Understanding OCD and OCPD

​Understanding OCD and OCPD
 
While people are familiar with obsessive-compulsive disorder (OCD), in my experience, it is often misunderstood. Some people might say, “Oh, I am just a bit OCD about this,” or suggest that they have OCD because they often clean their house. These types of statements often refer to behavior that could be more closely associated with obsessive-compulsive personality disorder (OCPD).
 
To help distinguish between OCD and OCPD, and to increase understanding of OCD in general, I will share some passages directly from the DSM-5-TR from the American Psychiatric Association. “OCD is characterized by the presence of and/or compulsions” (APA, 2022, p. 263). “Obsessions are recurrent and persistent thoughts, urges, or images that are experienced as intrusive and unwanted, whereas compulsions are repetitive behaviors or mental acts that an individual feels driven to perform in response to an obsession or according to rules that must be applied rigidly” (APA, 2022, p. 263). It is important to note that while most cases of OCD have both obsessions and compulsions, it is possible to have just obsessions or just compulsions (APA, 2022).
 
Here, I will provide a few examples and explain how obsessions and compulsions differ from typical preoccupations. Take the example of a person touching a potentially dirty public surface. Someone without OCD would likely wash their hands or use hand sanitizer and then proceed with their day. However, for someone who does have OCD, they will feel extreme anxiety, and their obsession might be the idea that there are deadly germs on one’s hand after touching that dirty surface, and that death is the likely outcome if nothing is done. Not only will a person with OCD experience distress about this possibility, but they will also attempt to suppress the obsession or resolve it by performing a compulsion (APA, 2022). In this case, a compulsion might be washing one’s hands exactly 5 times before continuing with the day. This ritual will likely be repeated whenever a dirty surface is touched or an obsessive thought occurs, which makes it easy to imagine how this might negatively affect an individual’s daily experience.
 
In contrast, Obsessive-Compulsive Personality Disorder (OCPD) is characterized by a “pervasive pattern of preoccupation with orderliness, perfectionism, and mental and interpersonal control, at the expense of flexibility, openness, and efficiency” (APA, 2022, p. 771). People with OCPD do not experience obsessions or compulsions and are instead merely preoccupied with being orderly, perfect, and mentally and socially in control (APA, 2022). People with OCPD are often labeled as “control freaks,” “high-strung,” or “bossy.” While individuals with OCPD also face challenges due to their preoccupations, it is not to the extreme levels seen in OCD, and it is generally not as distressing (APA, 2022). An example of an OCPD preoccupation might be doing too much research into a simple or inexpensive purchase, leading to the purchase never being made (APA, 2022). Some might call this “decision paralysis.” One last factor to note is that research shows that the majority of individuals with OCD do not meet criteria for OCPD (APA, 2022). So, while they share traits and have similar names, they are quite different.
 
Unlike my other blogs in this series, I am not going to offer any try-at-home tips for OCD or OCPD due to the unique challenges that come with these disorders. The most evidence-based treatment method for OCD is a desensitization program (whether systematic or flooding), which should be done with the assistance of a qualified mental health provider. Attempting to do desensitization on one’s own can lead to the opposite effect, known as sensitization, which can make obsessions and compulsions more extreme. I advise that if you are concerned about OCD, you seek out a mental health provider. OCPD and personality disorders in general are very difficult to treat on one’s own and see the best results when treated by mental health providers. So again, if you are concerned about OCPD, you should seek out a mental health provider.
 
Works Cited
American Psychiatric Association. (2022). Diagnostic and statistical manual of mental disorders (5th ed., text rev.). American Psychiatric Association.