Julie Miller's Mental Health Blog

Archive for the ‘“O” is for Obsessive Compulsive’ Category

Obsessive Compulsive Disorder (OCD).  Obsessive Compulsive Personality Disorder (OCPD).  These two are different.  Often I hear folks on the street saying something like “I’m so OCD” but I watch them for a few moments, and it’s pretty clear they are not OCD, but OCPD.

What’s the difference?  It’s kind of like this:

When I was a kid, my father owned Miller Redi-Mix, a concrete company that mixed, delivered, and poured concrete, that grey stuff that lines the streets, as gutters or sidewalks.  The grey stuff that makes up freeways and bridges.  Now, many people, even educated folks on national TV news, will call that grey stuff “cement.”  Holy cow.  That made my Dad’s neck hairs stand on end.  “CONCRETE!” he’d say emphatically, correcting the otherwise erudite speaker.  “Cement,” he’d say,” is the stuff that makes the sand and gravel stick together to make CONCRETE.”

Oh, and the other thing.  If a nice painting is hanging on the wall, that a PICTURE, not pitcher.  A pitcher is that glass thing from which you pour iced tea or lemonade on the porch during a hot day.

Oh, and one more thing.  It’s NUCLEAR, not nuculer.

So my Dad demonstrates a perfectionism and rigidity (sorry Dad) common for OCPD, not OCD.  OCD is characterized by ritual, counting, cleaning, etc.  OCPD is characterized by a chronic pattern of detail-oriented and rigidly focused perfectionist behaviors.

Since I’ve confessed here my family history of OCPD (probably just traits or fearures, not a full-blown personality disorder, although my coworkers and supervisees from the past may not agree), I can admit to being concerned about symmetry when multiple photos or PICTURES (nod to Dad) are hung on a wall.  I don’t have to get up to straighten the frames any more (thank you thousands of dollars in therapy), but I do notice when they are not straight or not symmetrically arranged.

I correct others (usually in my head, but sometimes aloud) when someone uses the word “dependency” when talking about chemical “dependence.”  A “dependency” is a colony, or a geographical area politically controlled by a distant country (thank you Sandra, my internship supervisor from many years ago).

Also, an ape is not a monkey.  An orangutan is an ape, not a monkey.  A chimpanzee is an ape, not a monkey.  A gorilla is an ape, not a monkey.

See what I mean?

OCPD is about detail, and things being just right, in one form or another.  While it makes my supervisors happy because I’m highly observant and detail oriented, it drives supervisees a little wild.  Fortunately, they have always indulged me.

What about OCD?  What’s your experience with it?


“Obsession” is mental preoccupation.  There are also tons of songs by this same name.  And a perfume, I think.  Maybe the word sounds or looks good, but it is one of the more unpleasant experiences an individual can experience.  Why?  An obsession is rarely about something really fun, pleasant, or helpful.  Sometimes, maybe, but among most of us, it’s irrational and unpleasant.

An obsession to smoke.  Can’t think about anything else until that mental obsession is relieved by smoking.

An obsession with a person.  Can’t think about anything else until there is relief, such as going out on a date with her.  Or having sex with him.  Or beating my wife because I think she’s having an affair.  (This last example will probably raise some eyebrows.)

An obsession to drink, use drugs, spend money, gamble, clean, count, etc.  All mental obsessions which increase anxiety until they are acted upon.  Then there is a sense of relief, and the central nervous system is regulated.

The central nervous system (CNS) becomes disregulated through a variety of means.  I’m stressed.  I’m running on empty.  Something happens at home that’s upsetting.  A the boss yells at me at work.  A car cuts me off in traffic.  I spill my coffee on my clean white shirt.  I may have difficulty regulating because I didn’t learn good skills as a kid, or I had caregivers who used alcohol or drugs to regulate, and I never learned anything else.

Maybe I’m depressed.  My emotional “shock absorbers” are shot.  My system is not “regulated,” meaning that it’s not running smoothly, on all cylinders.

To survive, my CNS must seek regulation.  I’m a creature of habit, as all homo sapiens are.  What has worked for me in the past will be automatic.  Whatever has helped me feel relief will be my first choice. Cleaning, counting, rituals, smoking, drinking, snorting, spending, controlling others, violence, eating, gambling, masturbation, pornography, sex, restricting, purging, etc.

Other options?  Tons.   Moderate exercise.  Meditation.  Music.  Playing the piano.  Bubble baths.  Self-manicures.  Chopping wood.  Carrying water.  Weeding.  Painting a room.  Sewing a shirt.  Hand quilting. Petting your dog.  Playing with your cat.  Teaching your fish a trick (yes, they can be trained).

But these alternatives won’t even occur to me unless I notice the disregulation and examine what triggered it in the first place.

The first step is always “notice.”  And yes, it sounds stupid and annoying.  But truly, it’s the first step.