- Living with Someone Who Has Obsessive Compulsive Personality Disorder
- A Dangerous Cult
- My OCPD Husband Can't Tolerate My 'flaws'
- How Our Helpline Works
- Interpersonal Functioning in Obsessive-Compulsive Personality Disorder
In addition, we found that individuals with OCPD, with and without OCD, also reported high levels of personal distress as compared to healthy controls. Personal distress on the IRI measures a more self-oriented aspect of empathy, feelings of personal anxiety and unease in tense, difficult interpersonal relationships. Interestingly, individuals with pure OCPD reported higher levels of fantasy on the IRI, which involves the tendency to transpose themselves imaginatively into the feelings and actions of fictional characters.
The fantasy subscale of the IRI encompasses cognitive empathy, which is considered to be a more intellectualized reaction to others rather than an emotional reaction Davis, , thus it is likely that OCPD individuals use a more cognitive, intellectualized style to cope with interpersonal situations by escaping into fantasy rather than taking another's perspective McWilliams, Our findings showing that OCPD individuals report an interpersonal profile that is controlling, hostile, sensitive to interpersonally warm behavior by others, and low on perspective taking is consistent with the research on systemizing.
In fact, Hummelen et al. However, contrary to our expectations, individuals with OCPD, with and without comorbid OCD, did not report more systemizing than healthy controls. We did find that men in the OCPD group reported more systemizing than women in the OCPD group, which is line with previous research showing higher rates of systematizing in males Baron-Cohen et al.
One possible explanation for our findings may be that the interpersonal control and dominance associated with OCPD may manifest in different ways in males and females. In OCPD males, interpersonal control may be more related to deriving rules, analyzing, and making predictions about another's behavior, which is consistent with increased systemizing. As this is the first study to assess systemizing in OCPD, further research is needed on this interpersonal dimension.
Despite evidence showing individuals diagnosed with OCPD frequently seek individual psychotherapy Bender et al.
The current study suggests that targeting the interpersonal profile associated with OCPD may offer a useful avenue for developing treatment interventions for this clinical population. In particular, we found that individuals with OCPD report hostile dominant interpersonal problems. This is consistent with previous research investigating the interpersonal style associated with maladaptive perfectionism, a hallmark symptom of OCPD.
In the depression treatment literature, perfectionism has also been shown to impede successful treatment regardless of modality Blatt, ; Blatt et al. Our current results combined with previous research suggest the importance of designing treatment interventions tailored to target the interpersonal hostility and dominance associated with OCPD, such as skills training to promote emotional awareness and relationship flexibility.
We also found that individuals with OCPD may be able to experience empathic concern for others, but lack the skills to appropriately respond to or fully understand the affective experience of another person low perspective taking. Treatment interventions aimed to increase perspective taking and the capacity to respond to emotion in a fluid and appropriate manner may improve treatment outcome for this population Dimaggio et al.
Similarly, in the current study, individuals with OCPD seemed to report higher use of intellectualized coping strategies when faced with interpersonal situations high fantasy on the IRI. Interventions aimed at reducing this reliance on intellectualization as a coping skill may also improve treatment outcome for OCPD individuals.
Finally, we found that OCPD individuals, with and without OCD, reported increased sensitivity to interpersonal warmth enacted by others, which may also have implications for psychotherapy. It is quite possible based on our results that a patient with OCPD may become frustrated, irritated, or even angry by any perception of interpersonal warmth by the therapist, which will in turn inhibit the development of the therapeutic alliance.
Through a thorough understanding of interpersonal functioning in OCPD, the therapist can begin to anticipate and predict the effects of therapeutic behaviors on the OCPD patient in order to facilitate a working alliance and improve treatment outcome Tracey, The current study and its conclusions have several limitations. Second, our findings may not generalize to OCPD individuals who do not respond to advertisements for research or who refuse to participate in research.
While this is consistent with previous research e. Finally, our outcome data is limited by its reliance on self-report data. Future studies should include informant ratings e. In conclusion, this study provided the necessary first step toward clarifying interpersonal functioning in OCPD. Overall, our results suggest that interpersonal deficits are an important feature of OCPD pathology, consistent with the greater emphasis on interpersonal dysfunction in the DSM5 proposed model for personality disorders included in section 3 of the DSM5.
Finally, this study points to new treatment directions for OCPD. Interventions tailored to target the interpersonal profile of OCPD may be beneficial, such as skills-based approaches to increase perspective taking and the capacity for understanding and responding to emotion. National Center for Biotechnology Information , U.
Living with Someone Who Has Obsessive Compulsive Personality Disorder
Author manuscript; available in PMC Jan 1. Cain , a Emily B. Ansell , b H. Blair Simpson , c, d and Anthony Pinto c, d. Author information Copyright and License information Disclaimer. Address correspondence to Nicole M. See other articles in PMC that cite the published article. Abstract The core symptoms of obsessive-compulsive personality disorder OCPD often lead to interpersonal difficulties.
Open in a separate window. Procedures The institutional review board approved the study and participants provided written informed consent before testing. An example of a circumplex structural summary. Results Demographic and clinical characteristics for the three groups are presented in Table 1. Comparisons on Empathy and Systemizing Between Groups We then compared the three groups on the subscales of the IRI to investigate differences in perspective taking, fantasy, empathic concern, and personal distress while controlling for gender Table 3.
A Dangerous Cult
Discussion The current study represents an important first step in understanding interpersonal functioning in OCPD by systematically examining measures of interpersonal problems, interpersonal sensitivities, empathy, and systemizing in a clinical sample with a principal diagnosis of OCPD, with and without comorbid OCD. Limitations and Future Directions The current study and its conclusions have several limitations. The relationship between restrictive and repetitive behaviors in individuals with autism and obsessive compulsive symptoms in parents.
Child Psychiatry and Human Development. Construction of circumplex scales for the Inventory of Interpersonal Problems. Journal of Personality Assessment. Canadian Journal of Psychiatry. The prevalence and structure of obsessive-compulsive personality disorder in Hispanic psychiatric outpatients. Journal of Behavior Therapy and Experimental Psychiatry. The hyper-systemizing, assortative mating theory of autism. Prog Neuropsychopharmacol Biol Psychiatry. The Systemizing Quotient SQ: An investigation of adults with Asperger syndrome or high functioning autism and normal sex differences.
Phil Trans Royal Soc. Treatment utilization by patients with personality disorders. American Journal of Psychiatry.
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The destructiveness of perfectionism: Implications for the treatment of depression. When and how perfectionism impedes the brief treatment of depression: Journal of Consulting and Clinical Psychology. Interpersonal subtypes in social phobia: Diagnostic and treatment implications. A multidimensional approach to individual differences in empathy.
My OCPD Husband Can't Tolerate My 'flaws'
Measuring individual differences in empathy: Evidence for a multidimensional approach. Journal of Personality and Social Psychology.
Progressively promoting metacognition in a case of obsessive-compulsive personality disorder treated with metacognitive interpersonal therapy. Theory, Research, and Practice. American Psychiatric Press; Empathy and symptoms dimensions of patients with obsessive-compulsive disorder. 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. 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. This indecisiveness can have devastating effects on academic, professional and interpersonal relationships. From early adolescence, through college, perfectionism can take an otherwise straight "A" student and bring him to the brink of failure due to incomplete assignments.
Having to get the term paper exactly correct makes for an almost impossible task. An extremely difficult time making decisions always looking for the correct choice contributes to procrastination. Frequently even starting a task seems impossible, due to a need to sort out the priorities correctly. If it takes an hour to complete the first paragraph of a report, because revision after revision never seems to get it perfect, imagine the anguish experienced when contemplating the completion of a two thousand word essay.
The time it could take to complete a ten page report might be multiplied by five due to checking or rewording so that it is just so. Imagine a college student who has to choose a major and in doing so be convinced that she is completely correct in her choice. The expression of this, "need", to have a perfect academic fit is seen in some students having multiple majors during their four year stint.
Changing colleges, due to emerging complications and disillusionment, is also a possible manifestation of OCPD. 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. 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. 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.
- Daniel A. Bochner, Ph.D. - Obsessive Compulsive Personality Disorder.
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- 12 Ways Life Can be Difficult Living with Someone with OCPD?
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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 becomes 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 humor often mistaken for seriousness. Jokes or sarcasm seen by the deliverer as obvious are mistaken for insults and political incorrectness. 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.
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. 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. Accompanying Rituals Common rituals, which accompany the OCP syndrome typically, involve 1 perfectionism, 2 hoarding, and 3 ordering. Perfectionism as expressed by the OCPD is not the admirable quality often sought by the world at large.
As a ritualistic aspect of this condition the OCP perfectionism entails checking and rechecking "completed" tasks to be absolutely sure that there are no imperfections. It could literally take upwards of 10 to 20 minutes to fill out a check or mail an envelope due to a rigid need to ensure that there are absolutely no mistakes. It is as if, to make a mistake which might be noticed would ruin ones reputation for life. Perfectionism could also take the form of a need for over completeness -- reading and rereading material until a sense of absolute clarity exists. Not only is it extremely time consuming but the overall content of the story is lost.
The forest is missed while examining each leaf, of each branch, of each tree. This disposition can also have an adverse impact on one's conversational style. In the course of a conversation sometimes information is sought which involves such minutiae that the questioned person becomes lost and frustrated. Slight inconsistencies or mistakes, within another's conversation, are often perceived by the OCPD sufferer. These details, no matter how peripheral to the conversation, must be brought out into the open and clarity must be achieved.
In some cases the corporate environment rewards a person's perfectionism.
It is not uncommon for persons with OCPD to reach high levels on the corporate masthead because their productivity was not sufficiently impaired while their high standards seemed to reflect the company's dedication for quality. How often do we find subordinates complaining about the tyrant at the top? But more on this subject latter. Occasionally the OCPD sufferer may acknowledge that other ideas are also functionally correct, but then go off and spend a great deal of time and effort at coming up with an even more correct idea.
How Our Helpline Works
This effort may produce a modicum of improvement at the expense of efficiency and productivity. Hoarding involves the excessive saving or collecting of items typically thought of as junk , such that it intrudes on the quality of life for the hoarder or those living with such a person. In a significant percentage of cases, people lack the insight that they are behaving in an unhealthy manner. When persons are not cognizant of the irrational nature of this condition it is referred to as overvalued ideation ego-syntonic OCD.
Typically this form of OCD involves a poor prognosis since the individual is rarely willing to confront the challenges offered by the treatment. This lack of willingness to see one's own culpability has a very adverse impact on the quality of life for those around her. Many hoarders, however, are well aware of the adverse impact of this condition and suffer tremendously as a consequence of seeing all free space within their living environment occupied. Renting extra storage space to pick up the overflow of ones own living environment is not uncommon.
Where hoarding is a component of OCPD, the justification for saving items typically involves one of the following rationales. In many instances there is a deep commitment related to the "sinfulness of waste. Maybe when she's a new parent the baby will be able to use these diapers. Throwing away four year old TV guides would cause a tremendous upheaval since Mom may want to see which program was on NBC 9: Another determinant for hoarding involves the endless projects on the "to do list.
The very fact that the obsessive compulsive has to prove their worth clearly demonstrates that they are not convinced of their own self-worth. The obsessive compulsive, however, does not truly rely on love from others for their self-esteem, as it may at first seem. Unlike other personality disorders in which there was no love for the individual's true self as a child - that is, their weaknesses, desires, need for independence, their natural born assertiveness or aggressiveness - the obsessive compulsive personality knows that those things have been accepted within them.
As opposed to feeling those things should not exist within them, the obsessive compulsive instead feels those things should never be allowed to harm their relationships. They have observed disdain and rigidity with respect to those aspects of themselves and have thus deemed those aspects harmful. The obsessive compulsive thus aims to control these harmful emotions by doing things "right" or by "being good.
The control obsessive compulsives maintain over their very human attributes does not require wholesale denial as it does in other personality types, but the rigidity that was once experienced as disapproval is now co-opted within the obsessive compulsive to ensure those traits are not expressed. The obsessive compulsive does not need love for those attributes. They do know they can be loved in spite of them. But because they are deemed to be harmful, the obsessive compulsive works diligently so these potentially harmful feelings will not be seen.
In that process, they become their own harshest critics. Instead of proving themselves to others, the obsessive compulsive aims to continually prove themselves to themselves. If they can be perfect enough, they believe, perhaps they will be beyond criticism. In the psyche of the obsessive compulsive, to be beyond criticism is to be worthy of unconditional love For the complete article, please buy The Emotional Toolbox book.
Interpersonal Functioning in Obsessive-Compulsive Personality Disorder
Because they tend to overlap quite a bit, they are often confused with one another. In this article, I discussed aspects of obsessive compulsive disorder to the extent that they are involved in the obsessive compulsive personality. That is, ritualistic cleaning or hand washing, counting, obsessing on particular thoughts, locking and re-locking doors, checking all sorts of things, buttoning and re-buttoning, etc Differentiating thee two issues is important because much of obsessive compulsive disorder is genetic, while obsessive compulsive personality may be related to genetic issues, but is more specifically related to a particular orientation to life.
Obsessive compulsive personality, and especially mere traits of obsessive compulsive personality, can have very little relation to genetics at all.