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Understanding the Symptoms of OCPD - Dental Health Medical Blog

Understanding the Symptoms of OCPD

If someone has a personality disorder, it means that their thoughts and actions differ in meaningful ways from what is considered normal in their culture (via PsychDB). Their questionable thought and behavior patterns typically show up in adolescence or young adulthood and remain steady over the course of their lives. These patterns also cause the person significant psychological distress or keep them from being effective at work or having healthy relationships. What distinguishes personality disorders from other psychiatric disorders is that the thoughts and behaviors are both inflexible and pervasive, meaning that they are consistent across all of their relationships and life contexts.

Obsessive-compulsive personality disorder (OCPD) is one of the most common personality disorders, according to a review in Personality and Mental Health. A review in Current Psychiatry Reports notes that it is estimated that between 3% and 8% of people in the general population have OCPD. According to The Diagnostic and Statistical Manual of Mental Health Disorders Fifth Edition (DSM-5), the symptoms that are at the core of OCPD are perfectionism and a strong desire for order and control — and all of this is at the expense of completing tasks, having healthy relationships, and being able to go with the flow (via PsychDB). OCPD occurs in both men and women but is more common in men (per Merck Manual). If you think you or a loved one might have OCPD, it is important to meet with a mental health professional for an assessment (via Psychology Today).

Poor performance despite perfectionism

Perfect-looking male and female coworkers

Uncompromising perfectionism was found to be a core trait of OCPD in a study published in Personality Disorders: Theory, Research, and Treatment. The word “perfectionist” is often used to describe someone who is conscientious and high-performing. Someone such as a straight-A student might have the optimal amount of perfectionism that motivates them to succeed. However, this is very different from the perfectionism in OCPD. An individual with OCPD sets such high standards that even they themselves cannot meet them (per Psychology Today). According to a review in Current Opinion in Psychiatry, this poor executive functioning, or trouble finishing tasks, may be caused by anomalies in brain functioning.

For someone with OCPD, delaying a task or having trouble completing it can also come from the inability to decide the “right” or “best” way to do it (per Psychology Today). In fact, a small study in CNS Spectrums found that those with OCPD initially spent more time thinking before starting the task compared to those without OCPD. Someone with OCPD can also get very engrossed in details, rules, and order, so much so that they lose sight of the bigger picture (per Merck Manual). In addition, someone with OCPD also has a hard time accepting constructive criticism because it leads them to feel attacked. To avoid criticism, or out of fear of failure, a person with OCPD may use extreme caution or spend an inordinate amount of time on decision-making, or may never come to a decision at all, according to a paper in BJPsych Bulletin. 

Lack of self-awareness

Woman yelling at partner

Unlike those with obsessive-compulsive disorder (OCD), people with OCPD lack self-awareness and an understanding of how they affect others (per McMaster University). According to the DSM-5, the compulsions and intrusive thoughts experienced by OCD are not wanted — and those with the condition are often significantly distressed by having these thoughts, or feeling as if they must perform their obsessive actions (via National Library of Medicine). Further, some people with OCD know that their thoughts and behavior are irrational.

In contrast, those with OCPD don’t think that there is anything wrong with them, but believe that others are the problem (per International OCD Foundation) and that their way of doing things is the only right way (via PsychDB). They may also tend to be very fixated on rules and procedures with which they are comfortable and believe to be correct (per International OCD Foundation). And they place their unreasonable high standards on others, which can lead the people in their lives to feel hurt or abused (via McMaster University).

Need for control

Man agitated at work

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People with OCPD have a high need for control, according to Psychology Today. They set the same perfectionistic standards for others that they set for themselves, and as you would expect, others can’t meet those standards. As a result, those with OCPD are often unwilling to delegate tasks to others. Or if they do, they insist on the person performing the task precisely as they instruct (via International OCD Foundation).

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This desire for control is not limited to the workplace — it occurs in personal relationships as well. According to Psychology Today, an intimate partner of someone with OCPD might feel judged by, and find it impossible to please, their partner. They might also find that their relationship lacks playfulness and spontaneity because the person with OCPD is so fixated on perfection and planning every little thing. Someone with OCPD can also get incredibly frustrated if even inconsequential things do not happen as planned, in turn causing a stressful situation for everyone in the household.  

Rigid thinking

"Wrong" and "right" blocks

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In general, people have a sense of right and wrong, and neuroscience has found areas of the brain that are involved in moral decision-making, according to an article in Frontiers for Young Minds. At the same time, most people also can understand that many moral dilemmas do not have clear-cut answers and instead fall in a gray area (per PennState). However, as an article in BJPsych Bulletin notes, those with OCPD tend to see everything in terms of black and white with no gray in between. As such, one possible DSM-5 criterion for OCPD is inflexibility when it comes to morality, ethics, and values — even within the context of their culture or religion (via PsychDB). According to an article in the Encyclopedia of Personality and Individual Differences, the term for this inflexible thinking is cognitive rigidity — and this is a central part of OCPD, per an article in CNS Spectrums. Someone with OCPD is not able to adapt their thought processes when given new information or when faced with a change in circumstances. They think only their perception and methods are correct — often with little or no evidence to back up these feelings (via BJPsych Bulletin). And as Psychology Today explains, a person with OCPD can also judge their partner based on very strict moral codes, adding to the strain in the relationship. 

Workaholic nature

Asian man working at night

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Perseverance is usually thought of as a positive characteristic to have. However, “workaholism” means poor work-life balance, or prioritizing work at the expense of all other parts of life such as relationships and physical and mental health (via Psychology Today). One study in Personality Disorders: Theory, Research, and Treatment found workaholism to be associated with OCPD. This can happen in a few ways. One is because the person does not like to delegate tasks to others, they put more unnecessary work on themselves (via Psychology Today). Another is that they can be micromanagers rather than trusting delegates to complete work properly. Or, their high, unrealistic standards can lead them to put more time into work than is needed.

A study in Biological Psychiatry suggests that those with OCPD have a very high tolerance for delayed gratification. This is high self-control, or the ability to give up short-term pleasures for a larger reward later (per Berkeley Well-being Institute). Tolerance for delayed gratification can be a good thing — the willingness to put in the work early on can set you up for long-term success, according to research in Frontiers in Psychology. However, extreme self-control can be as problematic as intense impulsivity, leading someone to overwork themselves without ever reaping any rewards like vacation or time with family (per Biological Psychiatry). 

Hoarding

Collection of blue pens

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According to the DSM-5, a person with OCPD will often hoard useless objects (via Merck Manual). Examples include pens that no longer write, or discarded pieces of paper (per Psychology Today). As a result, their home or workspace can be cluttered with things they don’t need. This might sound like hoarding disorder. However, unlike someone with OCPD, a person with hoarding disorder may be embarrassed by their behavior, according to psychologist Julie Pike, speaking to the American Psychological Association. Or for some individuals, hoarding can be a result of trauma, as a study in the Journal of Obsessive-Compulsive and Related Disorders found.

But why might someone with OCPD hoard? According to the American Psychiatric Association, hoarding behaviors have been found to be linked with perfectionism. As an example, the book “Obsessive-Compulsive Personality Disorder” includes a case vignette of a man who is a staunch believer that any amount of waste has negative effects on the environment. Thus, he saved as much as he could of items like plastic tubing if there was even the tiniest chance it could be reused. Rather than being embarrassed by this, he denied that his behavior was problematic even though it caused problems in his marriage.

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Hoarding money is also a symptom of OCPD, and it’s not done out of reasonable frugality (via PsychDB). Even if someone with OCPD is financially secure, they can hesitate to spend any money because they believe it should be saved for a future emergency or need (via Psychology Today). They might even be reluctant to spend money on things like food or clothing for themselves or family members.

Lack of empathy

Laughing man with upset woman

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Empathy is the ability to put yourself in someone else’s shoes and appreciate how their experiences have affected their thoughts and feelings (via Psychology Today). This ability is essential for connecting with others and developing nurturing relationships. A small study in the Journal of Personality Assessment suggests that those with OCPD have a lower ability to empathize with others compared to people without the disorder. More specifically, the study found that those with OCPD had a lower ability to imagine others’ experiences and see things from their perspectives. Unsurprisingly, the study participants with OCPD reported more interpersonal problems and distress compared to those without OCPD.

According to PsychDB, someone with OCPD is also unable to engage in emotional intimacy, which hinders closeness with others. Furthermore, the authors of the study in the Journal of Personality Assessment state that the high need for interpersonal control can cause someone with OCPD to be highly hostile toward others. They explain that those with OCPD tend to be tense or touchy in response to those who try to connect with them emotionally, perhaps because warmth from others can interfere with their interpersonal motives: To control others while being emotionally fixed and restrained. 

Intense negative emotions

Man yelling

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There is really no such thing as “good” or “bad” emotions — all are important to the human experience because they help you understand what is happening around you (via Greater Good Magazine). However, those with OCPD not only have a greater propensity toward experiencing upsetting emotions, but they also feel them intensely, as found in a study in the Journal of Personality Disorders. The study also found that those with OCPD had a greater propensity to feel anger compared to those without OCPD. They also often look nervous or fearful, and in fact, anxiety disorders are often comorbid with OCPD (per PsychDB). Furthermore, a paper in BJPsych Bulletin describes long-term relationships of those with OCPD as having a lot of friction because of the grudges they can hold against their partners.

Additionally, the study in the Journal of Personality Disorders found that the participants with OCPD had greater difficulty in managing their emotions compared to those without OCPD. These difficulties included the inability to identify their emotions, the inability to set aside upsetting feelings and focus on something else when they need to, and a lack of acceptance of their feelings. 

Family members have OCPD

Chromosomes

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There is no one cause of OCPD – genetics, environment, and childhood experiences can play a role in the development of the disorder (via MedlinePlus). A review in Current Psychiatry Reports summarizes that the two main causes of OCPD that are supported in the scientific literature are genetics and unhealthy familial relationships. With regard to the latter, according to a study in the Journal of Personality Disorders, nearly three quarters of those with OCPD report having experienced some form of childhood abuse or neglect.

Authors of a review in Europe’s Journal of Psychology suggest that the science thus far has found heritability to be the biggest predictive factor of OCPD. A large study of adult twins in Psychological Medicine found that heritability contributed more to OCPD traits than environmental factors. Another research study of sibling pairs in the journal Depression & Anxiety found a link between a particular chromosome and the OCPD traits of hoarding and indecision. 

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