Talk:Obsessive-compulsive personality disorder
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Oh, just trash the article and start over again! (OCPD victim) —Preceding unsigned comment added by 64.61.163.114 (talk) 00:12, 24 January 2008 (UTC)
I expanded the stub, but didn't know enough about treatment of the problem to give it a full description. Joyous 03:56, Jun 22, 2004 (UTC)
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[edit] hyphens
The name of the condition, "obsessive compulsive personality disorder," does not include a hyphen. I have (rather obsessively) removed instances of the hyphen where they occasionally appeared in the main text, but I do not know how to remove the hyphen from the topic title above.
If someone knows how to do this, please do.
That might involve migrating to a new page and replacing the old one with a redirect.
- Are you sure? I don't have a physical copy of the DSM-IV-TR, but all the online sources with the diagnostic criteria have a hyphen in the name.--NeantHumain 00:35, 4 February 2006 (UTC)
[edit] treatment information
treatment information from www.mentalhealth.com/rx/p23-pe10.html
im not entirely sure about how to put this in, and as i am only 16, i think it 'best' for an elder to arrange/fit this in.
on another note, i would like to see this page expand, and i would like more examples, as i feel i have obsessive compulsive personality disorder. i notice alot of signs, sometimes with similar results to examples given in OCD (obsessive compulsive disorder) although these tasks, such as checking that a door is locked, do not cause me any pain or such, i do worry sometimes, but not overly.
Medical Treatment
Basic Principles
When they are confronted with physical illness, individuals with compulsive personality disorder are particularly troubled by the sense of loss of control over bodily functions. There may be exaggerated worries about submitting to authority figures.
The patient will attempt to ward off these anxieties by redoubling efforts at composure and presenting a precisely detailed, orderly account of progression of symptoms in an emotionally detached manner.
A scientific approach on the part of the physician - as conveyed in thorough history taking and careful diagnostic workups - is reassuring and fosters the trust necessary for an effective therapeutic alliance. A well-articulated account of the disease process and treatment alternatives reassures the patient that someone is in control and that the doctor respects the patient's capacities to participate as an informed partner in the healing process. The reassurance provides a foundation upon which the patient can begin to reconstruct a sense of order in everyday life.
Patients with compulsive personality disorder are not reassured by vague impressionistic overviews of their prognosis. Patients feel most comfortable when the doctor provides documentary evidence in the form of specific laboratory test results, e.g., electrocardiograms or x-rays, or cites actual reports from the literature when presenting statistics about risk factors.
The healing process may be promoted by harnessing patients' innate thoroughness through encouraging intake and output and weight fluctuations and control of graduated exercise programs. When feasible, patients can take over management of more routine procedures, such as changing their surgical dressings. Meticulous adherence to treatment protocols will restore morale as patients regain a sense of mastery and dignity in taking charge of their lives. The physician must remain alert to the possibility that compulsive patients may wish to carry this self-healing process too far and cross the boundaries of their competence while stubbornly resisting the expertise offered by the health care team. The use of medications in these patients is generally not productive.
Hospitalization
Occasionally, when obsessional rituals and anxiety reach an intolerable intensity, it may be necessary to hospitalize the patient until the shelter of an institution and the removal from external environmental stresses bring about a lessening of the symptoms to a more tolerable level.
Antidepressant Drugs
During the past decade, sporadic case reports have described dramatic improvement in severely disabled obsessive-compulsive patients after the administration of tricyclic antidepressant or monoamine oxidase inhibitors.
Psychosocial Treatment
Basic Principles
Patients with Compulsive Personality Disorder who seek treatment usually do so because of symptoms which reflect, or are similar to, Axis I diagnoses of Obsessive-Compulsive Disorder, Affective Disorder, or occasionally Paranoia.
Individual Psychotherapy
Long-term psychotherapy is the treatment of choice. The focus must be on feelings rather than thoughts and would emphasize the clarification of the defenses of isolation of affect (intellectualized distancing from emotions) and displacement of hostility.
The treatment of the personality disorder itself should be psychotherapeutic, and may be intensive in nature if the patient is sufficiently motivated and tolerant. Needs to control and related fears of destructive impulses are important issues at all levels of treatment, from simple scheduling requests, to intellectualization and rationalization, to other resistances to fantasy and free association. Many of the characteristics which lead to a successful life for such a patient, and which appear to the inexperienced therapist to make for an excellent therapeutic candidate, are actually symptoms which can become serious impediments to psychotherapy.
The therapist must avoid competing with the patient and should be able to tolerate the patient's verbal attacks, retaining a therapeutic posture rather than allowing the session to deteriorate into an intellectual discussion or otherwise nonproductive interchange. Those patients with Compulsive Personality Disorder who show signs of deteriorating toward severe rituals or paranoia under stress should probably not be treated so intensively.
As is always the case in choosing patients for insight psychotherapy, the criteria for selection depend primarily on factors other than symptoms: (1) the prominence of situational precipitating events, (2) the capacity to relate to the physician, (3) evidence of good relationships with others, (4) stable work patterns, (5) the capacity to tolerate anxiety and depression, (6) the ability to express emotion, (7) intelligence, (8) the ability to be introspective, (9) flexibility in thinking and behavior, and, perhaps most important of all, (10) motivation for change.
Supportive psychotherapy undoubtedly has its place in the psychiatrist's armamentarium, especially for that group of obsessive-compulsive patients who, despite symptoms of varying degrees of severity, are able to work and make a social adjustment. The continuous and regular contact with an interested, sympathetic, and encouraging professional may make it possible for patients to continue to function by virtue of this help, without which they would become completely incapacitated by their symptoms.
Group and behavioral therapy occasionally offer certain advantages. In both contexts, it is easy to interrupt the patient in the midst of his maladaptive interactions or explanations. Preventing the completion of his habitual behavior raises his anxiety and leaves him susceptible to new learning. The patient can also experience direct rewards for change, something less often possible in individual psychotherapies.
Desensitization techniques may be helpful to certain patients in removing or reducing the severity of symptoms. As in the phobias, a hierarchy of increasingly anxiety-provoking stimuli is constructed, and the patient is systematically exposed to these stimuli step by step, either in imagination or in vivo, in combination with a variety of measures applied to induce a countering relaxation.
In flooding, the patient is required to face the most anxiety-provoking stimuli and to experience the full tide of anxious affect thus aroused. Flooding is often combined with response prevention, called apotrepic therapy by some clinicians; the patients are not only confronted with the frightening stimulus, but are restrained from carrying out their defensive-compulsive actions. Modeling may be added to response prevention; that is, patients are accompanied by the therapist, who remains calm and inactive during the exposure to the arousing stimulus and who provides patients with a model after which to pattern their own behavior.
Therapeutic techniques have also been devised to control obsessional thoughts. Saturation requires patients actively to concentrate on the obsessional thought without letting their minds wander. Clinical experience shows that, after 10 to 15 minutes of such concentration, the obsessional thought loses some of its attention-compelling energy, and patients are unable to keep their minds focused on it. Thought-stopping involves the therapist in a vigorous interaction with the patient. As the patient broods on the obsessional thought, the therapist suddenly yells "Stop!" or applies an aversive stimulus to counteract the patient's obsessional preoccupation.
Family Therapy
Any psychotherapeutic endeavors must include attention to family members through the provision of emotional support, reassurance, explanation, and advice on how to manage and respond to the patient.
Isn't "Anal Retentive" one of the fruedian classifications, being [bodily orifice]+{retentive|expressive} ? Pmurray bigpond.com 03:17, 22 February 2006 (UTC)
Help For Adult Children of OCPD
Any helping resources for adult children of parents with OCPD who may have lifelong emotional and behavioral legacies due to growing up in an OCPD controlled household?
161.98.13.100 18:52, 8 September 2007 (UTC)
[edit] neurosurgery for OCPD!?
I deleted the sections about medication and surgery because as far as I know this information was misleading at best. To the best of my knowledge, medication is generally not prescribed or indicated, and I am quite confident there is no neurosurgerical procedure believed to benefit those with OCPD or other personality disorders.
- No one operates for a personality disorder. By definition they are behavior problems not biological. —The preceding unsigned comment was added by 68.22.19.194 (talk) 21:20, 31 January 2007 (UTC).
[edit] see also anal retentive?
While "anal retentive" may be descriptive of a number of individuals with OCPD, so is "bipedal." There isn't room for all adjective phrases which may be related to OCPD.
- Unlike bipedal, which applies to basically all human beings, anal retentive has a particular relationship with obsessive-compulsive personality disorder. Obsessive-compulsive disorder was one of the character fixations under the old Freudian scheme: the anal character. See, for example, This website describes it as ,"a person whose main energy in life is directed towards having, saving and hoarding money and material things as well as feelings, gestures, words, energy. It is the character of the stingy individual and is usually connected with such other traits as orderliness, punctuality, stubbornness, each to a more than ordinary degree."
- Basically anal retentive or anal character is an older name for obsessive-compulsive personality disorder.--NeantHumain 21:25, 2 January 2007 (UTC)
[edit] self-help inappropriate?
The self-help section seems completely inappropriate for an encylopedia entry. 207.172.96.134 17:03, 4 September 2007 (UTC)
