Obsessive-Compulsive Personality Disorder: Understanding the Overly Rigid, Controlling Person

407 Pages·2016·1.85 MB·English

by  Martin Kantor

Copyright © 2016 by Martin Kantor, MD
All rights reserved. No part of this publication may be reproduced, stored in a retrieval system, or
transmitted, in any form or by any means, electronic, mechanical, photocopying, recording, or otherwise,
except for the inclusion of brief quotations in a review, without prior permission in writing from the
publisher.
Library of Congress Cataloging-in-Publication Data Names: Kantor, Martin, author.
Title: Obsessive-compulsive personality disorder : understanding the overly rigid, controlling person /
Martin Kantor, MD.
Description: Santa Barbara, California : Praeger, 2016. | Includes bibliographical references and index.
Identifiers: LCCN 2016016194| ISBN 9781440837883 (alk. paper) | ISBN 9781440837890 (ebook)
Subjects: LCSH: Obsessive-compulsive disorder.
Classification: LCC RC533 .K364 2016 | DDC 616.85/227—dc23 LC record available at
https://lccn.loc.gov/2016016194
ISBN: 978-1-44083788-3
EISBN: 978-1-44083789-0
20 19 18 17 16 1 2 3 4 5
This book is also available as an eBook.
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Contents
Introduction
Part I: Description
1 Selected Definitions
2 Mental Status (Excepting Thought and Behavior)
3 Mental Status: Thought
4 Mental Status: Behavior
5 The Interpersonal Venue: OCPD Fallout
6 Other Psychological Venues
7 The Social Venue
Part II: Causation
8 Causation
Part III: Treatment
9 Theoretical Considerations
10 Handling Specific Symptoms
11 Technical Aspects—Dealing with Resistances
12 Dealing with OCPD’s Realistic Difficulties
13 Reasons to Triumph over Being OCPD—Self-Help
Notes
Index
Introduction
lthough a significant number of individuals suffer from OCPD (obsessive-
A
compulsive personality disorder), scientists and laypersons alike
nevertheless pay the most attention to OCD (obsessive-compulsive disorder).
Either the existence of OCPD is entirely overlooked, or OCPD is subsumed
under the rubric of OCD. In either event, OCPD becomes relegated to a
secondary and hence devalued status: inadequately described, poorly understood,
and not treated in a way that is tailored to the specific individual patients at hand
and the disorder from which they are suffering.
Descriptively, OCPD is not as debilitating as OCD. But while OCPD may
not take life, it can significantly ruin it. It can also compromise the lives of
others in the OCPD’s orbit—those who fall into the path of OCPD, touched, and
too often diminished, by the OCPD of a family member, friend, partner, or
coworker.
In the realm of causality, it is currently fashionable to discuss OCPD strictly
from the cognitive-behavioral perspective, with a bow to mindfulness causality
and therapy. I prefer to view OCPD from many perspectives, not just one or a
few. Hence mine is an eclectic approach that studies OCPD from multiple
vantage points, not only the cognitive behavioral, but also the psychodynamic
and the interpersonal. My book especially emphasizes how OCPD arises out of
the flames of (id) desire that are then cooled by a guilty conscience, demanding
the use of defense mechanisms even though, while these defense mechanisms
reduce anxiety, they do so counterproductively—that is, at an unacceptable cost
to functionality.
In the realm of therapy, I go beyond an approach involving “mere” symptom
removal to focus not only on the symptoms that bedevil the human sufferers
from this disorder, but also on the human sufferers that their OCPD symptoms
afflict. I believe that without such a broad focus, we can’t satisfactorily reassure
the worried, calm the anxious, firm up the indecisive, tone down the
uncompromising, give succor to the lonely, offer hope to the hopeless, move the
stalled forward, induce interpersonal cooperation in the stubborn, and help the
rigid become more flexible, while simultaneously enhancing the OCPD’s social
performance, thus improving his or her chances for interpersonal satisfaction and
increasing the likelihood that he or she will achieve occupational success.
My method also applies to understanding and treating the social
manifestations of OCPD, of which there are many—too many of which go
unrecognized. On the wider stage, ultimately OCPD makes for emotionally hog-
tied leaders who create rigid bureaucracies, organizations born and sustained, not
as if attuned to coming up with creative solutions to real problems, but as if
dedicated to reaffirming the predictable, reinforcing the dull and mundane, and
reasserting those views that serve idiosyncratic philosophy created in an isolated
bathysphere that keeps out any consideration of one’s immediate and pressing
social responsibilities. Caring only for balance and seeking only faultlessness;
searching for the mot juste instead of seeking true justice; doing what is overall
statistically valid but not individually appropriate (e.g., performing superfluous
blood tests or failing to offer necessary ones like a PSA titer to a male age 85
because “statistically cancer of the prostate is rare at this age”—not okay if you
happen to be that older person who defies those odds) OCPD bureaucracies fail
to discharge what should be their most important responsibility and to carry out
their most urgent mission: to help those in dire and true need seeking comfort
but unfortunately looking for it in all the wrong places, and trying to get it from
those who are not necessarily in the best position to give it.
When personal OCPD symptoms are recognized and removed, OCPDs’
relationships are enhanced and OCPD-inspired bureaucracies undone. This both
improves the life of all concerned who come into contact with individuals with
OCPD, and enhances the functionality of the organizations to which the OCPDs
belong.
My medical school mentor put it this way some time ago: “Listen to the
patient; he or she is telling you the diagnosis.”
To which I now add: listen to the diagnosis of OCPD; it is telling you all
about your patient.
Part I
Description
CHAPTER 1