Personality disorders are persistent and unceasing psychological disorders that greatly affect the patient's life. The disorders affect one's carrier, family and other aspects of social life. They exist in a continuum and hence they can be mild or severe depending on how extreme they are, and the extent to which the patients' exhibit features associated with particular personality disorders. Most people are able to cope with mild forms of personality disorders but during times of stress and external pressures, the disorder becomes severe and starts interfering with a person's emotional and mental functioning. There are many types of personality disorders which include compulsive- obsessive disorder, paranoid personality disorder, schizoid personality disorder and schizotypal personality disorder among others. This paper aims at analyzing the compulsive- obsessive disorder and its treatment (Malcolm, 2004).Obsessive - compulsive personality disorder (OCPD)
This is an anxiety disorder characterized by the patient undergoing multiple and repeated obsessions as well as compulsions that impede the patient's capacity to function socially, occupationally or academically. This is because the patient wastes a lot of time during attacks in marked fear and other forms of distress that he or she suffers. An obsession in this case refers to an abnormal thought, an impulse, or an image which occur persistently causing severe anxiety to the patient. The thoughts are usually irresistible to the sufferer despite the fact that he realizes that they are not rational. Some of the obsessions include worries about cleanliness, safety, order, etc. A compulsion on the other hand, refers to the behavior engaged in by the patient repeatedly as a result of the obsessions. Such compulsions may include too much washing of one's hands, lock checking, and skin picking or too much arranging of items (Baer, 2005).Many causes are thought to contribute to obsessive- compulsive disorder although faulty parenting is thought to be a risk factor in its development. Research has shown that a child's development is dependent on appropriate responsiveness to his needs and parental warmth. The presence of the variables makes the child feel valued and secure. However, many children, who are punished for every mistake they make no matter how trivial it is and rarely get rewarded, tend to develop the personality disorder. In this case, OCPD develops as a way of avoiding being punished. Genetic contribution is also thought to cause OCPD although it has not been well documented. Cultural influence is another causative agent for OCPD. Some cultures are much authoritative and rule- bound and therefore, encourages one to develop practices that are likely to contribute to the disorder (Stein, 2006).One symptom of OCPD is persistent over- concern with emotional, psychological and behavioral control of oneself as well as others. Excessive conscientiousness makes the sufferers to be poor in problem solving and also experience a lot of trouble when making decisions. Therefore, they are normally highly inefficient. The people's need for autonomy is easily distressed by, minor unforeseen events, or schedule alterations. According to DSMIV-TR criteria a person suffering from OCPD displays at least four of the following characteristics.
-being preoccupied with details, rules and regulations, organization, order, schedules and lists to the extent of losing a major goal-Extreme concern about perfection in minor details, which always interfere, with projects completion.-Being over-committed to work and efficiency that makes one shun friendship and leisure activities although the long hours of work do not have any significant financial gain.-too much moral rigidity and inflexibility in ethical matters as well as values that are not accounted for by the principles of his religion and culture-Hoarding items or keeping worn-out and useless things although they may not have any sentimental or monetary value.-insisting that tasks must be completed through the person's persona; preferences-being stingy with oneself as well as others.-Extreme inflexibility and stubbornness (Samuels, 2000).The history of diagnosis of obsessive -compulsive personality disorder, in medicine, in medicine dates about 100 years. In the United States of America, the number of people with the disorder is between 1-2 percent i.e. 2-3 million individuals. The frequency of its occurrence and its symptoms are the same regardless of the person's culture. On average, people start experiencing the disorder at a young age of19 years, although it may develop during childhood or teenage years and develop by the age of 30 years. Past experience has shown the disorder to affect more men than women with the number of women suffering from the disorder being almost double that of women. Past research has attributed this disparity to gender stereotyping. This is because men have more permission from culture to act in obstinate, preservative and controlling manner (Villemarette, 2004).Diagnosis of OCPD
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Due to the nature of the disorder, it is very hard for it to be diagnosed as the person's sole reason for seeking medical help. Usually the people are not aware of the discomfort that their stubbornness and inflexibility causes others probably because the traits help them control the others. The patients enter therapy for other reasons such as anxiety disorders, relationship difficulties and other stress related medical problems. Therefore, diagnosing OCPD is highly dependent on carefully observing and appropriately assessing the patient's behavior. Evidence of attitudes and behaviors related to OCPD is not enough; the symptoms have to be severe enough to cause interruptions on one's interpersonal and occupational functioning. The diagnosis would include distinguishing between OCPD and obsessive compulsive disorder (OCD). An individual with obsessions and compulsions which he or she experiences as being alien and not rational is most likely suffering from OCD. On the other hand, a person feeling comfortable with the compulsive and obsessive behavior such as extreme care of how things are arranged most likely suffers from OCPD. While the thoughts and behaviors experienced in OCD seldom affect real- life situations, individuals with OCPD are extremely preoccupied in the management of the various tasks they encounter in their daily living. OCPD have some features that are common even in other personality disorders. While a person with narcissistic disorder is also extremely occupied with perfection and critical. However, unlike a person with OCPD who is stingy to the point of denying himself basic things so that he does not spend money, people with narcissistic personality disorder are only stingy with others. Similarly, people with schizoid personality disorder do not have the capacity for intimacy. The difference is that although people with OCPD have problems of intimacy, they experience caring and usually long for intimate relationships. Other medical conditions may appear like OCPD. However, the difference is that their onset symptoms are directly related to the specific illness. Behaviors related to drug abuse could also be mistaken for OCPD if the substance abuse has not yet been discovered. Furthermore, OCPD diagnosis may be complicated due to the fact that compulsive behaviors similar to those of OCPD are normal variants in a given culture, religion or profession. Therefore, for it to be concluded that a person is suffering from OCPD, the behaviors have to be extremely severe such that they impair one's functioning (Penzel, 2000).Treatment for OCPD involves both psychotherapy and medication. Insight oriented psychodynamic techniques and cognitive behavioral therapy have been found helpful in the treatment of patients with OCPD. Through this method, the patients are taught on how to get satisfaction in life by establishing close relationships and engaging in recreational activities instead of getting extremely preoccupied with work- related activities. This greatly improves their quality of life. Patients with type A characteristics, which include being competitive, time urgency and extreme preoccupation with work, are taught on relaxation techniques, which greatly enrich the quality of life they live. The main challenge in administering therapy to a patient suffering from OCPD disorder is that people with OCPD rarely trust others; they have a tendency of doubting and questioning everything about the therapeutic process. Therefore, most patients do not follow the instructions given by the therapist. This fools the therapist into believing that the whole process is successful while the patient may only be superficially compliant (Ryle & Kerr, 2002).In the past, medication for obsessive- compressive personality disorders were believed to be ineffective as they failed to address the root causes of this disorder. However, studies carried out recently show that use of drugs may be a practical adjunct to the psychotherapeutic efforts. Such medicines as selective serotonin re uptake inhibitors (SSRIs) are a great help to the patient with rigidity and compulsiveness although the patient may not have shown indications of pre-existing depression. Medication helps the person in thinking clearly and making better and faster decisions as it enhances concentration. In other words, medication assists the patient in functioning with reduced distress (Jefferys, 2008).People with OCPD do not experience their full potential of success in professions or social life owing to their emotional detachment and their controlling behavior. However, as discussed earlier, studies have greatly associated the development of OCPD to bad early life experiences such as the absence of parental love, over control and inflexibility while having little or no rewards for impulsive, emotional expression. This means that to a large extent, parents can play a great role in preventing the occurrence of OCPD. Therefore, parents need to be enlightened on the need for good upbringing practices if prevention of OCPD is going to achieve much success.