Obsessive and compulsive personalities

Concluding this series of articles on character, based on the research of Nancy McWilliams, I propose to consider obsessive and compulsive personalities.

It is important to emphasize that thinking and doing are the leading motives of a person in modern times. And understanding the reasons for actions and emotional aspects are less valued.

General characteristics of obsessive and compulsive personalities

These people enjoy the thought process. It is predicted that they will be quite successful in those areas of activity that require scrupulous execution of tasks.

Psychologists note that this is a classic type of personality organization of a neurotic level. They have a ritualized nature of their actions. This calms them down and balances them out. For example, at intervals of three days, carry out general cleaning of the apartment. The clients themselves, who talked about this at psychological sessions, noted that it calms them down, gives them the opportunity to relax and switch from anxious thoughts.

Drives, affects and temperament of obsessive and compulsive personalities

Psychologists note that such clients are hypersensitive. Sensitive to various aspects and nuances of the conversation.

Psychoanalysts pointed to the presence of anal problems in this personality type - fixation for approximately the period from 18 months to 3 years.

Cleanliness, stubbornness, restraint and concealment - the toilet training scenario. Parents taught such children to control their bowel movements. And such children acquire early bodily experience.

Rejection of what is natural, instead of what is naturally acceptable to him. The child is doomed to fail. It gives rise to aggressive fantasies and feels dirty.

In this regard, maintaining self-identity is important. A person has completely different, including physiological manifestations.

There is an increased sensitivity to ethical issues. Most likely, this is a consequence of introjects from childhood. For example, broadcasting to everyone around him that “men shouldn’t cry.”

The basic conflict is anger, fighting the fear of being punished. It's rationalized. Feelings are often hidden. They prefer to talk about what they think rather than what they feel.

Also, such individuals often experience anger. They are quite often irritated. But they deny it and get angry. This could be passive aggression. For example, endless irony.

Also, in a psychological session, such clients have shame. They place high demands on themselves. The same thing is projected onto others. Shame is recognized as mild sadness.

Obsessive-compulsive disorder: symptoms

Markers of obsessive-cognitive disorder:

irrational fears and phobias;
frightening images and attractions;
anxiety;
multiple double-checking of your actions;
a feeling that something bad will happen (fear of infection, pollution, misfortune);
obsessive defensive actions;
getting stuck on one thought;
irrational desire to count;
pedantry and perfectionism.

Obsessive thoughts interfere with work and rest. They cause nightmares and insomnia, loss of appetite, isolation, inattention and mistakes at work. A person’s whole life comes down to the idea of how to get rid of obsessions.

Obsessive thoughts interfere with work and rest. They cause nightmares and insomnia, loss of appetite, isolation, inattention and mistakes at work.

Defense and adaptation processes in obsessive and compulsive people

The leading defense for such individuals is isolation (for obsessive people) and destruction of what has been done (for compulsive people).

One can also note rationalization, moralization, and intellectualization in such clients. At a psychological session, this may look like some detachment, a long “explanation”, reasoning with an evidence base.

If we talk about cognitive defenses that are used against drives, affects and desires, it can be noted that for obsessive individuals, thought processes and cognitive abilities are of great value.

Feelings can be devalued, believing that their manifestation is associated with childhood, weakness, dirt. Moreover, it is very difficult for them to talk about some mistakes or failures that have occurred in their lives.

Nancy McWilliams in her book gives the example of a widow who cannot be consoled. She is busy and very immersed in all the details of the funeral of her deceased husband. This is a completely adequate situation for the event that took place, however, if you become too immersed in the hustle and bustle, then there is no access to feelings.

Obsessive company managers exhaust themselves and their employees. As a rule, they are very anxious and often hold meetings for the sake of meetings. Such people can be effective in fulfilling formal social roles. But at the same time, it is difficult for them to express tender feelings without experiencing anxiety and shame.

They often turn emotional interaction into depressing cognitive interaction. You can talk about something for a very long time, in different words, avoiding direct appeal to feelings.

In states of obsession approaching borderline states, detachment may appear as schizoid (detachment).

Obsessive-compulsive disorder: treatment

Treatment methods are the same for both children and adults. Complex treatment is used: psychotherapy, medication, self-help. Let's look at each component in more detail.

Psychotherapy

The task of a psychotherapist is to find and work through the true cause of the disorder. Depending on the case, cognitive behavioral psychotherapy, psychoanalysis, family psychotherapy, Gestalt therapy, psychodrama, art therapy, exposure method and other techniques are used.

A psychologist helps not only get rid of the causes of obsession and OCD itself, but also restores a person’s self-esteem and restores self-confidence. Under the supervision of a specialist, the client learns to establish relationships with others and returns to normal functioning.

The psychotherapy program is selected individually. When treating children, it is important to correctly diagnose the condition and take into account the characteristics of age. For example, three-year-olds often come up with rituals before bedtime. Over time this goes away on its own.

Taking medications

Antidepressants, tranquilizers, atypical antipsychotics, mood stabilizers are prescribed. In particularly advanced cases, hospital treatment is indicated.

You cannot self-medicate! The drug, dosage, regimen and course of treatment are selected by the attending physician. Amateur activities are dangerous due to complications and the formation of addiction to pills.

Self help

Try the thought stopping method. Every time you feel obsessive, say “Stop!” After that, analyze the thought according to this plan:

What is the likelihood that this will actually happen? It’s very good if you can calculate the real figure and find some statistics. However, you can go the other way. For example, you are afraid of being attacked by a maniac. Consider how relevant this is to where you live. Have you heard similar news? Have there been any recorded cases of attacks on other people?
Make a list of deprivations due to obsessions. How and to what extent do thoughts interfere with your life?
How bad do your compulsions make you feel?
Will your life be better and easier if there are no obsessions or compulsions in it?

It’s even better to learn to mentally say “Stop!” and switch to something pleasant, remember or imagine something positive. You need to focus as little as possible on the idea of “How to get rid of obsessive thoughts,” because this is also an obsession. The less you feed the “mental gum”, the less pronounced your thoughts will be.

To recover, you need to reconsider your lifestyle. We need to cross out what led to and supported OCD. It is useful to change your diet, habits, get rid of addictions, learn to rest and relax. The success of treatment depends on the wishes and actions of the patient himself.

The support of loved ones plays an important role. Many people do not understand a person with ACS. And the patients themselves are afraid to admit their thoughts, to tell someone about their condition. They are afraid that they will be considered crazy and socially dangerous. It is very important to have someone to support the patient.

Behavioral Defenses Against Drives, Affects, and Desires

Destruction of what compulsive people have done is often noted.

Drunkenness, overeating, and sexual adventures are often observed in such individuals.

Compulsivity differs from impulsive action in its repetitive persistence.

Compulsive patterns are not always reasonable. There is over-involvement. They may exaggerate certain aspects of the situation.

Fantasies of omnipotent control. It is important for them to warn something. It is important to distinguish between thoughts and actions.

Obsessive and compulsive people believe that they can control the uncontrollable if only they do everything right. When working with them, the psychologist draws attention to the fact that there are things they cannot influence. They also delimit responsibility for committed actions and deeds. For example, such a client may complain to the psychologist that he is not able to fully influence his spouse. The extent of its influence is limited by psychological boundaries. Awareness allows you to build interpersonal relationships more correctly.

If we talk about reactive formation as a psychological defense mechanism of the psyche, it is important to note that obsessive and compulsive personalities are directed against the desire to be bad. There is a fixation on both sides of the conflict - cleanliness and disorder. They are frightened by internal impulses and strive to get rid of them.

Obsessive-compulsive disorder

We are talking about a disorder when obsessions become constant and give rise to compulsions. This is a syndrome of obsessive states, which is always closely associated with fear and anxiety. Obsessive thoughts are negative in nature; most often a person is afraid that something will happen to him or his loved ones. As a counterbalance, he comes up with a protective ritual - compulsion. Obsessive actions help to temporarily get rid of obsessive thoughts.

Diagnostic criteria for obsessive disorder:

a single attack from a week to several years;
relapses of compulsions combined with periods of complete remissions;
continuous increase in symptoms, constant complication of the course.

OCD operates according to the following scheme: obsessive thought (obsession) – fear due to this thought – defensive action (compulsion). Actions bring only temporary relief, this cycle repeats again and again. A person scares himself; fear and anxiety are both a consequence and a cause of obsessive thoughts.

Obsessive-compulsive disorder can be progressive (constantly develops and becomes more complicated), chronic (approximately the same severity of the syndrome remains) and episodic (uncontrolled isolated cases, which are often combined with panic attacks).

In children

OCD is less common in children and adolescents than in adults. Moreover, it is diagnosed in adolescents a little more often than in children. Manifestations of pathology do not differ from those in adults and do not depend on the gender of the child.

Examples of childhood obsessions:

fear of losing mom and dad, going to a shelter;
fear that parents will divorce;
hatred of brothers and sisters, desire to kill them;
fear of being an outcast in class;
fear of getting a bad grade;
fear of being alone;
fear of getting lost.

Teenagers are often afraid that they will not achieve anything in life, that they will not become anyone.

In adults

Most often, obsessive neurosis occurs between 15 and 25 years of age. The course, causes and symptoms are no different from the disorder in children. However, other frequently encountered experiences can be identified.

Examples of obsessions in adults:

fear of hitting someone on the road or getting hit by a car yourself;
fear that something will happen to loved ones, they will be attacked;
fear that the person himself will be attacked;
fear of accidentally harming someone;
fear of leaving an electrical appliance, gas or water on at home and thereby depriving yourself and other people of housing;
fear of noticing manifestations of homosexuality and pedophilia in oneself;
experiences in the love sphere (“is the person with me”, “how to confess your feelings”);
fear of saying something wrong;
fear of getting sick;
fear of losing material wealth, going broke;
fear of being alone;
thoughts of murder or suicide;
thoughts of sexual perversion;
other.

Examples of compulsions:

compulsive hand washing;
rechecking household appliances;
thorough and repeated cleaning of the house;
multiple checks of your actions and work performed;
arranging books in alphabetical order;
other.

Object relations

The parents of such people tend to set high behavioral standards and demand obedience. They punish for wrongdoing.

In this regard, a pedantic pursuit of the ideal and systematic movement towards the goal are often noted.

Excessive strictness can demand a lot from children, including in the emotional sphere. A harsh upbringing is noted. In such families there is no place for love and affection; temptations are eradicated.

Psychologists note the morally elevated role of such clients when they talk about social status.

Control is the focus in such families. Punishment for freedom of expression.

Parents' restraint in emotions does not allow children to recognize their own feelings and sensations. And, even more so, talk about them. In a psychologist’s office with a client, you can learn to do this again.

Control is expressed through moralized statements. For example, parents might broadcast something like this to their child: “What will your neighbors think of you? How could you?". Or “That’s right!” Parents explain it this way.

Self-control and then rewards. This is welcomed in the family. Raised using shame.

Or vice versa, children may be abandoned. They are guided by the opportunity to survive according to the rules they received outside the home. The desire to cultivate opposite qualities in oneself.

Obsessive and compulsive self

Based on guilt. Concerned with issues of control and morality. Morality in terms of holding back negative manifestations.

Conditions similar to paralysis can occur when it is impossible to make a choice. At the same time, the psychologist helps the client feel his body, and only then get closer to the emotions that arise in connection with the situation that the person is talking about in the session.

As a rule, such clients delay making decisions until ideal conditions are achieved.

From such clients during a psychological session you can hear the phrase “Yes, but.” They seem to agree with the psychologist’s statement, but are looking for ways to avoid responsibility for this decision, or to find a “loophole” that will allow the issue to be resolved ambiguously.

Obsessive individuals tend to delay making decisions, especially important ones. Choice implies responsibility for one's actions. And compulsive people decide before they have thought about it.

They can be altruists. If a client talks about this at a psychological session, then it is important to find out what need is behind it.

The psychological support of compulsive individuals lies in doing, while that of obsessive individuals lies in thinking. They are afraid of their own hostile feelings. They value self-control above other personal qualities.

Focused excessively on details, instead of perceiving a holistic phenomenon or event. At a psychological session, it is important to clarify what is behind this. This leads to awareness.

Prevention of OCD

It is known that the neuroticism of the population increases every year.
Modern man has a pampered lifestyle. He doesn't move much. A personal car, washing machines and dishwashers, vacuum cleaners, microwave ovens, televisions and computers help a person become overloaded psychologically, and it is not enough to be physically tired. Human psychophysics is not designed for such comfort. Villagers who do hard work every day do not have neuroses, depression, or insomnia, with the exception of severe forms of diseases of organic origin.

It's hard to deny yourself comfort. However, psychologists urge people to try, whenever possible, to give preference to something real, natural, refusing surrogates. That is, just walk with your child in the park, and not surf the Internet while in the park. Choose to walk rather than drive. You need to put more stress on yourself physically.

When I saw her for the first time... everything in my head went silent. All the tics, all the constantly flickering pictures simply disappeared. When you have OCD, you don't really have quiet moments. Even in bed, I think: “Did I close the doors? Yes. I washed my hands. Yes". But when I saw her, the only thing I could think about was the curve of her lips, like the curve of a hair clip. Or an eyelash on her cheek. An eyelash on her cheek. I knew I had to talk to her. Neil Hilborn

Therapeutic recommendations when a psychologist works with obsessive and compulsive clients

When working with such clients, a psychologist is required to maintain goodwill.

It is important to consider that they are vulnerable to shame. Eliminate advice.

And the struggle for power can lead to early object relations. They need warm, trusting relationships. This should be taken into account.

Creating emotional comfort is one of the leading tasks of a psychologist during a session. One may ask how much a psychologist can talk. Wait for rationalization to complete. When a client talks endlessly about something.

You can use art methods, metaphors, creativity. This will allow you to express your feelings and thoughts through additional means.

During the session, it is important to identify the affect and acknowledge it. What good will happen if I allow myself to feel these things? The answers to these questions add vitality. And sometimes it’s just important to be, not to do.

You should also not judge or control the client.

Psychological portrait of a person with OCD

People suffering from obsessive-compulsive disorder tend to be intellectually developed.
They avoid conflicts, they want everything to be good, peaceful, so that no one quarrels or fights. They suppress negative emotions and aggression. These are friendly people who take everything to heart. They are afraid of change.

Moving to live in another city or changing jobs is like death for such a person. These people prefer predictability and regularity. Typically, patients with OCD are attentive to the smallest details. They are used to controlling both themselves and their own thoughts, as well as other people. They are confident that they are responsible for everything that happens.

10 Personality Disorders: Symptoms and Signs

Differential diagnosis

Obsessive and compulsive individuals in comparison with schizoid individuals: obsessive individuals in the withdrawal stage are isolated. It is important for them to feel safe.

Compared with narcissistic personalities: Criticality and self-criticism of absessive and compulsive personalities. The psychologist may be suspected of moral failure.

Versus Organic Lesions: Rigidity of decision, it may appear as if the client has organic lesions.

It is important to note that the support of a psychologist will allow you to maintain emotional closeness with the client.