One study found that OCPD is the most common personality disorder followed by narcissistic and borderline personality disorders.
Learn the signs of obsessive-compulsive personality disorder.
Savvy Psychologist is hosted by Dr. Monica Johnson. A transcript is available at Simplecast.
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Ever since I started reviewing various mental health disorders, I’ve received so many warm responses from you all. Some of you spoke about how you have the disorder and you felt that my description was accurate and others approached me with even more questions. Either way, I love it and encourage you to reach out to me more! Because of all of your lovely questions, I am going to review another one called obsessive-compulsive personality disorder and you don’t want to miss it!
Welcome back to Savvy Psychologist. I'm your host, Dr. Monica Johnson. Every week on this show, I'll help you face life's challenges with evidence-based approaches, a sympathetic ear, and zero judgment.
The first thing I’ll get out of the way is that obsessive-compulsive personality disorder or OCPD is not the same thing as obsessive-compulsive disorder or OCD. If you have questions about OCD or want to do a comparison of the two, I encourage you to listen or relisten to my episode on OCD.
In terms of the prevalence of the disorder, a review of five epidemiological studies (three of which are in the United States) found a median prevalence rate of 4.7%. However, I have seen ranges from 2.4% to 7.9% depending on the study. One study found that OCPD is the most common personality disorder followed by narcissistic and borderline personality disorders. Which is interesting because I rarely hear about OCPD in the media but narcissism and BPD are mentioned all the time! Given this information, it makes sense to me why so many of you who are diagnosed with OCPD reached out to me to talk about it.
I want to remind everyone that you shouldn’t self-diagnose and that if anything I state here seems to ring true for you, please get evaluated by a mental health professional to ensure that you can get an accurate diagnosis and talk about treatment options. Additionally, while I review the criteria that make up this diagnosis, remember that anyone may suffer from one or two of these issues and that doesn’t mean they have OCPD. Any combination of these symptoms can be present in a person, meaning that the disorder can look different depending on the person and their individual differences (e.g. racial and ethnic background, gender, nationality, etc.).
That being said, we turn back to our trusty DSM-TR! The fundamental feature of OCPD is a preoccupation with perfectionism, orderliness, and mental and interpersonal control, at the expense of flexibility, openness, and efficiency. As with all personality disorders, this pattern begins by early adulthood and is present in a variety of contexts.
The first criterion of OCPD is a preoccupation with details, rules, order, organization, lists, or schedules to the extent that the major point of the activity is lost. Typically individuals with OCPD attempt to maintain a sense of control through these behaviors. Consequently, they can overfocus on trivial details, lists, or procedures to the extent that they’re missing the point of why they’re doing the activity in the first place. They can be excessively cautious and prone to repetition in an effort to avoid mistakes. In fact, they can check for mistakes so much that they lose track of time.
For example, someone with OCPD can get so stuck in the minutiae or so hung up on the fact that they misplaced a to-do list that they would rather focus on this than find an alternative solution so they can focus on the task at hand. The alternative solution could be something as simple as taking 5 minutes to jot down what you remember from your previous list and trying to move forward. Those with OCPD can be so preoccupied that they will dismiss the annoyance of other people in regard to these habits because they preferentially respond to either their anxiety about making a mistake or their rules about how a task should be done.
The second criterion is showing perfectionism that interferes with task completion. For example, they may be unable to complete a project because their overly strict standards are not met. Additionally, they tend to be excessively devoted to productivity and work at the expense of leisure activities and personal relationships. It’s not uncommon for them to feel like they don’t have time to take a day off. They may keep postponing a vacation or other pleasurable activities. Even if they do participate in a vacation, they may feel highly uncomfortable about going without taking work with them so that they don’t “waste time.” They may take household chores seriously and like to have their homes so clean that you could “eat off the floor.” In terms of interpersonal relationships, they may be more likely to engage in a formal activity like sports vs open-ended hanging out.
Those with OCPD may force themselves or others to follow rigid moral principles or extremely strict and high standards of performance. This is because they can be excessively scrupulous, conscientious, and inflexible about matters of morality, values, or ethics. In fact, they can be ruthlessly judgmental of others and self-critical of themselves for any moral or ethical missteps. They are often rigidly deferential to rules and authority and will insist on compliance to the letter with no exception.
To give an example, let’s say your friend is a waiter at a restaurant and you go there for your 32nd birthday because they have great pasta and wine. In all the excitement, you forget your ID and want to get an alcoholic beverage. Your friend—who is also your waiter—denies getting you the beverage because you don’t have ID. This is despite the fact that they know you are of legal drinking age, that it’s your birthday, that you’ve been friends with them for 10 years, and that there will be zero negative consequences for either party.
Individuals with OCPD are unable to throw out old or worthless items even when they have no sentimental value and can sometimes be described as a “pack rat.” You know that person that is holding on to those old RCA red, yellow, and white cables like we’re all going to suddenly go back in time and start watching VHS or laserdiscs again? Not that laserdiscs were ever really a thing. But in all seriousness, they tend to get hung up on this idea that “you never know” when you’ll need this obviously defunct or worn-out item.
Another feature of OCPD is a reluctance to delegate tasks to others. They stubbornly insist that everything be done their way and that people conform to their way of doing things. They may provide excruciatingly detailed instructions on how to mow their lawn, wash dishes, or scoop the litter box and can have the tendency to micromanage even the most basic of tasks. They are often not open to alternative suggestions for how to complete a task and may reject offers for help even when they are incredibly behind because they believe that no one else can do it right. The person with OCPD does not believe in the old adage that there is “more than one way to skin a cat.” At this point, it may go without saying that one criterion of OCPD is rigidity and stubbornness.
Lastly, those with OCPD may adopt a miserly spending style for themselves and others. This is because money can be seen as something to hoard for future catastrophes. I’ve done sessions with folks with OCPD who made 6-figure salaries, where we explored the pros/cons of spending $5 on an item because to them it seemed wasteful to spend money on something that related to leisure activity.
If you or someone you know may be suffering from OCPD, seek help because there are a variety of treatment options including CBT, DBT, and RO-DBT to name a few. These are all services that we offer at my practice and have seen individuals' symptoms improve. It can be incredibly difficult to exist day to day with OCPD due to the level of perfectionism, anxiety, fear, rigidity, and interpersonal difficulties that can arise from this personality disorder. I wish you well as you embark on your journey of self-discovery, self-acceptance, and self-evolution.
Had you heard about OCPD before this episode? Let me know on Instagram @kindmindpsych. You can also reach out to me via my email at psychologist@quickanddirtytips.com, or leave a voicemail at (929) 256-2191.