Now, most of us are familiar with (unresearched) fiction's depiction of an OC sufferer - they're that person who is meticulously measuring every grain in making coffee and almost have a stroke whenever they see a pile of magazines that aren't perfectly in line.
Actually, the perfect example here would be Death The Kid from Soul Eater.
Death is obsessed with symmetry – his house is completely symmetric: posters are directly opposite each other on walls, etc. If his enemy is symmetric he will refuse to fight it (even letting himself get beaten half to death), but if it’s asymmetric he will destroy it. If anyone pointed out the asymmetric stripes in his hair he would have a tantrum and he fainted when he had to write out his name because the “k” could never be symmetric.
The point is – he is a typical example of non-researched fictional OCD (I’ll mention that they justify his madness later but he serves as a great example). However, fact varies greatly from fiction.
Obsessive Compulsive Disorder
This falls under what is known as an “anxiety disorder”. It is characterized by recurring intrusive/unwanted thoughts (a.k.a. obsessions) and repetitive behavioural/mental rituals (a.k.a. compulsions). Sufferers usually know that this is all rather irrational but they have a great deal of trouble controlling their obsessions and it’s hard to resist the compulsion.
The main idea is that the obsessions cause worry on the part of the sufferer and, obsessions being what they are, they have trouble trying to think of something else. This is where the compulsion comes in – it’s the sufferer trying to distract themselves from the obsession or lessen the effect of the obsession. If they don’t carry out their particular compulsion, anxiety will be experienced in the form of the obsession.
Common obsessions:
• thoughts of contamination
• repeated doubts
• need for orderliness – this one is the most common in fiction
• aggressive impulses
• sexual imagery – this one is actually rather common
• religion
Common compulsions:
• Checking
• Washing
• Ordering – also very common in fiction
• Requesting or demanding reassurance from other people ( e.g. 'Did I lock the door?')
• Praying
• Counting
• Repeating words silently
An interesting fact is that about 20% of OCD sufferers have a tic (sudden, repetitive, stereotyped, nonrhythmic movements [motor tics] and utterances [phonic tics] that involve discrete muscle groups), thus it could be related to Tourette Syndrome but this is yet to be confirmed. Also, about 3 out of 100 people will get OCD in their lives.
“Tics are movements or sounds "that occur intermittently and unpredictably out of a background of normal motor activity", having the appearance of "normal behaviors gone wrong". The tics associated with Tourette's change in number, frequency, severity and anatomical location. Waxing and waning—the ongoing increase and decrease in severity and frequency of tics—occurs differently in each individual. Tics also occur in "bouts of bouts", which vary for each person.”
A quick note on Tourette Syndrome is that while the most publicized symptom is Coprolalia (spontaneous swearing and other bad words/phrases), it actually occurs in only about 10% of patients. Echolalia (repeating the words of others) and palilalia (repeating one's own words) occur in a minority of cases. The most common motor tic is blinking, while the most common vocal tic is throat clearing.
Obsessive Compulsive Personality Disorder
To put it simply, OCPD sufferers are perfectionists and believe that no-one else can be trusted to complete a task properly. Sufferers of this anxious personality disorder are preoccupied (read: obsessed) with orderliness, perfectionism, and control. At first you may be thinking “Hey! What’s the difference between OCPD and OCD where the obsession is order?” however, while OCD sufferers know that their thoughts are intrusive/unwanted/wrong, OCPD sufferers believe that their thoughts are correct and hence do not try to suppress them or distract themselves from them. This can be a problem as they spend their early life ignoring/avoiding the symptoms – if they ever end up acknowledging the symptoms.
Some, but not all, OCPD sufferers show an obsession with cleanliness – not to be confused with domestic efficiency as paying too much attention to details can actually make daily activities difficult to accomplish.
Symptoms tend to start in early adulthood and may interfere with one’s ability to complete tasks due to their standards being too rigid – for instance, wanting something redone exactly to the instructions given and ignoring anything better/more efficient route. An example can be derived from Harry Potter: The Half-Blood Prince. If Harry was to work in a group assignment with someone with OCPD in Potions class and tried to use the Prince’s annotated text book, the OCPD sufferer would probably make Harry do the potion over again following the normal instructions, no matter how much better the other potion would have been – even if they saw the results to be better.
Other symptoms of OCPD that aren’t similar to those of OCD are:
• Excess devotion to work
• Inability to throw things away, even when the objects have no value
• Lack of flexibility
• Lack of generosity
• Not wanting to allow other people to do things
• Not willing to show affection
• The aforementioned reoccupation with details, rules, and lists
Another striking feature is that they tend to polarize their beliefs and actions and those of others – that is to say, set them on extreme scales such as “right” and “wrong” with very little in between. This sort of perception strains interpersonal relationships and the frustration can even result in violence (known as disinhibition). This probably contributes to why sufferers of OCPD tend towards pessimism, depression, and in extreme cases, suicide.
Actually, a rather good example of possible OCPD on TV is Monica from Friends – she’s an extreme perfectionist who seems to panic rather than get mad (most of the time), has an obsession with cleanliness and order, and even hoards a lot of stuff. She is not very flexible and I can recall her saying something like “Rules are good - they help contain the fun.” (I don’t recall the exact phrase) and has always shown strict adherence to the rules. Also, a recurring theme is that when she is performing a task she is reluctant to delegate or accept assistance because she thinks other people will do it wrong – unless she is bossing them around every step of the way. A dominant character trait is that she actually enjoys cleaning up.
Now, a fellow who will show up again in my blog is Theodore Millon – he developed a series of subtypes of different disorders. These subtypes are basically “dominant disorder with features of another disorder” – e.g. for the personality disorder of Narcissism there is the subtype of “unprincipled narcissism” which has features of Antisocial Personality Disorder, and for Antisocial Personality Disorder there is the subtype of “reputation-defending antisocial” which has features of Narcissism. (both of these disorders will be covered more extensively later)
Anyway, Millon’s subtypes for OCPD are
• conscientious compulsive—including dependent features.
• puritanical compulsive—including paranoid features.
• bureaucratic compulsive—including narcissistic features.
• parsimonious compulsive—including schizoid features. Resembles Fromm's hoarding orientation[20]
• bedeviled compulsive—including negativistic (passive-aggressive) features.
A quick summary, for the times being, is that
• Paranoid - Constant distrust and suspicion of others.
• Shizoid - Asocial. No concern for what others think of you. Little to no desire to form personal relationships of any sort.
• Narcissistic - Self-centered and thinks they are the Greatest Person Ever. Constantly need affirmation that they are, indeed, awesome.
• Dependent - the constant need to rely and depend on others. Find it difficult to make even very simple choices on their own.
Why do these two get mistaken for each other a lot? Apart from the similar names, of course. Well, as you can see, their symptoms follow the same basic pattern – compulsions caused their obsession – except in OCD the compulsion is to deal with the obsession tend to get very distressed with their actions while in OCPD it is to assist the obsession (perfection) and usually enjoy the task. I will mention that the two conditions can be suffered by the same person.
Sufferers of these disorders tend to be high achievers and feel “a sense of urgency about their actions”. They will have rigid routines and feel upset if someone interferes with them. One thing I didn’t know before researching this was that they may have trouble expressing their anger, thus choosing more appropriate emotions such as anxiety. This is why OCD is known as an anxiety disorder and OCPD as an anxious personality disorder.
However, as seen above, it’s when you look at the additional symptoms of OCDP that you really see the differences between the two disorders – this is where most fiction falls short.
Now, to end this post I will direct you to the World Health Organization's ICD-10. As is the case with most organizations, they like to use completely difference names to what everyone else learns. Here, OCDP is (F60.5) Anankastic personality disorder.
It is characterized by at least three of the following:For some reason, whenever I read a page on mental/physical health it urges me to see a psychiatrist/doctor if I display symptoms so I guess I will say that too – if you think you may match the symptoms as listed by the World Health Organization I’d suggest getting a formal diagnosis before treating yourself. Internet quizzes are unreliable and can only give an indication – even then, if you were in an odd mood when taking the quiz your results can get really messed up.
1. feelings of excessive doubt and caution;
2. preoccupation with details, rules, lists, order, organization or schedule;
3. perfectionism that interferes with task completion;
4. excessive conscientiousness, scrupulousness, and undue preoccupation with productivity to the exclusion of pleasure and interpersonal relationships;
5. excessive pedantry and adherence to social conventions;
6. rigidity and stubbornness;
7. unreasonable insistence by the individual that others submit exactly to his or her way of doing things, or unreasonable reluctance to allow others to do things;
8. intrusion of insistent and unwelcome thoughts or impulses.
Includes:
• compulsive and obsessional personality (disorder)
• obsessive-compulsive personality disorder
Excludes:
• obsessive-compulsive disorder
It is a requirement of ICD-10 that a diagnosis of any specific personality disorder also satisfies a set of general personality disorder criteria.
An example is that when I take these quizzes I pretty much always rank highly on either Bipolar or Cyclothymia for the depressive illnesses, and for the personality disorder ones I typically score highly in Paranoid, Schizoid, and Schizotypal. However depending on my mood I have also gotten high results in Narcissism, Avoidant, Dependent, and Antisocial... on the same test.
So, I’m going to say that while the internet is a great place to find information you really need a qualified mental health specialist to make a diagnosis.
On a less serious note – my next post will take place over the next day or two as I am still writing it and we are experiencing a heat wave where I live and I’d rather not accidentally overheat my laptop if I don’t have to.
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