may also make others uncomfortable during social events because of their focus on rules and perfection. For example, a person with OCPD might become extremely frustrated by “house rules” in Monopoly because they are not the written “official” rules. The person might refuse to play, or spend a lot of time criticizing others’ play or seeking ways to improve it. This behavior is diagnostic Criterion 3 for OCPD in the Diagnostic and Statistical Manual of Mental Disorders, 5th edition (DSM-V).

Observe the person’s sense of morality and ethics. An individual with OCPD is excessively concerned about morals, ethics and what is right and wrong. They are excessively concerned about doing the “right thing” and has very rigid definitions of what that means, with no room for relativity or mistakes. They are constantly worried about any rules they might have broken or which they might have to break. They are usually extremely deferential to authority and will comply with all rules and regulations, no matter how insignificant they may seem. People with OCPD extend their concepts of morality and values to others. It is unlikely for a person with OCPD to accept that another person, for example from a different culture, could have a sense of morality if it is different from their own. People with OCPD are often harsh on themselves as well as others. They may see even minor mistakes and infractions as moral failures. “Extenuating circumstances” do not exist for people with OCPD. This behavior is diagnostic Criterion 4 for OCPD in the Diagnostic and Statistical Manual of Mental Disorders, 5th edition (DSM-V).

Look for hoarding behavior. Hoarding is a classic symptom of Obsessive-Compulsive Disorder, but it can also affect people with OCPD. A person with OCPD may refrain from disposing of even those items that are useless or are of little or no worth. They may hoard with an intention that there is nothing that is of no use: “You never know when this might come in handy!” This goes from old, leftover food to receipts to plastic spoons to dead batteries. If the person could imagine that there could ever be a reason it might be useful, it stays. Hoarders truly value their “treasure” and any attempts by others to disturb their collection greatly annoys them. The inability of others to understand the benefits of hoarding surprises them. Hoarding is very different from collecting. Collectors get enjoyment and pleasure out of the things they collect, and they don’t experience anxiety about getting rid of worn-out, useless, or unneeded items. Hoarders generally feel anxiety about discarding anything, even if it is no longer functioning (like a broken iPod). This behavior is diagnostic Criterion 5 for OCPD in the Diagnostic and Statistical Manual of Mental Disorders, 5th edition (DSM-V).

Look for trouble delegating responsibility. People with OCPD are often perceived as “control freaks.” They find it very hard to delegate responsibility for a task to others, because the task might not be performed in the way they believe it should be. If they do delegate tasks, they will often provide an exhaustive list of instructions on how to perform even simple tasks like loading the dishwasher. People with OCPD will often criticise or attempt to “correct” others who are doing a task in a way other than they themselves would do it, even if the other technique is effective or makes no difference to the final result. They do not like to have others suggest different ways of doing things, and may react with surprise and anger if this happens. This behavior is diagnostic Criterion 6 for OCPD in the Diagnostic and Statistical Manual of Mental Disorders, 5th edition (DSM-V).

Observe the person’s spending behaviors. People with OCPD not only have trouble getting rid of useless things, they also are perpetually “saving for a rainy day.” They are usually reluctant to spend money even on necessities because they are worried about saving for a future catastrophe. They may live well below their means, or even in a standard of living that is lower than is healthy, in an attempt to save money. This also means that they cannot even part from money by giving it to somebody in need. They will usually attempt to dissuade others from spending money too. This behavior is diagnostic Criterion 7 for OCPD in the Diagnostic and Statistical Manual of Mental Disorders, 5th edition (DSM-V).

Consider how stubborn the person is. People with OCPD are extremely stubborn and inflexible. They do not like and cannot take people questioning them, their intentions, actions, behaviors, ideas and beliefs. For them, they are always on the right side and there is no alternative to what they do and how they do things. Whoever they feel opposes them and fails to submit to their dominance is not cooperative and responsible. This stubbornness often makes even close friends and family unhappy to interact with the person. An individual with OCPD will not accept questioning or suggestions even from loved ones. This behavior is diagnostic Criterion 8 for OCPD in the Diagnostic and Statistical Manual of Mental Disorders, 5th edition (DSM-V).

Recognizing OCPD in Relationships

Look for friction. People with OCPD do not restrain themselves from imposing their ideas and views on others, even in situations where most other people would consider such behavior inappropriate. The idea that this kind of attitude and behavior could upset people and lead to friction in relationships often does not occur to them, nor will it stop them from doing what they intend to do. A person with OCPD is not likely to feel guilty when crossing the boundaries even if it means monitoring, controlling, meddling and intruding into other people’s lives so that there is perfection and order in everything. They get upset, angry and depressed if other people are not following their directions. They may become angry or frustrated if it seems like people are not aligned with them in their effort to bring everything under control and to make everything perfect.

Look for work-life imbalance. People with OCPD generally spend a considerable part of their waking hours at work—and they do it by choice. They are hardly left with any time for leisure. Their leisure time, if any, is spent on trying to “improve” things. Because of this, the person may not have many (or any) friendships. If a person with OCPD tries to spend their leisure time on a hobby or some activity such as painting or some sports such as tennis, they do not paint or play for the fun of it. They are constantly in the pursuit to master the art or the game. They will apply the same theory to family members and expect them to set out on a pursuit to excel rather than trying to have fun. This interference and meddling gets on the nerves of the people around them. This not only ruins the leisure time but can cause damage to relationships.

Observe how the person displays emotion to others. For most people with OCPD, emotions are a waste of precious time that could be otherwise used in their quest for perfection. They are generally very tight-lipped when comes to expressing or displaying feelings. This reticence is also due to a worry that any expression of emotion must be perfect; a person with OCPD will wait for an extremely long time to say anything to do with feelings in order to make sure that it is “just right.” People with OCPD may come across as stilted or overly formal when they try to display their feelings. For example, they may try to shake hands when the other person goes in for a hug, or use overly stiff language in an effort to be “correct.”

Consider how the person responds to emotions in others. People with OCPD not only have trouble expressing emotion, they also have difficulty tolerating its presence in others. People with OCPD may visibly display discomfort in a situation where people are emotional (such as at a sporting event or family reunion). For example, most people would likely consider greeting a friend whom they haven’t seen in awhile as an exciting, emotional experience. A person with OCPD may not experience it this way, and might not even smile or offer a hug. They may seem to feel “above” emotions and look down on people who display them as “irrational” or inferior.

Recognizing OCPD in the Workplace

Consider the person’s work schedule. Satisfying people with OCPD through their work is a herculean task, let alone impressing them. They are the definition of workaholics, but workaholics who make things difficult for others at work. People with OCPD see themselves as loyal and responsible workers and put in long hours at work, even though those hours are often unproductive. This behavior is a usual practice for them and they expect all other employees in the company to follow suit. In general, people with OCPD put in long hours at work but are very poor role models. They have an inability to set a good precedent for people working under them and with them. They are more task-oriented and fewer people (relationship) oriented. They cannot strike a balance between tasks and relationship. They often fail at encouraging people to follow them and their directions. It’s important to acknowledge that some cultures place a very high value on working long hours or spending most of one’s time at work. This is not the same as OCPD. For individuals with OCPD, it is not a compulsion to work, but a willingness to work.

Watch interactions with others. People with OCPD are rigid and stubborn in how they approach situations, including those with colleagues or employees. They may be “over involved” in the personal lives of their coworkers and do not allow room for personal space or boundaries. They will also assume that the way they behave at work is the way everyone should behave. For example, a manager with OCPD might deny an employee’s request for personal leave because they would not take leave for the reason given. They might believe that the employee’s first loyalty should be to the company, rather than any other obligation (including family). People with OCPD do not consider that something could be wrong with them and their way of functioning. They view themselves as the epitome of perfection and order; if this attitude irks somebody then it is because they are not dependable and does not believe in working for the welfare of the organization.

Watch for signs of interference. People with OCPD feel that others are not aware of how to do things in a better manner. According to them, theirs is the only way and the best way to do things. Collaboration and cooperation are not valued. A person with OCPD is likely to be a “micromanager” or a terrible “team player,” as they will generally try to force everyone to do things their way. A person with OCPD is not comfortable with letting others do the job their way lest they make mistakes. They are generally reluctant to delegate responsibilities and will micromanage others if they must delegate. Their attitude and behavior convey the message that they do not trust others and does not have confidence in them and their abilities.

Look for missed deadlines. Very frequently, people with OCPD get so caught up in the pursuit of perfection that they miss deadlines, even important ones. They have a lot of difficulty with effective time management because of their compulsive attention to every single minor detail. Over a period of time their nature, fixations and attitude gives rise to dysfunctional conflicts which push them into isolation as more people tend to express their displeasure at working with them. Their intractable attitude and perception of themselves complicates things at work and can go to the extent of pushing peers/subordinates away from them. When they lose the support system, they become even more adamant about proving to the others that there is no alternative to how they do things. This can further alienate them.

Seeking Treatment

See a mental health professional. Only a trained mental health professional can diagnose and treat people with OCPD. Fortunately, treatment for OCPD is generally more effective than it is for other personality disorders. An appropriate mental health professional would be a psychologist or psychiatrist; most family doctors and general practitioners do not have the training to recognize OCPD.

Participate in therapy. Talk therapy, and particularly Cognitive Behavioral Therapy (CBT), is usually considered to be a highly effective treatment for people with OCPD. CBT is done by a trained mental health professional, and involves teaching the person how to recognize and change unhelpful ways of thinking and behaving.

Ask your doctor about medication. In most cases, therapy is sufficient to treat OCPD. In some cases, your physician or psychiatrist may also recommend a medication such as Prozac, a selective serotonin reuptake inhibitor (SSRI).

Understanding the Disorder

Learn what OCPD is. OCPD is also called anankastic personality disorder (depending on where you live in the world). As the name suggests, it is a personality disorder. A personality disorder is where there is ongoing maladaptive patterns of thinking, behaviours and experiences that transcend different contexts and significantly affect much of the person’s life. As such with OCPD, there is a preoccupation with the need for power and control over one’s own environment. These symptoms must involve a pervasive pattern of a preoccupation with orderliness, perfectionism, interpersonal and psychological control. Such control must come at the expense of efficiency, openness and flexibility as there is a strong level of rigidity in one’s beliefs that often interferes with the ability to complete tasks.

Distinguish between OCPD and Obsessive Compulsive Disorder. OCPD is a completely different diagnosis from obsessive compulsive disorder (OCD), although it shares some of the same symptoms. An obsession, as the name suggests, means the individual’s thoughts and feelings are completely dominated by a persistent idea. This, for example, could be cleanliness, security or many other things that have significant meaning to the individual. A compulsion involves performing an action repeatedly and persistently without leading to a reward or pleasure. These acts are often performed to make the obsessions go away, such as repeatedly washing one’s hands due to an obsession with cleanliness or repeatedly checking one’s door is locked 32 times due to an obsession that if this does not occur, someone may break in. Obsessive compulsive disorder is an anxiety disorder involving intrusive obsessions that must be addressed through acting out on compulsive behaviours. People who suffer from OCD often recognize that their obsessions are illogical or irrational but feel like they cannot avoid them. People with OCPD, which is a personality disorder, often do not recognize their thoughts or pervasive need for inflexible control of all areas of their lives as irrational or problematic.

Recognize the diagnostic criteria for OCPD. The Diagnostic and Statistical Manual of Mental Disorders, 5th edition (DSM-V) states that in order to have the diagnosis of OCPD, the patient needs to have four or more of the following symptoms present in a variety of contexts that interferes with the individual's life: 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 their 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 their way of doing things Adopts a miserly spending style toward both self and others; money is viewed as something to be hoarded for future catastrophes Shows significant rigidity and stubbornness

Recognize the anankastic personality disorder criteria. Similarly, the World Health Organisation’s International Classification of Disease 10 specifies that the patient must satisfy the general diagnostic criteria for a personality disorder (as mentioned above) and have three of the following symptoms to be diagnosed with anankastic personality disorder: Feelings of excessive doubt and caution; Preoccupation with details, rules, lists, order, organization or schedule; Perfectionism that interferes with task completion; Excessive conscientiousness, scrupulousness, and undue preoccupation with productivity to the exclusion of pleasure and interpersonal relationships; Excessive pedantry and adherence to social conventions; Rigidity and stubbornness; Unreasonable insistence by the individual that others submit exactly to their way of doing things, or unreasonable reluctance to allow others to do things; Intrusion of insistent and unwelcome thoughts or impulses.

Know some risk factors of OCPD. OCPD is one of the most common personality disorders; the DSM-V estimates that between 2.1-7.9% of the general population suffer from OCPD. It also appears to run in families, so OCPD may have a genetic component. Men are about twice as likely to have OCPD as women. Children who grew up in controlling, rigid homes or environments may be more likely to develop OCPD. Children who grew up with parents who were too stern and disapproving or overly protective may be more likely to develop OCPD. 70% of people with OCPD also suffer from depression. About 25-50% of people with OCD also have OCPD.