People with obsessive-compulsive personality disorder do not necessarily have the more commonly discussed obsessive-compulsive disorder (OCD), although many individuals think the two conditions are the same. Those with obsessive-compulsive personality disorder (OCPD) generally have an inflexible pattern of thinking, feeling, and behaving, whereas those with obsessive-compulsive disorder have obsessions (recurrent, persistent thoughts) and compulsions (repetitive behaviors).
Sound confusing? Michael's story is fairly typical of OCPD. By 25, Michael had established his career as a dancer in a modern troupe. He diligently practiced dancing every evening without missing a night. By day he worked as a waiter in a café. His co-workers knew he was finicky and they often teased him about not being able to touch leftovers on customers' plates. Sometimes Michael would even pick up used dishes with napkins, fearing that he would be contaminated otherwise.
He had many feather pillows around his apartment. Standard ones lined his bed, designer ones were in the living room on his couch, and a big red one was on a mat that he used to work out. After a hard day at the restaurant and stressful night of practice he'd come home, stretch out somewhere, and happily grab a pillow to put under his head. His hands would keep moving over the pillow until he found feathers to crack.
Michael had the opportunity to become a lead dancer in a show that his troupe was putting on in the fall. He doubled his practice time, reduced his hours at the restaurant and tried to lose even more weight. He was already quite fit, but he knew that the artistic director of the troupe liked his male dancers to look almost anorexic. Everyone told him to take it easy, complaining that he looked too gaunt and seemed to be straining himself. Michael ignored them. He slept only four hours a night to squeeze in more practice time and ate even less. He began to realize that something was, in fact, wrong when he found himself compelled to align the pillows perfectly on his bed and couch before he could fall asleep. Then he found it necessary to balance all his pillows.
He explained his problems to his weekly psychotherapy group, which he had considered eliminating to save time. The other group members asked him if snapping the feathers and balancing his pillows gave him a sexual sensation. Michael said no. He told them that he'd been cracking feathers since childhood, but the balancing compulsion was new. They were sympathetic and tried to offer suggestions to help. Afterward, the social worker who led the group took Michael aside and recommended a psychiatrist. When Michael consulted the doctor, he was given a diagnosis of obsessive-compulsive personality disorder.
The doctor was able to identify Michael's problem primarily because he recognized the following eight traits, which are often evident to friends and family who live with someone with OCPD.
1. A preoccupation with details, rules, and schedules to the point in which any joy in the activity is lost. If two pillows were on one side of Michael's couch, then two would have to be on the other side. He couldn't rest if he didn't do this. In addition, he would sit for more than an hour and crack the feathers in his pillows, whereas earlier in his (arguably less stressful) life, he'd only spent a few minutes. The time wasted on this compulsion angered and distressed him, but he found he couldn't stop.
2. A sense of perfectionism that interferes with getting tasks accomplished. In Michael's case, he wanted to put gloves on when he worked as a waiter, but he knew he would be mocked by other employees if he did that. Many times he took twice as long as the other waiters to clear tables, but he wouldn't let anyone help him.
3. Friends and family members play a second or tertiary role in life. A patient of mine called Emily was so involved in her fledgling photography career that her family and friendships were not considered important. Like Michael, if friends or family members wanted to visit or suggested going out, she would put them off -- to the extent that she became reclusive. As a result, people with OCPD typically have few friends and their family often disregards them.
4. Excessive rigidity and stubbornness. If the director told Michael to stretch his leg in a certain way, Michael would do it exactly as he was told, even if it was painful or inappropriate for the dance.
5. Over-conscientiousness and inflexibility about his or her values. Emily, the patient mentioned above, would attend church every Sunday and expect everyone else to do the same, whether or not it was part of their belief system.
6. He or she resembles a hoarder. In Michael's case, since he had trouble throwing anything out, some of his pillows dated back to his childhood
7. The person often can't let others work for him or her because they often don't meet his or her standards. Even though they needed help in their respective jobs, both Michael and Emily couldn't let others work for them because they didn't meet their exacting -- and often unrealistic -- standards.
8. An unhealthy use of money -- often excessively hoarding money or being miserly. Michael had packets of money stashed around his apartment that he never used even when he needed it.
When Michael was compelled to pick on the feathers of his pillow for an hour, he was bordering on having obsessive-compulsive disorder (OCD). However, with the psychiatrist's help and group therapy, Michael was able to limit his feather-picking and eventually become more social and less rigid in his thinking and behavior. People with OCD are usually not able to stop themselves so easily from their compulsions or obsessions without medications or extensive behavioral therapy, which is another clue to their difference.
If someone you know or love displays traits such as those that Michael or Emily did, then please encourage them to get help either with individual psychotherapy or group therapy. It will make all the difference in the world to that person and everyone around him.