Obsessive-compulsive disorder (OCD or OCD) and obsessive-compulsive personality disorder (OCPD) are often confused. This has major consequences for people who suffer from one of these disorders. Obsessive-compulsive disorder is characterized by intrusive thoughts or images (obsessions) and actions a person takes to neutralize these obsessions (compulsions). Obsessive-compulsive personality disorder involves strong perfectionism and a preoccupation with neatness. Many people think of obsessive-compulsive disorder, also called compulsive disorder, of Monica from Friends, who compulsively scrubs her entire apartment. However, this is a wrong assumption. A major problem with this incorrect image of obsessive-compulsive disorders is that many people do not recognize an obsessive-compulsive disorder in themselves or that they do not properly understand the compulsiveness of other people. Some people even find it frightening when people with OCD talk about their compulsive ideas, for example because they think these people are dangerous. This contributes to the stigmatization of compulsive disorders. But what exactly is the difference between obsessive-compulsive disorder and obsessive-compulsive personality disorder?
What is OCD?
An obsessive-compulsive disorder consists of obsessive thoughts/obsessions on the one hand and compulsive actions/compulsions on the other.
Obsessive thoughts
Obsessive thoughts or obsessions are frightening thoughts or images that intrude on the thoughts of the person with an obsessive-compulsive disorder. Everyone sometimes has these kinds of unwanted thoughts or images, which can be about religion, violence or sex, for example. Most people quickly let go of these thoughts. However, people with obsessive-compulsive disorder are frightened by these thoughts and attach too much importance to them, which can cause them to become anxious or develop feelings of guilt (,I must be a bad person to have these kinds of thoughts,). Because people with obsessive-compulsive disorder often actively try to suppress or avoid these thoughts, they surface more and more often. This is like being told not to think about a white polar bear. When these thoughts and images come up at random and cause tension, they are called ‘intrusions’. These intrusions are very unpleasant and cause a lot of tension. Often the person with an obsessive-compulsive disorder has the idea that these intrusions will not disappear or even become reality if he/she does not perform certain actions.
Compulsions
The actions that someone does to reduce the intrusions are the compulsive actions or ‘compulsions’. An example is someone who is afraid that he will hurt someone else and as a result tries to avoid all sharp objects. This person may become so obsessed with this that he/she becomes anxious at the sight of any sharp object and eventually stops leaving his/her home for fear of encountering sharp objects. Performing these compulsions (or avoiding difficult situations) sometimes reduces the unpleasant feeling or makes the intrusions go away, but only for a short time. More and more compulsions are needed to make the intrusions and the unpleasant feeling they bring disappear. If the person with a compulsive disorder gives in to performing compulsive actions, the system of compulsive actions can quickly expand and get out of hand. This means that things often have to be done in a very precise way before they are ‘right’. It is very important that people with obsessive-compulsive disorders quickly receive the right help, because the complaints do not disappear on their own, but rather become worse.
What is Obsessive-Compulsive Personality Disorder (OCPD)?
People with obsessive-compulsive personality disorder (OCPD), or compulsive personality disorder, want to keep everything under control as much as possible and set very high standards for themselves. They are preoccupied with cleanliness and orderliness. These are often very perfectionistic people, who strive for such a high degree of perfection that they do not get things done. Their great focus on work can come at the expense of other activities, such as friendships. Because things have to be done in a fixed way, they do not find it easy to outsource things. They may be overly conscientious and rule-oriented, wanting to hoard all their money and finding it difficult to throw things away.
The difference
Monica from Friends therefore shows more characteristics of a compulsive personality disorder (OCPD) than of an obsessive-compulsive disorder (OCD). The confusion is understandable: people with both disorders can exhibit very perfectionistic and rigid behavior. They believe that things have to go a certain way, because otherwise it is not good enough. An important difference is that people with OCD suffer from intrusions, while this does not fall under a compulsive personality disorder. Another important difference is the nature of the actions: people with a compulsive personality disorder often exhibit actions that are aimed at perfecting/making something concrete, while the compulsions of someone with a compulsive disorder can also be completely ‘useless’. For example, consider counting or not thinking about certain words.