AMA - Obsessive Compulsive Personality Disorder

Doesn't OCD manifest in different ways for different people?

Could you talk about how you experience it?

Thanks for sharing and letting us grow from your experience.

>> Doesn't OCD manifest in different ways for different people?

I'm sure OCD does. But I'm not diagnosed with OCD, I'm diagnosed with OCPD.

To answer the logical subsequent question; OCPD is a personality disorder, while OCD is an anxiety disorder.

In length, this means that OCD manifests in a way where the patient feels anxious, out of control, and "compelled" to do things to get rid of that anxiety - or they may feel that they are having continuous, reoccuring thoughts which are wrong, out of character, or very disturbing; they'll feel compelled to do things or avoid situations so these thoughts won't occur.

This then means that OCPD, as a personality disorder, is less to do with symptoms of anxiety (though it can be comorbid with OCD, or any other anxiety disorder, of course) and more to do with maladaptive ways the patient functions in their lives in general. Broadly, OCPD centers around control; managing uncertainties, preventing failures, preparing for disasters, and avoiding any other uncomfortable situations. They accomplish this by being perfectionists, coming up with rules/systems/lists, and/or hoarding money/objects "just in case". The idea is that, as a personality disorder, these traits become maladaptive and dehibilitating. Focusing on doing a task The Right Way without realizing you've lost sight of the true goal; hoarding objects which are basically useless; being so frugal or devoted to work you damage personal relationships; etc.

Or, the short version: OCD patients are anxious andthink and/or do things that they don't want to. OCPD patients do things because they're convinced it's the Right and Best Way to do things, and don't believe there's anything wrong with it.

>> Could you talk about how you experience it?

My diagnosis of OCPD is relatively recent in my long, long history of mental health counseling - because like most patients with OCPD, I didn't think there was anything wrong with the way I saw things. I was in therapy for social phobia, generalized anxiety, and major depression. Those were what was wrong, not how I was handling the world.

Of course, dealing with OCPD in a world which finds perfection unrealistic just adds to things like anxiety and depression if you're already struggling with that. But I was convinced; cognitive behavioral therapy said that thoughts influenced behaviors, so therefore, if I Thought The Right Things, and I did Everything Right, then my depression and anxiety should go away.

The storm of judgment, of trying to ignore or silence my negative thoughts and feelings, and telling myself everything I was feeling re: mental illness was unimportant and wrong - these only added to my problems.

Fortunately, as so many of my Rules deal with people-pleasing and Doing The Right Thing by doing things for others, I didn't suffer as much from the negative social consequences most OCPD people do. But there were odd times, of course. I had a crying fit once because my fiance insisted we didn't need to keep five gazillion plastic shopping bags "just in case". My friends don't take me out shopping because I refuse to buy things for myself. But they're small things, not really the stuff that's been getting in my way.

Dialectical behavioral therapy has been extremely helpful for me in many ways. First, it gave me a vocabulary to talk about my problems which I didn't possess before. Second, it made sense to my OCPD brain - for example, PLEASE means that you need to daily Do The Right Things to improve your chances of having a good mental health day. Third, it's been teaching me to apply non-judgmental stance and validation towards myself, which has been extremely difficult for me.

I'm slowly trying to retrain myself; there isn't a "right" or "wrong" way for me to do things. There are "healthier" things, and "more effective" ways, and "more efficient" ways. I've learned not to judge my OCPD habits; with the DBT skills they can be an asset. But I'm also doing my best to not allow my OCPD habits to judge me. If I can't do something Exactly Right, or I lose something important, or I need to buy something new for myself - that's all okay.

Validation is especially key to my current therapy at the moment. These thoughts - from my insecurities to my judgments to my desire for control - are all real. They're neither "good" or "bad". Reinforcing that in my mind has been so difficult, but it's been helping me a lot. If I know things aren't "right" or "wrong", that I just need to make the best decision I can using the resources I've got - that's the goal I'm working towards.