May 8, 2025 • 13 mins
Ever double-checked that your door was locked, even though you knew it was? That momentary doubt is normal—but what happens when these urges become overwhelming and constant? Drawing distinct lines between everyday quirks and clinical conditions, we untangle the often confused Obsessive-Compulsive Disorder (OCD) and Obsessive-Compulsive Personality Disorder (OCPD).
The key distinction is profound: OCD manifests as intrusive, unwanted thoughts triggering repetitive behaviors to reduce anxiety. These thoughts feel foreign to the person experiencing them—what psychologists call "ego-dystonic." Despite recognizing their irrationality, people with OCD feel powerless to stop the cycle that consumes at least an hour daily. Most shocking is the 11-year average delay between symptom onset and treatment, largely due to shame and misdiagnosis.
By contrast, OCPD represents a pervasive personality pattern centered on orderliness, perfectionism, and control. Unlike OCD, people with OCPD typically view their traits as rational or even virtuous—they're "ego-syntonic." This fundamentally different self-perception drives treatment differences: while OCD responds well to Exposure and Response Prevention therapy and medication, OCPD requires longer-term approaches focused on building flexibility and self-awareness.
We examine how cultural context complicates recognition of OCPD, as traits like diligence and meticulousness often receive positive reinforcement. Someone might excel professionally while struggling significantly in relationships due to rigidity and control needs. Consider how our society's emphasis on productivity and perfection might blur the line between dedication and disorder—when do high standards become harmful?
Whether you're a mental health professional seeking clarity or someone trying to understand these conditions better, this episode provides the framework to distinguish between unwanted symptoms and ingrained personality traits, guiding the path toward appropriate support and treatment.
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This podcast is not associated with the NBCC, AMFTRB, ASW, ANCC, NASP, NAADAC, CCMC, NCPG, CRCC, or any state or governmental agency responsible for licensure.
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Episode Transcript
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Speaker 1 (00:00):
Welcome to the Licensure Exams podcast.
You lovely therapists, you knowthat little mental nudge when
things aren't quite right, likebooks on a shelf, Mm-hmm.
You know double-checking thestove even when you're pretty
sure it's off.
Speaker 2 (00:15):
Yeah, we all have those little quirks, those
moments.
Speaker 1 (00:18):
Right, but what if those feelings, those urges,
become well constant, reallyoverwhelming?
That's kind of the area we'regetting into today.
Speaker 2 (00:27):
Exactly.
A lot of you listeners haveasked about the difference
between you know everydaytendencies like that and maybe
more formal conditions.
So today we're doing a deepdive into two specific ones
obsessive compulsive disorder,that's, ocd, and obsessive
compulsive personality disorderOCPD.
Okay, and we've got theofficial diagnostic criteria
(00:50):
straight from the DSM-5-TR.
We'll look at treatments tooand, crucially, what really
separates them.
Speaker 1 (00:56):
Perfect.
Yeah, our mission here isreally to unpack all of that to
give you a much clearer pictureof what makes each one distinct.
We'll cover, like the mainfeatures, how they're diagnosed,
typical treatment, goals andmethods and I think this is key
how people with OCD versus OCPDactually see their own thoughts
and behavior.
Hopefully this clears up someof the confusion that's
(01:18):
definitely out there betweenthese two.
Speaker 2 (01:20):
Okay, so let's kick off with excessive
compulsiveorder OCD.
What's really striking aboutOCD is just how intrusive it
feels.
Speaker 1 (01:29):
Intrusive okay.
Speaker 2 (01:30):
The DSM-5 TRA criteria really zeroes in on
this.
It says OCD involves havingobsessions or compulsions or
actually quite often both.
Speaker 1 (01:40):
Okay, so let's define obsessions a bit more clearly.
Speaker 2 (01:56):
What does that actually mean in this context?
Is it just worrying a lot?
And they cause pretty markedanxiety or distress?
The key difference from regularworries is that they aren't
just excessive concerns about,you know, real life problems.
They feel intrusive, they'reunwanted and the person actively
tries to push them away, ignorethem or somehow neutralize them
(02:20):
.
Often that's where thecompulsions come in.
Speaker 1 (02:22):
Ah, okay, so the compulsions are linked to the
obsessions.
What are they exactly?
Speaker 2 (02:26):
Compulsions are basically repetitive behaviors.
Things you can see likeexcessive hand washing, checking
things over and over.
Speaker 1 (02:35):
Like the stove example earlier.
Speaker 2 (02:37):
Exactly, or they can be mental acts, things happening
inside the person's head, likecounting, maybe repeating words
silently.
Okay, and the person's head,like counting, maybe repeating
words silently Okay.
And the person feels drivenlike they have to perform these
actions often according toreally strict, self-imposed
rules.
Speaker 1 (02:52):
And why.
What's the goal?
Speaker 2 (02:54):
Well, it's usually not about pleasure.
It's aimed at reducing thatanxiety, the obsession stirred
up, or trying to prevent adreaded event or situation from
happening.
Speaker 1 (03:04):
Got it.
So the obsession createsanxiety, the compulsion tries to
relieve it.
Speaker 2 (03:08):
Precisely and for it to be diagnosed as OCD according
to the DSM-5-TR.
These obsessions or compulsionshave to be really
time-consuming howtime-consuming Generally the
guideline is more than an hourper day or they have to cause
clinically significant distressor impairment in important areas
(03:29):
of life like work orrelationships, social life,
school, just general functioning.
It has to really interfere.
Speaker 1 (03:38):
That makes sense.
It's not just a quick thought.
It's actually impacting theirlife negatively.
Now, you mentioned this thingabout how long it takes people
to get help.
Speaker 2 (03:46):
Yes, that was quite striking.
While the DSM criteria don'tset like a minimum time you have
to have symptoms for adiagnosis, they just need to be
persistent and not caused by,say, medication or another
condition.
The source has highlighted thisaverage delay it's about 11
years between the onset of OCDsymptoms and actually starting
(04:08):
treatment 11 years Wow, that's areally long time to be
struggling.
Speaker 1 (04:12):
Why such a delay?
Speaker 2 (04:12):
Well, the sources point to a couple of big factors
.
Shame and secrecy are huge.
People often feel reallyembarrassed by these thoughts or
behaviors, afraid of whatothers might think, so they hide
it.
Speaker 1 (04:24):
I can see that.
Speaker 2 (04:25):
And then there's misdiagnosis OCD can sometimes
look like other anxietydisorders or even just extreme
worry, so it might not getpicked up correctly right away.
Speaker 1 (04:34):
Okay, so it's a combination of internal feelings
and maybe external diagnosticchallenges.
Speaker 2 (04:39):
Exactly.
It can be hard for someone toeven recognize that what they're
experiencing is a treatabledisorder.
Speaker 1 (04:45):
So let's say someone does get diagnosed.
What are the primary goals whentreating OCD?
What are they aiming for?
Speaker 2 (04:52):
The immediate goals are usually about reducing the
frequency and intensity of boththe obsessions and the
compulsions and, alongside that,improving overall daily
functioning.
Reducing distress Plusaddressing any co-occurring
conditions is important becausethings like depression or other
anxiety issues often gohand-in-hand with OCD.
(05:14):
The focus is often on relapseprevention, building skills to
manage symptoms if they flare upand, really importantly,
increasing the person'stolerance for uncertainty and
distress without resorting backto those compulsions.
Speaker 1 (05:29):
Okay, learning to live with some level of
uncertainty, and how dotherapists actually measure if
the treatment is working?
You mentioned something aboutquantifiable goals.
Speaker 2 (05:39):
That's right.
Therapy often involves settingvery specific, measurable
targets, for instance, maybeaiming to reduce the time spent
on rituals to less than one houra day.
Speaker 1 (05:51):
Concrete numbers.
Speaker 2 (05:52):
Yeah, and tools like the Y-Box, that's, the
Yale-Brown Obsessive-CompulsiveScale, are commonly used.
It helps assess the severity ofsymptoms at the start and track
progress throughout treatment.
Speaker 1 (06:04):
Okay, got it.
So what are the main treatmentapproaches?
What actually happens intherapy?
Speaker 2 (06:09):
The cornerstone really is cognitive behavioral
therapy, or CBT.
The basic idea of CBT islooking at the links between
unhelpful thoughts, feelings andbehaviors, and within CBT
there's a very specific andhighly effective technique for
OCD called Exposure and ResponsePrevention ERP.
Speaker 1 (06:29):
ERP okay.
Speaker 2 (06:30):
That's considered the gold standard psychological
treatment.
Neurobiological factors arealso understood to play a part.
Speaker 1 (06:38):
You mean like brain chemistry?
Speaker 2 (06:39):
Yes, particularly involving the neurotransmitter
serotonin, research points todysregulation in serotonin
pathways.
This understanding supports theuse of certain medications.
Speaker 1 (06:51):
Like antidepressants.
Speaker 2 (06:52):
Specifically SSRIs.
Selective serotonin reuptakeinhibitors are often the first
line.
They help regulate serotoninlevels, which can dampen down
the intensity of the obsessionsand compulsions for many people.
Speaker 1 (07:08):
Okay, let's back up to ERP.
You said exposure and responseprevention.
What does that actually looklike in practice?
It sounds intense.
Speaker 2 (07:15):
It can be, yes, but it's done gradually and
collaboratively.
Erp involves systematically,step-by-step, exposing the
person to the very thoughts,images, objects or situations
that trigger their obsessionsand anxiety, facing the fear,
but and this is the crucial partpreventing them from engaging
(07:36):
in their usual compulsiveresponse.
The response prevention bit anexposure might be touching a
doorknob they see as dirty, andthe response prevention part is
resisting the urge toimmediately wash their hands for
, say, an agreed upon amount oftime.
Speaker 1 (07:52):
Wow, so they have to sit with that anxiety.
Speaker 2 (07:54):
They do, and what happens over time with repeated
practice is that the linkbetween the trigger and the
compulsive urge weakens.
The anxiety naturally decreaseson its own without the ritual.
It's a process calledhabituation.
Speaker 1 (08:13):
Okay, that makes sense.
Speaker 2 (08:14):
Challenging, but I can see the logic.
What about the cognitive partof CBT?
Right cognitive restructuringthat focuses more directly on
the thinking patterns.
It involves identifying,examining and challenging the
specific irrational or unhelpfulbeliefs that often fuel the
obsessions.
Speaker 1 (08:27):
Like what kind of beliefs?
Speaker 2 (08:28):
Things like having an inflated sense of
responsibility, feeling likeyou're solely responsible for
preventing harm, oroverestimating the probability
of a threat, thinking a fearedoutcome is much more likely than
it actually is, or needingcertainty.
Speaker 1 (08:44):
Right, challenging those core assumptions Exactly.
Speaker 2 (08:47):
And we mentioned medications.
Often SSRIs are used, sometimesat higher doses than for
depression.
If SSRIs aren't effectiveenough on their own, sometimes
other medications, like certainatypical antipsychotics, might
be added in low doses to augmentthe effect.
Speaker 1 (09:04):
Gotcha Any other approaches?
Speaker 2 (09:06):
Mindfulness-based strategies are also increasingly
integrated.
They help people learn toobserve their intrusive thoughts
and feelings with a bit moredistance and non-judgment,
rather than immediately gettingentangled with them or trying to
fight them.
Speaker 1 (09:20):
Okay, so kind of acknowledging the thought
without having to act on it.
Speaker 2 (09:23):
Precisely.
It complements ERP andcognitive work well.
Speaker 1 (09:27):
All right, that gives us a really solid picture of
OCD.
Now let's shift gears to theother condition,
obsessive-compulsive personalitydisorder, ocpd.
The names are so similar it'sbound to cause confusion.
Speaker 2 (09:40):
Absolutely, and it's one of the main reasons we
wanted to cover this.
While the names overlap, OCPDis fundamentally different.
It's classified as apersonality disorder.
Speaker 1 (09:50):
Okay, so what does that mean?
Speaker 2 (09:52):
It means it's characterized by a pervasive
pattern, something deeplyingrained in the person's way of
being, related to orderliness,perfectionism and a strong need
for mental and interpersonalcontrol.
Pervasive pattern, so likeacross many areas of life.
Speaker 1 (10:08):
The DSM-5 TRA criteria state, this pattern
usually begins by earlyadulthood and shows up in
various contexts, and for adiagnosis, someone needs to
display at least four out ofeight specific characteristics.
Okay, four out of eightspecific characteristics.
Speaker 2 (10:22):
Okay, four out of eight.
What are those characteristics?
Can you run through them?
Speaker 1 (10:25):
Sure.
So number one is beingpreoccupied with details, rules,
lists, order, organization orschedules, often to the point
where the actual purpose of theactivity gets lost.
Speaker 2 (10:36):
Okay, losing the forest for the trees, kind of.
Speaker 1 (10:39):
Sort of yeah.
Two is perfectionism thatactually interferes with
completing tasks.
They might get so bogged downin getting it just right, they
never finish.
Three is excessive devotion towork and productivity, often
excluding leisure activities andfriendships.
Work becomes everything.
Four is beingover-conscientious, scrupulous
and inflexible about matters ofmorality, ethics or values
(11:02):
beyond what's typical for theirculture or religion.
Speaker 2 (11:05):
Very black and white thinking there.
Five is an inability to discardworn out or worthless objects,
even when they have no realsentimental value.
Hoarding tendencies cansometimes be part of it.
Six is reluctance to delegatetasks or work with others unless
they submit to exactly theirway of doing things.
The control aspect, again Seven, is a miserly spending style,
(11:30):
hoarding money for futurecatastrophes, being very
reluctant to spend on themselvesor others.
And eight general rigidity andstubbornness, difficulty
compromising or seeing otherpoints of view.
Speaker 1 (11:43):
Wow, okay, that definitely paints a very
different picture from the OCDsymptoms.
We talk about the specificintrusive thoughts and rituals.
Speaker 2 (11:52):
Very different.
Speaker 1 (11:53):
And the sources mention something absolutely
critical here the idea ofegocentronic versus egodistonic.
Can you explain that?
Speaker 2 (12:00):
This is probably the single most important
distinction.
Egocentronic means the personexperiences these traits, their
perfectionism, their need fororder, their rigidity, as being
consistent with their self-image.
Speaker 1 (12:13):
So they think it's normal or even good.
Speaker 2 (12:16):
Often, yes, they might see these traits as
rational, logical, desirable orsimply part of who they are.
They might even see them asvirtues like being diligent or
prudent.
They don't typically view thesetraits themselves as the
problem.
Speaker 1 (12:33):
Whereas with OCD you said it's ego-dystonic.
Speaker 2 (12:35):
Right.
People with OCD generallyexperience their obsessions and
compulsions as intrusive,unwanted, irrational and
distressing.
They conflict with theirself-image.
They know something is wrong orexcessive, even if they can't
stop it.
That's ego-dystonic,inconsistent with the self.
Speaker 1 (12:55):
Okay.
So OCPD folks might think thisis just how I am and it's the
right way to be, while OCD folksoften think this isn't me.
I wish these thought surgeswould stop.
Speaker 2 (13:06):
That's a great way to put it, and you can immediately
see how this difference impactstreatment seeking.
Speaker 1 (13:11):
Yeah, if you don't think there's a problem with
your traits, why would you seekhelp to change them?
Speaker 2 (13:15):
Exactly.
People with OCPD might come totherapy, but often it's because
of problems caused by theirtraits, like relationship
conflicts or trouble at work dueto inflexibility or maybe
co-occurring depression, ratherthan wanting to change the core
traits themselves, at leastinitially.
Speaker 1 (13:34):
That makes sense and the DSM also mentioned that
these OCPD patterns are enduringand inflexible, starting early
on.
Speaker 2 (13:40):
Yes, typically emerging in adolescence or early
adulthood and persisting.
It's a chronic pattern unlessthere's intervention.
And the sources also noted therole of culture.
How so Well.
In some cultures or workenvironments, traits like
extreme meticulousness, strongwork ethic or frugality might be
highly valued.
Speaker 1 (14:00):
Right seen as positive attributes.
Speaker 2 (14:02):
Yeah.
So sometimes the problematicaspects of OCPD can be masked or
even reinforced by theenvironment, potentially
delaying recognition that it'sactually a personality disorder
causing significant impairment,especially in relationships or
overall well-being.
Speaker 1 (14:18):
Interesting.
So if someone with OCPD doesend up in treatment, what are
the goals?
Usually it sounds differentfrom just reducing OCD symptoms.
Speaker 2 (14:26):
Very different.
The focus isn't typically oneliminating specific obsessions
or compulsions, because thosearen't the core issue.
Instead, therapy aims to helpthe person become aware of their
rigid patterns and the impactthey have.
Speaker 1 (14:40):
Okay, building self-awareness.
Speaker 2 (14:42):
Yes, and then working towards reducing that overall
rigidity, improvinginterpersonal relationships,
learning to collaborate,compromise, be more empathetic.
Enhancing emotional expressionis often a goal too, as people
with OCPD can sometimes seemquite constricted emotionally.
Speaker 1 (15:03):
So more flexibility, better connections.
Speaker 2 (15:05):
Exactly Fostering flexibility and thinking and
behavior, maybe reducing some ofthe workaholic tendencies, if
that's an issue, and addressingany comorbid conditions like
depression or anxiety, which arecommon.
It's less about symptomreduction, like in OCD, and more
about modifying these ingrainedpersonality patterns to improve
(15:25):
overall quality of life andrelationships.
Speaker 1 (15:29):
Okay, and what therapies are used for OCPD?
Is it still CBT?
Speaker 2 (15:33):
CBT can be helpful.
Yes, particularly the cognitiveparts challenging rigid
thinking patterns likeperfectionism and the need for
absolute control.
But because we're dealing withdeeper, long-standing
personality patterns, otherapproaches are often integrated
or used instead.
Psychodynamic therapy, forexample, can be very valuable.
Speaker 1 (15:55):
How does that work?
Speaker 2 (15:56):
It explores potential underlying conflicts, maybe
stemming from childhoodexperiences related to things
like autonomy, criticism orself-worth, which might
contribute to the development ofthese rigid defenses.
Speaker 1 (16:10):
Okay, digging a bit deeper into the roots.
Speaker 2 (16:12):
Exactly.
Schema therapy is anotherapproach that can be effective.
It focuses on identifying andchanging these deeply ingrained
negative patterns of thinkingand feeling, called early
maladaptive schemas, that drivethe OCPD traits Schemas like
(16:32):
core beliefs, improvingcommunication and relationship
skills, addressing theinterpersonal friction that OCPD
traits often cause.
Speaker 1 (16:41):
Can you give some examples of specific techniques
used within these therapies forOCPD?
Speaker 2 (16:45):
Sure.
So in CBT, a therapist mightwork with the person to
challenge all or nothing,thinking about success and
failure.
Behavioral experiments couldinvolve encouraging them to
deliberately delegate a task andnot micromanage it, to see that
the world doesn't end if it'snot done perfectly.
Speaker 1 (17:05):
Right testing those beliefs in the real world.
Speaker 2 (17:07):
Exactly.
Group therapy can be reallyhelpful too, providing a safe
space to get direct feedback onhow their rigidity or control
needs impact others and topractice more flexible social
skills.
Speaker 1 (17:21):
I can see how that would be valuable.
Speaker 2 (17:23):
Psychodynamic techniques might involve
exploring early relationshipswith caregivers, looking for
patterns related to criticism orcontrol.
Related to criticism or control, and schema therapy might use
techniques like role-playing tohelp the person challenge their
inner critic, that harsh,demanding voice driving the
perfectionism.
Speaker 1 (17:40):
Okay, a range of tools, depending on the person
and the approach.
Speaker 2 (17:44):
Definitely.
It's often a longer-termprocess than OCD treatment.
Speaker 1 (17:48):
Right, okay, so we've looked at OCD, we've looked at
OCPD individually.
Now let's really crystallizethose key differences.
Speaker 2 (17:56):
So let's recap the main distinctions.
First, just a coresymptomatology OCD is about
those intrusive thoughts, images, urges, the obsessions and the
repetitive behaviors or mentalacts, the compulsions.
Speaker 1 (18:10):
All right specific symptoms.
Speaker 2 (18:11):
Whereas OCPD is about those pervasive personality
traits, the intensepreoccupation with order,
perfection and control.
It's the overall pattern.
Speaker 1 (18:22):
Got it.
And the second big one wetalked about was insight right.
Speaker 2 (18:25):
Yes, insight.
Generally, OCD is egodistonic.
The person recognizes thethoughts, behaviors as excessive
or irrational, causing distress.
Ocpd is typically egocentronicthe person sees their traits as
part of them, often as logicalnormal or even virtuous.
Speaker 1 (18:49):
They don't inherently see the trait as the problem
and that difference hugelyimpacts treatment motivation.
Speaker 2 (18:51):
Absolutely.
It's a fundamental differencein how the condition is
experienced.
Speaker 1 (18:54):
Okay, what else?
Speaker 2 (18:56):
Their DSM-5-TR classification is different.
Ocd is underobsessive-compulsive and related
disorders.
Ocpd is under personalitydisorders in cluster C, the
anxious-fearful cluster, whichreflects the different
diagnostic focus.
For OCD, it's confirmingobsessions and meritorious
compulsions.
(19:16):
For OCPD, it's identifying thatpattern of at least four
characteristic personalitytraits.
Speaker 1 (19:22):
Okay, and do they tend to show up alongside other
mental health issues differently?
Comorbidity.
Speaker 2 (19:28):
Yes, there are tendencies.
Ocpd seems more frequentlylinked with depressive disorders
.
Ocd has stronger links withother anxiety disorders like
panic disorder or social anxiety.
Speaker 1 (19:41):
Interesting and the treatment pathways diverge quite
a bit, as we discussed.
Speaker 2 (19:45):
Significantly.
Ocd treatment often focuses onERP and SSRIs, directly
targeting symptom reduction, andcan sometimes show results
relatively quickly.
Ocpd treatment is typicallylonger-term psychotherapy CBT,
psychodynamic schema therapyaimed at modifying those deeply
(20:06):
ingrained personality patterns,improving insight and
flexibility.
Medication isn't usually theprimary treatment for the core
OCPD traits, though it might beused for co-occurring conditions
like depression.
Speaker 1 (20:20):
So that affects the prognosis or the expected
outcome too.
Speaker 2 (20:23):
Generally, yes.
Ocd often responds more readilyto targeted treatments like ERP
.
Ocpd, being a personalitypattern, usually requires more
sustained therapeutic effort toachieve significant change.
It's changeable, but it takestime.
Speaker 1 (20:40):
Okay, what about neurobiology?
Any differences known there?
Speaker 2 (20:43):
There's more distinct research on OCD, pointing to
things like serotonin systemirregularities and hyperactivity
in brain circuits like theorbital frontal cortex Right.
For OCPD, the neurobiologicalmarkers aren't as clearly
defined.
Some research links it tocognitive inflexibility, but
there isn't a specific brainsignature identified.
Speaker 1 (21:04):
In the same way as for OCD, Fascinating, and you
touched on culturalinterpretation earlier,
especially for OCPD.
Yes, that's an importantpractical difference.
Speaker 2 (21:12):
Because some OCPD traits yes, that's an important
practical difference Becausesome OCPD traits, like diligence
, meticulousness, thriftinesscan be viewed positively in
certain cultures or contexts.
Speaker 1 (21:21):
Like a strong work ethic.
Speaker 2 (21:23):
Exactly.
It can sometimes be harder torecognize when these traits
cross the line into apersonality disorder causing
impairment, especiallyinterpersonal problems.
Ocd symptoms being more overtlystrange or time-consuming are
perhaps less likely to bemisinterpreted as positive.
Speaker 1 (21:41):
Right.
And finally, how does thefunctional impairment, the way
it messes up someone's life,tend to differ?
Speaker 2 (21:46):
That's another key distinction With OCD.
The impairment often stemsdirectly from the time consumed
by rituals, the avoidance oftriggering situations and the
sheer distress caused byobsessions.
Speaker 1 (21:59):
It takes up space and energy.
Speaker 2 (22:01):
A lot of it With OCPD .
While someone might be highlyfunctional, even successful, in
structured work environments,the impairment frequently
manifests in interpersonalrelationships.
Impairment frequently manifestsin interpersonal relationships.
Their rigidity, difficultydelegating, need for control,
emotional constriction andperceived criticism of others
can lead to significant conflictwith partners, family, friends
(22:25):
and colleagues.
They might struggle withteamwork or intimacy.
Speaker 1 (22:30):
Okay, so OCD impacts more via the symptoms themselves
, OCPD more via the impact ofthe traits on relationships and
flexibility.
Speaker 2 (22:37):
That's a good summary of the general tendency.
Speaker 1 (22:39):
yes, All right, let's try and boil down the absolute
key takeaway for everyonelistening.
Speaker 2 (22:44):
Okay.
The absolute core difference isthis Think of OCD as being
driven by anxiety about specificintrusive thoughts, obsessions
leading to behaviors,compulsions aimed at reducing
that anxiety, which the personusually knows are excessive or
irrational, even if they can'tstop.
Speaker 1 (23:03):
Ego-dystonic.
Speaker 2 (23:04):
Right.
Think of OCPD as a pervasive,lifelong style characterized by
a need for order, perfection andcontrol, where the person often
sees these traits as reasonable, logical or even virtuous
aspects of themselves.
Speaker 1 (23:20):
Ego-syntonic.
Speaker 2 (23:21):
Exactly.
Ocd is more about unwantedsymptoms.
Ocpd is more about ingrainedpersonality traits perceived
differently by the individual.
Speaker 1 (23:31):
So for you, listening , really grasping that
difference, the intrusivesymptoms versus the pervasive
traits, and especially thategocentronic distal piece, gives
you a much sharper lens tounderstand these distinct
experiences.
Speaker 2 (23:45):
Absolutely, and it highlights why a correct
diagnosis is so vital forguiding the right kind of help.
The approaches are really quitedifferent.
Speaker 1 (23:53):
Definitely Okay.
Finally, maybe a littlesomething for you to mull over
after this Consider how much oursociety values things like high
productivity, efficiency,organization and well perfection
.
Speaker 2 (24:05):
Right.
Those things are often praised.
Speaker 1 (24:07):
So think about how those societal values might
sometimes blur the lines ormaybe even inadvertently
reinforce some OCPD traits, evenif those traits are causing
someone private distress orcreating real friction in their
relationships, externally theymight just look like someone
who's incredibly conscientiousor successful.
Speaker 2 (24:28):
That's a really interesting point how external
validation or judgment interactswith the internal experience.
Speaker 1 (24:33):
Thanks for being with us today and remember it's in
there.
Welcome to the Licensure Exams podcast.
You lovely therapists, you knowthat little mental nudge when
things aren't quite right, likebooks on a shelf, Mm-hmm.
You know double-checking thestove even when you're pretty
sure it's off.
Speaker 2 (00:15):
Yeah, we all have those little quirks, those
moments.
Speaker 1 (00:18):
Right, but what if those feelings, those urges,
become well constant, reallyoverwhelming?
That's kind of the area we'regetting into today.
Speaker 2 (00:27):
Exactly.
A lot of you listeners haveasked about the difference
between you know everydaytendencies like that and maybe
more formal conditions.
So today we're doing a deepdive into two specific ones
obsessive compulsive disorder,that's, ocd, and obsessive
compulsive personality disorderOCPD.
Okay, and we've got theofficial diagnostic criteria
(00:50):
straight from the DSM-5-TR.
We'll look at treatments tooand, crucially, what really
separates them.
Speaker 1 (00:56):
Perfect.
Yeah, our mission here isreally to unpack all of that to
give you a much clearer pictureof what makes each one distinct.
We'll cover, like the mainfeatures, how they're diagnosed,
typical treatment, goals andmethods and I think this is key
how people with OCD versus OCPDactually see their own thoughts
and behavior.
Hopefully this clears up someof the confusion that's
(01:18):
definitely out there betweenthese two.
Speaker 2 (01:20):
Okay, so let's kick off with excessive
compulsiveorder OCD.
What's really striking aboutOCD is just how intrusive it
feels.
Speaker 1 (01:29):
Intrusive okay.
Speaker 2 (01:30):
The DSM-5 TRA criteria really zeroes in on
this.
It says OCD involves havingobsessions or compulsions or
actually quite often both.
Speaker 1 (01:40):
Okay, so let's define obsessions a bit more clearly.
Speaker 2 (01:56):
What does that actually mean in this context?
Is it just worrying a lot?
And they cause pretty markedanxiety or distress?
The key difference from regularworries is that they aren't
just excessive concerns about,you know, real life problems.
They feel intrusive, they'reunwanted and the person actively
tries to push them away, ignorethem or somehow neutralize them
(02:20):
.
Often that's where thecompulsions come in.
Speaker 1 (02:22):
Ah, okay, so the compulsions are linked to the
obsessions.
What are they exactly?
Speaker 2 (02:26):
Compulsions are basically repetitive behaviors.
Things you can see likeexcessive hand washing, checking
things over and over.
Speaker 1 (02:35):
Like the stove example earlier.
Speaker 2 (02:37):
Exactly, or they can be mental acts, things happening
inside the person's head, likecounting, maybe repeating words
silently.
Okay, and the person's head,like counting, maybe repeating
words silently Okay.
And the person feels drivenlike they have to perform these
actions often according toreally strict, self-imposed
rules.
Speaker 1 (02:52):
And why.
What's the goal?
Speaker 2 (02:54):
Well, it's usually not about pleasure.
It's aimed at reducing thatanxiety, the obsession stirred
up, or trying to prevent adreaded event or situation from
happening.
Speaker 1 (03:04):
Got it.
So the obsession createsanxiety, the compulsion tries to
relieve it.
Speaker 2 (03:08):
Precisely and for it to be diagnosed as OCD according
to the DSM-5-TR.
These obsessions or compulsionshave to be really
time-consuming howtime-consuming Generally the
guideline is more than an hourper day or they have to cause
clinically significant distressor impairment in important areas
(03:29):
of life like work orrelationships, social life,
school, just general functioning.
It has to really interfere.
Speaker 1 (03:38):
That makes sense.
It's not just a quick thought.
It's actually impacting theirlife negatively.
Now, you mentioned this thingabout how long it takes people
to get help.
Speaker 2 (03:46):
Yes, that was quite striking.
While the DSM criteria don'tset like a minimum time you have
to have symptoms for adiagnosis, they just need to be
persistent and not caused by,say, medication or another
condition.
The source has highlighted thisaverage delay it's about 11
years between the onset of OCDsymptoms and actually starting
(04:08):
treatment 11 years Wow, that's areally long time to be
struggling.
Speaker 1 (04:12):
Why such a delay?
Speaker 2 (04:12):
Well, the sources point to a couple of big factors
.
Shame and secrecy are huge.
People often feel reallyembarrassed by these thoughts or
behaviors, afraid of whatothers might think, so they hide
it.
Speaker 1 (04:24):
I can see that.
Speaker 2 (04:25):
And then there's misdiagnosis OCD can sometimes
look like other anxietydisorders or even just extreme
worry, so it might not getpicked up correctly right away.
Speaker 1 (04:34):
Okay, so it's a combination of internal feelings
and maybe external diagnosticchallenges.
Speaker 2 (04:39):
Exactly.
It can be hard for someone toeven recognize that what they're
experiencing is a treatabledisorder.
Speaker 1 (04:45):
So let's say someone does get diagnosed.
What are the primary goals whentreating OCD?
What are they aiming for?
Speaker 2 (04:52):
The immediate goals are usually about reducing the
frequency and intensity of boththe obsessions and the
compulsions and, alongside that,improving overall daily
functioning.
Reducing distress Plusaddressing any co-occurring
conditions is important becausethings like depression or other
anxiety issues often gohand-in-hand with OCD.
(05:14):
The focus is often on relapseprevention, building skills to
manage symptoms if they flare upand, really importantly,
increasing the person'stolerance for uncertainty and
distress without resorting backto those compulsions.
Speaker 1 (05:29):
Okay, learning to live with some level of
uncertainty, and how dotherapists actually measure if
the treatment is working?
You mentioned something aboutquantifiable goals.
Speaker 2 (05:39):
That's right.
Therapy often involves settingvery specific, measurable
targets, for instance, maybeaiming to reduce the time spent
on rituals to less than one houra day.
Speaker 1 (05:51):
Concrete numbers.
Speaker 2 (05:52):
Yeah, and tools like the Y-Box, that's, the
Yale-Brown Obsessive-CompulsiveScale, are commonly used.
It helps assess the severity ofsymptoms at the start and track
progress throughout treatment.
Speaker 1 (06:04):
Okay, got it.
So what are the main treatmentapproaches?
What actually happens intherapy?
Speaker 2 (06:09):
The cornerstone really is cognitive behavioral
therapy, or CBT.
The basic idea of CBT islooking at the links between
unhelpful thoughts, feelings andbehaviors, and within CBT
there's a very specific andhighly effective technique for
OCD called Exposure and ResponsePrevention ERP.
Speaker 1 (06:29):
ERP okay.
Speaker 2 (06:30):
That's considered the gold standard psychological
treatment.
Neurobiological factors arealso understood to play a part.
Speaker 1 (06:38):
You mean like brain chemistry?
Speaker 2 (06:39):
Yes, particularly involving the neurotransmitter
serotonin, research points todysregulation in serotonin
pathways.
This understanding supports theuse of certain medications.
Speaker 1 (06:51):
Like antidepressants.
Speaker 2 (06:52):
Specifically SSRIs.
Selective serotonin reuptakeinhibitors are often the first
line.
They help regulate serotoninlevels, which can dampen down
the intensity of the obsessionsand compulsions for many people.
Speaker 1 (07:08):
Okay, let's back up to ERP.
You said exposure and responseprevention.
What does that actually looklike in practice?
It sounds intense.
Speaker 2 (07:15):
It can be, yes, but it's done gradually and
collaboratively.
Erp involves systematically,step-by-step, exposing the
person to the very thoughts,images, objects or situations
that trigger their obsessionsand anxiety, facing the fear,
but and this is the crucial partpreventing them from engaging
(07:36):
in their usual compulsiveresponse.
The response prevention bit anexposure might be touching a
doorknob they see as dirty, andthe response prevention part is
resisting the urge toimmediately wash their hands for
, say, an agreed upon amount oftime.
Speaker 1 (07:52):
Wow, so they have to sit with that anxiety.
Speaker 2 (07:54):
They do, and what happens over time with repeated
practice is that the linkbetween the trigger and the
compulsive urge weakens.
The anxiety naturally decreaseson its own without the ritual.
It's a process calledhabituation.
Speaker 1 (08:13):
Okay, that makes sense.
Speaker 2 (08:14):
Challenging, but I can see the logic.
What about the cognitive partof CBT?
Right cognitive restructuringthat focuses more directly on
the thinking patterns.
It involves identifying,examining and challenging the
specific irrational or unhelpfulbeliefs that often fuel the
obsessions.
Speaker 1 (08:27):
Like what kind of beliefs?
Speaker 2 (08:28):
Things like having an inflated sense of
responsibility, feeling likeyou're solely responsible for
preventing harm, oroverestimating the probability
of a threat, thinking a fearedoutcome is much more likely than
it actually is, or needingcertainty.
Speaker 1 (08:44):
Right, challenging those core assumptions Exactly.
Speaker 2 (08:47):
And we mentioned medications.
Often SSRIs are used, sometimesat higher doses than for
depression.
If SSRIs aren't effectiveenough on their own, sometimes
other medications, like certainatypical antipsychotics, might
be added in low doses to augmentthe effect.
Speaker 1 (09:04):
Gotcha Any other approaches?
Speaker 2 (09:06):
Mindfulness-based strategies are also increasingly
integrated.
They help people learn toobserve their intrusive thoughts
and feelings with a bit moredistance and non-judgment,
rather than immediately gettingentangled with them or trying to
fight them.
Speaker 1 (09:20):
Okay, so kind of acknowledging the thought
without having to act on it.
Speaker 2 (09:23):
Precisely.
It complements ERP andcognitive work well.
Speaker 1 (09:27):
All right, that gives us a really solid picture of
OCD.
Now let's shift gears to theother condition,
obsessive-compulsive personalitydisorder, ocpd.
The names are so similar it'sbound to cause confusion.
Speaker 2 (09:40):
Absolutely, and it's one of the main reasons we
wanted to cover this.
While the names overlap, OCPDis fundamentally different.
It's classified as apersonality disorder.
Speaker 1 (09:50):
Okay, so what does that mean?
Speaker 2 (09:52):
It means it's characterized by a pervasive
pattern, something deeplyingrained in the person's way of
being, related to orderliness,perfectionism and a strong need
for mental and interpersonalcontrol.
Pervasive pattern, so likeacross many areas of life.
Speaker 1 (10:08):
The DSM-5 TRA criteria state, this pattern
usually begins by earlyadulthood and shows up in
various contexts, and for adiagnosis, someone needs to
display at least four out ofeight specific characteristics.
Okay, four out of eightspecific characteristics.
Speaker 2 (10:22):
Okay, four out of eight.
What are those characteristics?
Can you run through them?
Speaker 1 (10:25):
Sure.
So number one is beingpreoccupied with details, rules,
lists, order, organization orschedules, often to the point
where the actual purpose of theactivity gets lost.
Speaker 2 (10:36):
Okay, losing the forest for the trees, kind of.
Speaker 1 (10:39):
Sort of yeah.
Two is perfectionism thatactually interferes with
completing tasks.
They might get so bogged downin getting it just right, they
never finish.
Three is excessive devotion towork and productivity, often
excluding leisure activities andfriendships.
Work becomes everything.
Four is beingover-conscientious, scrupulous
and inflexible about matters ofmorality, ethics or values
(11:02):
beyond what's typical for theirculture or religion.
Speaker 2 (11:05):
Very black and white thinking there.
Five is an inability to discardworn out or worthless objects,
even when they have no realsentimental value.
Hoarding tendencies cansometimes be part of it.
Six is reluctance to delegatetasks or work with others unless
they submit to exactly theirway of doing things.
The control aspect, again Seven, is a miserly spending style,
(11:30):
hoarding money for futurecatastrophes, being very
reluctant to spend on themselvesor others.
And eight general rigidity andstubbornness, difficulty
compromising or seeing otherpoints of view.
Speaker 1 (11:43):
Wow, okay, that definitely paints a very
different picture from the OCDsymptoms.
We talk about the specificintrusive thoughts and rituals.
Speaker 2 (11:52):
Very different.
Speaker 1 (11:53):
And the sources mention something absolutely
critical here the idea ofegocentronic versus egodistonic.
Can you explain that?
Speaker 2 (12:00):
This is probably the single most important
distinction.
Egocentronic means the personexperiences these traits, their
perfectionism, their need fororder, their rigidity, as being
consistent with their self-image.
Speaker 1 (12:13):
So they think it's normal or even good.
Speaker 2 (12:16):
Often, yes, they might see these traits as
rational, logical, desirable orsimply part of who they are.
They might even see them asvirtues like being diligent or
prudent.
They don't typically view thesetraits themselves as the
problem.
Speaker 1 (12:33):
Whereas with OCD you said it's ego-dystonic.
Speaker 2 (12:35):
Right.
People with OCD generallyexperience their obsessions and
compulsions as intrusive,unwanted, irrational and
distressing.
They conflict with theirself-image.
They know something is wrong orexcessive, even if they can't
stop it.
That's ego-dystonic,inconsistent with the self.
Speaker 1 (12:55):
Okay.
So OCPD folks might think thisis just how I am and it's the
right way to be, while OCD folksoften think this isn't me.
I wish these thought surgeswould stop.
Speaker 2 (13:06):
That's a great way to put it, and you can immediately
see how this difference impactstreatment seeking.
Speaker 1 (13:11):
Yeah, if you don't think there's a problem with
your traits, why would you seekhelp to change them?
Speaker 2 (13:15):
Exactly.
People with OCPD might come totherapy, but often it's because
of problems caused by theirtraits, like relationship
conflicts or trouble at work dueto inflexibility or maybe
co-occurring depression, ratherthan wanting to change the core
traits themselves, at leastinitially.
Speaker 1 (13:34):
That makes sense and the DSM also mentioned that
these OCPD patterns are enduringand inflexible, starting early
on.
Speaker 2 (13:40):
Yes, typically emerging in adolescence or early
adulthood and persisting.
It's a chronic pattern unlessthere's intervention.
And the sources also noted therole of culture.
How so Well.
In some cultures or workenvironments, traits like
extreme meticulousness, strongwork ethic or frugality might be
highly valued.
Speaker 1 (14:00):
Right seen as positive attributes.
Speaker 2 (14:02):
Yeah.
So sometimes the problematicaspects of OCPD can be masked or
even reinforced by theenvironment, potentially
delaying recognition that it'sactually a personality disorder
causing significant impairment,especially in relationships or
overall well-being.
Speaker 1 (14:18):
Interesting.
So if someone with OCPD doesend up in treatment, what are
the goals?
Usually it sounds differentfrom just reducing OCD symptoms.
Speaker 2 (14:26):
Very different.
The focus isn't typically oneliminating specific obsessions
or compulsions, because thosearen't the core issue.
Instead, therapy aims to helpthe person become aware of their
rigid patterns and the impactthey have.
Speaker 1 (14:40):
Okay, building self-awareness.
Speaker 2 (14:42):
Yes, and then working towards reducing that overall
rigidity, improvinginterpersonal relationships,
learning to collaborate,compromise, be more empathetic.
Enhancing emotional expressionis often a goal too, as people
with OCPD can sometimes seemquite constricted emotionally.
Speaker 1 (15:03):
So more flexibility, better connections.
Speaker 2 (15:05):
Exactly Fostering flexibility and thinking and
behavior, maybe reducing some ofthe workaholic tendencies, if
that's an issue, and addressingany comorbid conditions like
depression or anxiety, which arecommon.
It's less about symptomreduction, like in OCD, and more
about modifying these ingrainedpersonality patterns to improve
(15:25):
overall quality of life andrelationships.
Speaker 1 (15:29):
Okay, and what therapies are used for OCPD?
Is it still CBT?
Speaker 2 (15:33):
CBT can be helpful.
Yes, particularly the cognitiveparts challenging rigid
thinking patterns likeperfectionism and the need for
absolute control.
But because we're dealing withdeeper, long-standing
personality patterns, otherapproaches are often integrated
or used instead.
Psychodynamic therapy, forexample, can be very valuable.
Speaker 1 (15:55):
How does that work?
Speaker 2 (15:56):
It explores potential underlying conflicts, maybe
stemming from childhoodexperiences related to things
like autonomy, criticism orself-worth, which might
contribute to the development ofthese rigid defenses.
Speaker 1 (16:10):
Okay, digging a bit deeper into the roots.
Speaker 2 (16:12):
Exactly.
Schema therapy is anotherapproach that can be effective.
It focuses on identifying andchanging these deeply ingrained
negative patterns of thinkingand feeling, called early
maladaptive schemas, that drivethe OCPD traits Schemas like
(16:32):
core beliefs, improvingcommunication and relationship
skills, addressing theinterpersonal friction that OCPD
traits often cause.
Speaker 1 (16:41):
Can you give some examples of specific techniques
used within these therapies forOCPD?
Speaker 2 (16:45):
Sure.
So in CBT, a therapist mightwork with the person to
challenge all or nothing,thinking about success and
failure.
Behavioral experiments couldinvolve encouraging them to
deliberately delegate a task andnot micromanage it, to see that
the world doesn't end if it'snot done perfectly.
Speaker 1 (17:05):
Right testing those beliefs in the real world.
Speaker 2 (17:07):
Exactly.
Group therapy can be reallyhelpful too, providing a safe
space to get direct feedback onhow their rigidity or control
needs impact others and topractice more flexible social
skills.
Speaker 1 (17:21):
I can see how that would be valuable.
Speaker 2 (17:23):
Psychodynamic techniques might involve
exploring early relationshipswith caregivers, looking for
patterns related to criticism orcontrol.
Related to criticism or control, and schema therapy might use
techniques like role-playing tohelp the person challenge their
inner critic, that harsh,demanding voice driving the
perfectionism.
Speaker 1 (17:40):
Okay, a range of tools, depending on the person
and the approach.
Speaker 2 (17:44):
Definitely.
It's often a longer-termprocess than OCD treatment.
Speaker 1 (17:48):
Right, okay, so we've looked at OCD, we've looked at
OCPD individually.
Now let's really crystallizethose key differences.
Speaker 2 (17:56):
So let's recap the main distinctions.
First, just a coresymptomatology OCD is about
those intrusive thoughts, images, urges, the obsessions and the
repetitive behaviors or mentalacts, the compulsions.
Speaker 1 (18:10):
All right specific symptoms.
Speaker 2 (18:11):
Whereas OCPD is about those pervasive personality
traits, the intensepreoccupation with order,
perfection and control.
It's the overall pattern.
Speaker 1 (18:22):
Got it.
And the second big one wetalked about was insight right.
Speaker 2 (18:25):
Yes, insight.
Generally, OCD is egodistonic.
The person recognizes thethoughts, behaviors as excessive
or irrational, causing distress.
Ocpd is typically egocentronicthe person sees their traits as
part of them, often as logicalnormal or even virtuous.
Speaker 1 (18:49):
They don't inherently see the trait as the problem
and that difference hugelyimpacts treatment motivation.
Speaker 2 (18:51):
Absolutely.
It's a fundamental differencein how the condition is
experienced.
Speaker 1 (18:54):
Okay, what else?
Speaker 2 (18:56):
Their DSM-5-TR classification is different.
Ocd is underobsessive-compulsive and related
disorders.
Ocpd is under personalitydisorders in cluster C, the
anxious-fearful cluster, whichreflects the different
diagnostic focus.
For OCD, it's confirmingobsessions and meritorious
compulsions.
(19:16):
For OCPD, it's identifying thatpattern of at least four
characteristic personalitytraits.
Speaker 1 (19:22):
Okay, and do they tend to show up alongside other
mental health issues differently?
Comorbidity.
Speaker 2 (19:28):
Yes, there are tendencies.
Ocpd seems more frequentlylinked with depressive disorders
.
Ocd has stronger links withother anxiety disorders like
panic disorder or social anxiety.
Speaker 1 (19:41):
Interesting and the treatment pathways diverge quite
a bit, as we discussed.
Speaker 2 (19:45):
Significantly.
Ocd treatment often focuses onERP and SSRIs, directly
targeting symptom reduction, andcan sometimes show results
relatively quickly.
Ocpd treatment is typicallylonger-term psychotherapy CBT,
psychodynamic schema therapyaimed at modifying those deeply
(20:06):
ingrained personality patterns,improving insight and
flexibility.
Medication isn't usually theprimary treatment for the core
OCPD traits, though it might beused for co-occurring conditions
like depression.
Speaker 1 (20:20):
So that affects the prognosis or the expected
outcome too.
Speaker 2 (20:23):
Generally, yes.
Ocd often responds more readilyto targeted treatments like ERP
.
Ocpd, being a personalitypattern, usually requires more
sustained therapeutic effort toachieve significant change.
It's changeable, but it takestime.
Speaker 1 (20:40):
Okay, what about neurobiology?
Any differences known there?
Speaker 2 (20:43):
There's more distinct research on OCD, pointing to
things like serotonin systemirregularities and hyperactivity
in brain circuits like theorbital frontal cortex Right.
For OCPD, the neurobiologicalmarkers aren't as clearly
defined.
Some research links it tocognitive inflexibility, but
there isn't a specific brainsignature identified.
Speaker 1 (21:04):
In the same way as for OCD, Fascinating, and you
touched on culturalinterpretation earlier,
especially for OCPD.
Yes, that's an importantpractical difference.
Speaker 2 (21:12):
Because some OCPD traits yes, that's an important
practical difference Becausesome OCPD traits, like diligence
, meticulousness, thriftinesscan be viewed positively in
certain cultures or contexts.
Speaker 1 (21:21):
Like a strong work ethic.
Speaker 2 (21:23):
Exactly.
It can sometimes be harder torecognize when these traits
cross the line into apersonality disorder causing
impairment, especiallyinterpersonal problems.
Ocd symptoms being more overtlystrange or time-consuming are
perhaps less likely to bemisinterpreted as positive.
Speaker 1 (21:41):
Right.
And finally, how does thefunctional impairment, the way
it messes up someone's life,tend to differ?
Speaker 2 (21:46):
That's another key distinction With OCD.
The impairment often stemsdirectly from the time consumed
by rituals, the avoidance oftriggering situations and the
sheer distress caused byobsessions.
Speaker 1 (21:59):
It takes up space and energy.
Speaker 2 (22:01):
A lot of it With OCPD .
While someone might be highlyfunctional, even successful, in
structured work environments,the impairment frequently
manifests in interpersonalrelationships.
Impairment frequently manifestsin interpersonal relationships.
Their rigidity, difficultydelegating, need for control,
emotional constriction andperceived criticism of others
can lead to significant conflictwith partners, family, friends
(22:25):
and colleagues.
They might struggle withteamwork or intimacy.
Speaker 1 (22:30):
Okay, so OCD impacts more via the symptoms themselves
, OCPD more via the impact ofthe traits on relationships and
flexibility.
Speaker 2 (22:37):
That's a good summary of the general tendency.
Speaker 1 (22:39):
yes, All right, let's try and boil down the absolute
key takeaway for everyonelistening.
Speaker 2 (22:44):
Okay.
The absolute core difference isthis Think of OCD as being
driven by anxiety about specificintrusive thoughts, obsessions
leading to behaviors,compulsions aimed at reducing
that anxiety, which the personusually knows are excessive or
irrational, even if they can'tstop.
Speaker 1 (23:03):
Ego-dystonic.
Speaker 2 (23:04):
Right.
Think of OCPD as a pervasive,lifelong style characterized by
a need for order, perfection andcontrol, where the person often
sees these traits as reasonable, logical or even virtuous
aspects of themselves.
Speaker 1 (23:20):
Ego-syntonic.
Speaker 2 (23:21):
Exactly.
Ocd is more about unwantedsymptoms.
Ocpd is more about ingrainedpersonality traits perceived
differently by the individual.
Speaker 1 (23:31):
So for you, listening , really grasping that
difference, the intrusivesymptoms versus the pervasive
traits, and especially thategocentronic distal piece, gives
you a much sharper lens tounderstand these distinct
experiences.
Speaker 2 (23:45):
Absolutely, and it highlights why a correct
diagnosis is so vital forguiding the right kind of help.
The approaches are really quitedifferent.
Speaker 1 (23:53):
Definitely Okay.
Finally, maybe a littlesomething for you to mull over
after this Consider how much oursociety values things like high
productivity, efficiency,organization and well perfection
.
Speaker 2 (24:05):
Right.
Those things are often praised.
Speaker 1 (24:07):
So think about how those societal values might
sometimes blur the lines ormaybe even inadvertently
reinforce some OCPD traits, evenif those traits are causing
someone private distress orcreating real friction in their
relationships, externally theymight just look like someone
who's incredibly conscientiousor successful.
Speaker 2 (24:28):
That's a really interesting point how external
validation or judgment interactswith the internal experience.
Speaker 1 (24:33):
Thanks for being with us today and remember it's in
there.
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