Saturday, November 21, 2009

Autism and OCPD

A few months ago my Cognitive Behavioral Therapist made a suggestion about me having Obsessive-Compulsive Personality Disorder (not to be confused with OCD, which I also have). Which is, essentially, an extreme version of what is popularly called an "anal-retentive" personality, stemming from Freud's ludicrous notion that perfectionism stems from refusing to go to the bathroom when one is little. Wikipedia describes the symptoms of OCPD as:

The primary symptoms of OCPD are a preoccupation with details, rules, lists, order, organization, and schedules; being very rigid and inflexible in their beliefs; showing perfectionism that interferes with completing a task; excessive focus on being productive with their time; being very conscientious; having inflexible morality, ethics, or values; hoarding items that may no longer have value; and a reluctance to trust a work assignment or task to someone else for fear that their standards will not be met.
Some people with OCPD, but not all of them, show an obsessive need for cleanliness. Those that do not show this tendency are sometimes good at setting up systems to maintain cleanliness, but may not follow through with the need to clean because of other "more important" priorities. For example, the need to get a good grade or finish a project at work might cause the OCPD person to have a quite messy and unorganized home. But if that same person was suddenly unemployed or finished with other activities, he or she could very well start becoming obsessed with cleanliness as other activities take up less time.
Completion of a task or problem by an OCPD individual can be affected when excessive time is used in getting such to be considered right. Personal and social relationships are often under serious strain because the OCPD individual insists on being in charge and the only one who knows what is right. Uncleanliness is seen by some OCPD individuals as a form of lack of perfection, as is untidiness. They may routinely spend considerable time using a precise manner, as for instance putting everything in precisely the right place in precisely the right manner. OCPD sufferers can be anxious about the potential for things to go wrong in their lives and respond by hoarding money.[3] Pathological money hoarding, looking like miserliness or stinginess to other people,[3] may occur to minimize that spent on daily living.
There are few moral grey areas for a person with fully developed OCPD. Actions and beliefs are either completely right or absolutely wrong, with the OCPD individual always in the right. As might be expected, interpersonal relationships are difficult because of the excessive demands placed on friends, romantic partners and children. Sometimes frustration with other people not doing what the OCPD individual wants spills over into anger and even violence. This is known as disinhibition.[4] Persons with OCPD often have a negative outlook on life (pessimism) with a low underlying form of depression.[5][6][7] This can at times become so serious that suicide is a real risk.[8] Indeed, one study suggests that personality disorders are a significant substrate to psychiatric morbidity. They may cause more problems in functioning than a major depressive episode.[9]
People with OCPD, when anxious or excited, may tic, grimace, or make noises, as in Tourette syndrome, or do impulsive[10] and unpredictable things, including risk taking. They may keep their homes perfectly organized, or be anxious about delegating tasks for fear that they won't be completed correctly. They may even insist on taking over a task someone else is doing so that it will be done properly. About one in four OCPD individuals may display rigid and stubborn characteristics, a defining criterion.

A pervasive pattern of preoccupation with orderliness, perfectionism, and mental and interpersonal control, at the expense of flexibility, openness, and efficiency, beginning by early adulthood and present in a variety of contexts, as indicated by four (or more) of the following:
  1. Is preoccupied with details, rules, lists, order, organization, or schedules to the extent that the major point of the activity is lost
  2. Shows perfectionism that interferes with task completion (e.g., is unable to complete a project because his or her own overly strict standards are not met)
  3. Is excessively devoted to work and productivity to the exclusion of leisure activities and friendships (not accounted for by obvious economic necessity)
  4. Is overconscientious, scrupulous, and inflexible about matters of morality, ethics, or values (not accounted for by cultural or religious identification)
  5. Is unable to discard worn-out or worthless objects even when they have no sentimental value
  6. Is reluctant to delegate tasks or to work with others unless they submit to exactly his or her way of doing things
  7. Adopts a miserly spending style toward both self and others; money is viewed as something to be hoarded for future catastrophes
  8. Shows rigidity and stubbornness

It fits me pretty well. I am an extreme perfectionist when I'm doing something, slowing me down. In issues of morality I tend to think in black and white even when I know in the back of my head that things are more complicated than that. I'm a big pack-rat and hate throwing things out. I hate delegating tasks and prefer to do them myself lest the person screw up and do it "the wrong way" (as I mentioned in a previous post when i worked at a preschool). And I am famous for being extremely stubborn.

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