What Does It Mean to Have Obsessive Compulsive Personality Disorder?
People with Obsessive Compulsive Personality Disorder spend a disproportionate amount of their time thinking and doing rather than enjoying other states of being, such as playing, sensing, daydreaming, intuiting, or creating art. Many very productive and admirable people would describe themselves this way.
How can we describe the Obsessive Compulsive Character? Wilhelm Reich described them as “living machines”, and Freud noted that they tend to be stubborn, stingy, and very orderly. Others have noted their harsh, rigid intellectuality, as well as the tendency to be perfectionistic, punctual, meticulous, overly conscientious, and lacking in adaptability. Overall, they are dependable, reliable and have high ethical standards. They have a robotic and mechanical way of being, and simply put, do not, emotionally speaking, “squeeze the juice” out of life.
Thinking, but Unable to Feel
As theorized by Nancy McWilliams in her book “Psychoanalytic Diagnosis”, Obsessive/compulsive people overvalue cognition and thought, and devalue feelings as being childish, or weak. In fact, they often do not even know what they feel, and often live very sterile lives, missing much of the enjoyment that comes from feeling and processing experiences. They also are at a significant disadvantage in moments when fantasy, emotions, and play have an important and legitimate role. For example, if a widow is ruminating obsessively about the details of her husband’s funereal, she denies herself not only the process of grief, but also the comfort of being consoled by friends and loved ones.
Since obsessive people base their self-worth on their ability to think, they usually only feel good about themselves by solving problems or completing tasks. When circumstances make it difficult for them to achieve or accomplish, shame is felt strongly and consistently for not meeting their unrealistic standards, which over time causes the obsessive person to become depressed. Losing a job is extremely difficult for almost anyone, but it is catastrophic for the OCD person.
Obsessive and compulsive people tend to worry a lot, trying to meet the demands of internalized parental figures that hold them to a high standard of behavior and thought. When they have to make a choice, they can become emotionally paralyzed easily, worried that they might make a mistake. This is an effort to keep all their options open and keep control over all possible outcomes. Unfortunately, because they cannot a make decision, they end up having no options at all.
The Basic Conflict: Control and Unfelt Anger
The basic conflict in obsessive/compulsive people is anger at feeling controlled versus the fear of being punished or condemned. The experience of being controlled, judged or required to perform causes angry feelings and sometimes aggressive fantasies, which is at odds with a compelling need to feel in control, clean, orderly and punctual, and feelings of being out of control, messy, or late are wrapped up in shame. This “rational” identity is essential for the maintenance of their ego, and as a result, emotions are submerged. Words are used to conceal feelings, not to express them.
Obsessive/Compulsive people fear their own hostile feelings, and suffer inordinate self-criticism over aggressive thoughts and fantasies. They are nervous about giving in to feelings of lust, vanity, greed, laziness and envy. Rather than accepting that these feelings sometimes arise, and that their self-worth should be based on their behaviors in response to these feelings, they feel guilty for even having the impulse. Shame is also strongly felt; they have high expectations for themselves and feel embarrassed to be seen by others as falling short of proper acts and thoughts.
Early Childhood: Overly Strict or Frighteningly Lax
The parents of obsessive and compulsive people are notorious for setting high standards of behavior and expecting early childhood conformity. In general, they are strict and consistent in punishing bad behaviors and rewarding the good. When the parenting is adequate and loving, they produce emotionally advantaged children who expect a lot of themselves and tend to achieve their goals. When the parenting is too exacting, harsh, and condemning, the obsessive/compulsive adaptations can take on a problematic form.
From an object relation point of view, what is notable about obsessive/compulsive people is the central importance of control in their family of origin. Control tends to be expressed in moralized, guilt-inducing terms in obsessive compulsive-breeding families, and moralization is actively modeled. As a result, the obsessive/compulsive person is also strongly motivated by guilt.
Another kind of family background that has been noted in the creation of the obsessive/compulsive character is one in which the child feels so bereft of clear family standards and so unsupervised by the adults around them that in order to push themselves to grow up, they hold themselves to idealized criteria. This idealized set of standards, since it tends to be abstract and not modeled by people known personally to the child, tends to be harsh and untempered.
Treatment with Obsessive Compulsive patients can be tricky, and it takes a sensitive clinician who is experienced in working with the obsessive/compulsive population, as they tend to exasperate others and can become controlling in the sessions. Refusing to control the patient while not emotionally disengaging is vital, and an appreciation for their vulnerability to shame is essential. Refusing to advise, hurry or criticize them for their obsessiveness will foster the most progress in treatment. It is also important to relate to them warmly and avoid cognitive interpretations, as patients need to learn to feel on an affective level.
If you need treatment for obsessive-compulsive disorder in Orange County, Newport Beach, Irvine, or Costa Mesa, please contact me, Jennifer De Francisco, LCSW, at (949) 251-8797.