Mental health articles

obsessive compulsive personality disorder ocd case Obsessive compulsive personality disorder (OCPD or OCD) has the essential feature of “a preoccupation with orderliness,
perfectionism, and mental and interpersonal control, at the expense of
fl exibility, openness, and effi ciency”. Although students oft en talk about being “anal,” and an academic environment
does reinforce a moderate amount of compulsivity, OCPD students’
need for order, preciseness, and details are extreme and interfere signifi cantly with interpersonal and career goals. Th ese students believe that they know
best, details are crucial, and people should strive for perfection.

Ralph is “driving everyone crazy” on the required work team of his
MBA program. He spends the entire time going over irrelevant details
and reviewing “to do lists” he’s created for the other members. If the
others do not complete assignments in the way he expects, he takes an
inordinate amount of time insisting on his way. Concerned that they’re
not accomplishing their goals, Ralph’s teammates requested his removal
from the team. Ralph also admits to having similar troubles with his
roommate, who no longer wants to live with him.

Individuals with OCPD dislike ambiguity, but ambiguity is what students
like Ralph face given the many novel situations in academic programs. By
clinging to rules, he tries to ease the anxiety of the unknown. Fearful of making
a mistake or failing, he has become overly detailed, analyzing and reanalyzing
everything. Th e goals of treatment therefore are to reduce his anxiety and to
help him see the big picture and recognize the emotional nuances of the group
situation.
Individuals with OCPD oft en respond to cognitive-behavioral interventions,
which appeal to their sense of structure (Millon et al., 2000). A
hierarchy of goals should be established, starting with the least anxiety
producing, to instill a sense of accomplishment. Also helpful is identifying
ways to reduce anxiety. Ralph picked exercise and mindful meditation,
known to decrease ruminative worry in individuals with OCPD; another
option would be progressive relaxation, especially for students who need
more structure. As Benjamin (1996) emphasizes, therapy can be viewed as
a scientifi c investigation, and so can appeal to students with OCPD because
of its analytical and logical nature. Th e therapist may have to remind the
student that blaming people is not as helpful as understanding what the
student wants from others and how best to achieve rewarding relationships.
Since OCPD students can become detail oriented and tangential, it
is important to direct their focus to feelings rather than facts. A therapy
group might be helpful as well, but again the therapist may need to intervene
if the student becomes tangential, gets into power struggles, or feels
overwhelmed by aff ect.
Crits-Christoph and Barber (2004) recommend interpersonal therapy or
psychodynamic individual therapy approaches, giving clients a measure of
control and autonomy. Th e goal of treatment is for students to replace impossible
expectations of self and others with realistic expectations. Typically the
treatment is long term, although short-term supportive-expressive therapy
shows some promise (Sperry, 2003). No controlled pharmacological studies have been reported, but there is some research support for the use of the SSRIs
citalopram and paroxetine to increase cooperative and affi liative behaviors.

Tags: disorder, OCD, Personality Disorder