Apr 03

“The Last Word”: A Shallow View of OCPD

The Last Word, starring Shirley MacLaine and Amanda Seyfried, is an enjoyable enough new feature film, though one that will probably be seen by a lot more viewers once it’s available on demand or to rent.

MacLaine’s character Harriet, in her early 80’s, is made out to be the ultimate lifelong control freak—and one peek at the trailer and you can see how amusingly unlikeable she’s been. But it’s a movie after all, and very possibly there will be a bit of redemption before it’s too late:

Themes of loss affect all three of the main female characters—besides Harriet, there’s her obituary-writer-for-hire Ann (Seyfried) and Harriet’s new child protégé Brenda (AnnJewel Lee Dixon). The losses, however, aren’t explored in any depth.

Nor is the psychiatric diagnosis (SPOILER ALERT) that Harriet’s uptight and estranged daughter Elizabeth (Anne Heche), a bright medical professional, informs her they share: Obsessive Compulsive Personality Disorder, or OCPD.

Some of the traits of OCPD, as offered by IOCDF (International OCD Foundation) follow. Not all these need be present in order for a diagnosis to be made:

  • Rigid adherence to rules and regulations
  • An overwhelming need for order
  • Unwillingness to yield or give responsibilities to others
  • A sense of righteousness about the way things “should be done”
  • Excessive devotion to work that impairs social and family activities
  • Excessive fixation with lists, rules and minor details
  • Perfectionism that interferes with finishing tasks
  • Rigid following of moral and ethical codes
  • Unwillingness to assign tasks unless others perform exactly as asked
  • Lack of generosity; extreme frugality without reason
  • Hoarding behaviors

OCPD is different, by the way, from OCD, obsessive-compulsive disorder. As Jenny Turner, The Guardian, stated as “the single most useful fact” she gleaned from David Adam‘s book about OCD, The Man Who Couldn’t Stop (2014):

OCD is completely different from OCPD, obsessive-compulsive personality disorder, which is simply to be a person with an unusually low tolerance for mess and imperfection – joke-anal people, like Monica from Friends. The need for order and ritual in the lives of OCPD people is ‘ego-syntonic’, odd and possibly anti-social, but simply part of who they are. In OCD people, on the other hand, the thoughts are ‘harrowing, ego-dystonic’, in endless, exhausting conflict with the person’s other drives and hopes. It’s like having a phobia, but worse, in that you can’t avoid it just by avoiding planes or spiders. The stimulus is internal. You generate it yourself.

In the brief scene in The Last Word in which OCPD is mentioned, we see that Harriet’s daughter Elizabeth has seemingly accepted her own condition and is trying to deal with it. From a clinical point of view not detailed in the film, it would be likely that she either inherited it via her mom’s genes, learned it via being raised by her mom, or both.

Harriet, though, couldn’t care less what Elizabeth has to say about OCPD and is most definitely not going to heed her advice to go see a therapist.

Which is highly plausible because: 1) At Harriet’s age she’s much less likely than younger folks to believe in the importance of such a diagnosis or care enough to address it, 2) Now in retirement, Harriet no longer has to deal with workplace relationships, one of the biggest issues for those with OCPD, and 3) Most people with OCPD, as part of the condition, think the way they are is okay and/or liveable.

In closing, another important point: It would be a faulty assumption to infer that because Harriet is so difficult, so is everyone else with OCPD. Many with OCPD, in actuality, exhibit their traits to a significantly lesser and/or harmful degree than Harriet.

Jun 19

OCPD (Obsessive Compulsive Personality Disorder) Not Same As OCD

OCPD (obsessive compulsive personality disorder) is not the same as OCD (obsessive compulsive disorder)—but more on that later.

First, some new info on OCD. The Man Who Couldn’t Stop: OCD and the True Story of a Life Lost in Thought is personal to author David Adam, who also did significant research on the issue in order to write this book.

Below is a sampling of how some reviewers summarize Adam’s own progress, including what’s helped him. Note: as these are all British sources, you’ll see corresponding spelling variations.

Leyla Sanai, The Independent: “Adam’s own OCD centred around an irrational fear of contracting HIV. In this book he covers the history and aetiology of OCD, the various treatments that have been tried without success, such as Freudian analysis, or behavioural aversion therapy, and his experience of cognitive behavioural therapy, CBT, which was greatly helpful.”

Jane Shilling, The Telegraph: “Cognitive behavioural therapy, plus a daily dose of antidepressants, has brought him to the point where he is able to control intrusive thoughts by thinking, ‘What would most people do?'”

Jenny Turner, The Guardian, quotes Adam: “But ‘even on the drugs and after CBT…for most people it’s a bit like being a recovering alcoholic…I will probably always have OCD.'”

And what was “the single most useful fact” reviewer Turner got from this book?

OCD is completely different from OCPD, obsessive-compulsive personality disorder, which is simply to be a person with an unusually low tolerance for mess and imperfection – joke-anal people, like Monica from Friends. The need for order and ritual in the lives of OCPD people is ‘ego-syntonic’, odd and possibly anti-social, but simply part of who they are. In OCD people, on the other hand, the thoughts are ‘harrowing, ego-dystonic’, in endless, exhausting conflict with the person’s other drives and hopes. It’s like having a phobia, but worse, in that you can’t avoid it just by avoiding planes or spiders. The stimulus is internal. You generate it yourself.

Perhaps because OCPD is considered ego syntonic, less is written about this than many of the other personality disorders. On the other hand, considering that many with OCPD (and/or their loved ones) do recognize their symptoms and do seek relief and/or support, what’s out there for these individuals?

One resource is a small book available online called Tightrope Walking: All You Need to Know About OCPD and Perfectionism, written by Gwyneth Daniel Cheeseman, PhD. From the intro:

We all know one or more. They’re more often than not the most decent good-hearted people. But they tread a tightrope, a knife edge, all day every day. It’s hard. It’s stressful. They suffer. But they have to be in CONTROL everywhere and all the time, even though that is not possible… In this handbook, I’ve referred to these people as Tightrope Walkers (TR Walkers). This is because they have a terrible balancing act to do. They’re up on their own, doing what is ‘right’. Treading a fine line, between what is perfectly correct in their own minds, and what would be a slip-up, a failing/falling, an error.

Another book that’s been around since 1992 is still touted on OCPD forums as well as in consumer reviews as an excellent resource. It’s written by psychiatrist Allan E. Mallinger and Jeannette Dewyze and is called Too Perfect: When Being in Control Gets Out of Control.

Some of the possible traits of someone with OCPD, according to the authors:

  • Fear of making mistakes or wrong decisions
  • Strong devotion to work
  • Need for order and firm routine
  • Frugality
  • Need to know and follow the rules
  • Emotional guarded-ness
  • Tendency to be stubborn and oppositional
  • Heightened sensitivity to pressure
  • Inclination to worry
  • Need to be above criticism
  • Chronic inner pressure to use every minute productively

You can take the most widely known self test for OCPD online for free at this link. Or read Too Perfect and find it there.