Episoder 24: OCD versus OCPD

Episode 24

OCD versus OCPD

In this episode of Purely OCD, your show hosts Kelley and Lauren review the differences between OCD and Obsessive Compulsive Personality Disorder (OCPD) and answer questions from viewers.

In order to consider the differences, they start by defining two terms:

Ego-syntonic vs. Ego-dystonic.

So what does it mean for a thought to be ego-syntonic? When thoughts are aligned with your values and identity, we woulld consider them ego-syntonic. Example: If someone has ego-syntonic thoughts about harming someone they are not concerned about having these thoughts but are, instead enticed by the idea of causing someone harm

When it comes to ego-dystonic thoughts, these are thoughts that are opposite to our genuine desires, our values and our identity. Example: If someone has ego-dystonic thoughts about harming someone they will not want to take actions consistent with these thoughts.

Someone with OCD may feel compelled to do things in a certain manner, though they find the behaviors themselves to be counter to what they would like to do. Someone with symmetry OCD, for instance, might feel compelled to line something up perfectly, but feel frustrated by the exacting standards that they must meet in order to quiet their minds. This is to say that the thoughts are ego-dystonic. When someone with OCPD has thoughts about doing things perfect, they actually believe that things should be done perfectly. Thus, with OCPD, the thoughts are ego-syntonic.

Some of the qualities that show up with OCPD include:

  • Rigidity 
  • Perfectionism
  • Unwillingness to let go in work settings

There is usually greater insight into the unreasonableness of concerns with OCD than in OCPD.

During the question and answer section, someone asks about treatment resistant OCD.

Kelley and Lauren discuss the issues with the idea of OCD – or any disorder – being treatment resistant. They talk about the fact that this label does not take all factors related to the efficacy of treatment into account. For example, someone might not respond to treatment because the person is struggling with another disorder.

Pervasive and persistent behavioral patterns are the hallmark of personality disorders like OCPD. There is a misconception, therefore, that when someone with a personality disorder has something inherently wrong with them. This is very similar to the idea of someone being treatment resistant.

Lauren floats out the idea that maybe someone’s lack of progress is more about an increased need for support than it is about being treatment resistant.


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Disclaimer: This information is meant to be general information not unique to any individual. Before following any guidance or advice found on this site or in the Purely OCD Podcast a visitor or listener should always consult with their own licensed healthcare practitioner. The Purely OCD Podcast and Website are not therapy or intended as a replacement for therapy. They are for educational purposes only.

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