Obsessive-Compulsive Personality Disorder (OCPD)

Diagnostic criteria: Perfectionism, order and control.

OCPD is characterized by a pervasive preoccupation with order, perfectionism, and mental and interpersonal control, at the expense of flexibility, openness, and efficiency.

It is not simply a matter of being organized, but a rigidity that interferes with life.

The individual becomes so preoccupied with details, rules, lists and schedules that the main object of the activity is lost.

Imagine someone who spends so much time formatting a report that he or she fails to write the content before the deadline.

Perfectionism interferes with the completion of tasks; they are unable to sign off on a project because it doesn't meet their overly strict standards.

They show excessive dedication to work and productivity, excluding leisure activities and friendships without obvious financial need. They are stubborn, scrupulous and inflexible in matters of morals, ethics or values.

In addition, they may be unable to dispose of worn-out or useless items, reluctant to delegate tasks unless others submit exactly to their way of doing things, and adopt a miserly style of spending, viewing money as something to be hoarded for future catastrophes.

Key difference from clinical OCD (Egosyntonia vs. Egodystonia)

It is vital to distinguish Obsessive-Compulsive Personality Disorder (OCPD) from Obsessive-Compulsive Disorder (OCD), which is an anxiety disorder.

Although they share similar names and can coexist, they are distinct entities. The fundamental difference lies in the perception of symptoms.

In clinical OCD, the symptoms are "egodystonic": the patient has intrusive obsessions (unwanted thoughts) and compulsions (rituals) that they recognize as irrational, annoying and beyond their control, causing them great anxiety. They want to stop compulsively washing their hands, but they cannot.

In contrast, in OCPD, the traits are "egosyntonic": the individual perceives their need for order, control and perfectionism as rational, correct and desirable.

They do not see their behavior as a problem, but consider that their way of acting is the "right" one and that it is others who are wrong for being disorganized or lax.

In addition, OCPD does not usually present the classic OCD obsessions and ritualized compulsions (such as repeatedly checking locks for fear of fire), but a generalized rigidity in personality and lifestyle.

Intervention: Flexibilization and rigidity management

Treatment of OCPD focuses on increasing cognitive flexibility and reducing the need for control.

Since these patients tend to intellectualize and rationalize, the therapist should avoid entering into endless logical debates and encourage contact with emotional experience. The aim is for the patient to learn to tolerate uncertainty and imperfection.

Cognitive-behavioral therapy helps to identify and modify underlying beliefs about the need for perfection and the fear of making mistakes.

Techniques such as problem solving help overcome paralysis by analysis and indecisio