Information about Obsessive Compulsive Personality Disorder – its presentation, symptoms and treatment options

Beliefs, emotions and behaviour:

These individuals see the world in terms of rules and regulations, schedules and hierarchies.  They find it difficult to understand or process new or different ideas if they are inconsistent with their own rules.  Their thinking, as well as their behaviour, is very controlled. They may struggle to remember times when they have gone against their rules/ beliefs or behaved in a less rigid uncontrolled manner.

Missing Interpersonal Ability:

Spontaneity; personal enjoyment

A perfectionist who is preoccupied by details, rules and schedules. They are work rather than pleasure focused. Such an individual may struggle to make decisions or allocate time to do things, incase they get it wrong.  They can be stubborn and demand everything to be done their way, and when it isn’t they become upset and punitive.  Generally they present as serious, rigid, formal and inflexible with regard to moral issues.  This person may be very critical of others and insist on people that they manage adhering to their strict rules and methods.  They prefer formal, polite and correct personal relationships.

How is OCPD different from OCD?

Obsessive Compulsive Disorder is an anxiety disorder, and obsessive behaviour is a means of attempting to control this.  It is often started due to a significant event and is time-limited.  People with OCD have insight and know their behaviour is a problem. Those with OCPD believe their behaviour is normal and ‘the right way’ to do things – it is a way of life.  OCD can effect functioning in all areas of life, whereas OCPD will often hinder relationships but help in work environments where routine and rules are seen as positive.

Chris grew up in a strict army environment with his grandmother and uncle, after his mother was unable to look after him.  He became obsessed with motors from an early age. He describes how from the age of 8 he would take cycles apart and put them back together again for hours at a time. 

Chris is extremely routine and has a strict set of rules that he expects others around him to follow.  He works as a lorry driver and can talk in great detail about the routes he drives and mechanisms of the lorry.   

His second marriage was to a lady some years younger than him whom he idolised and gave up everything for.  He never saw any issues in their relationship, although she was not faithful to him, describing him as controlling and unbearable when they were together.    When she asked to separate Chris could not accept he had done anything wrong or understand why she would want to split up. This has led him to constantly message her asking for her to take him back, and strong expressions of anger.

example presentation

What are the symptoms?

The DSM 5 sets out the diagnostic criteria as: A pervasive pattern of preoccupation with orderliness, perfectionism, and mental and interpersonal control. This is at the expense of flexibility, openness, and efficiency. OCPD begins by early adulthood and is present in a variety of contexts, as indicated by four (or more) of the following:

• Is preoccupied with details, rules, lists, order, organisation, or schedules to the extent that the major point of the activity is lost.
• Shows perfectionism that interferes with task completion. For example, is unable to complete a project because his or her own overly strict standards are not met.
• Excessively devoted to work and productivity to the exclusion of leisure activities and friendships.
• Overconscientious, scrupulous, and inflexible about matters of morality, ethics, or values .
• Unable to discard worn-out or worthless objects even when they have no sentimental value.
• Is reluctant to delegate tasks or to work with others unless they submit to exactly his or her way of doing things.
• Adopts a cheap spending style toward both self and others; money is viewed as something to be hoarded for future catastrophes.
• Shows rigidity and stubbornness.

Treatment for Obsessive Compulsive Personality Disorder

If you believe you may have Obsessive Compulsive Personality Disorder, please speak to your GP in the first instance.

There is limited research into the psychological treatment for this Personality Disorder. However, Radically Open DBT has been designed for individuals who have disorders linked to over control, which OCPD would fit into. There is also some evidence that individuals with OCPD are likely to have greater levels of anxiety, depression and emotion regulation. Cognitive behavioural therapy may help to alleviate these symptoms.