by Richard Loebl, LCSW, BCD
Charlene is a very bright, successful marketing professional in her mid-thirties. When she started therapy with me she told me she was OCD. She struggled with distressing levels of anxiety and worry, and she described herself as a perfectionist and a “control freak”. Charlene didn’t fit the most “typical” clinical description of OCD because she didn’t have compulsive “rituals” – repetitive, irrational patterns of behavior such as frequent hand washing. Nor did her obsessive ruminations meet the diagnostic criteria for OCD or Obsessive-Compulsive Personality Disorder. In fact, after many years of treating and studying OCD, I’ve found there are many types or faces of OCD.
Traditional Definitions & Descriptions of OCD
OCD in all of its variations is far more common than previously thought. Medical research also shows that there is a strong genetic basis for the disorder. Anxiety and worry is a prominent feature of OCD – and the compulsions are behavioral attempts to manage or control the anxiety and the distressing thoughts.
Obsessive-Compulsive Disorder
1. Obsessions are “Recurrent and persistent thoughts, urges, or images that are experienced… as intrusive and unwanted…” and cause anxiety, worry and distress (DSM-5, American Psychiatric Association). Attempts are made to ignore or suppress the thoughts.
2. Compulsions are… “Repetitive behaviors or mental acts” (like checking behavior and counting) in response to the thoughts. These behaviors are not rational or realistic, and are often excessive.
3. The thoughts and behaviors are often very time consuming and cause severe distress.
Obsessive-Compulsive Personality Disorder
1. This type of personality is rigidly and excessively focused on rules, organization, perfectionism and control (individuals with OCD, the anxiety disorder mentioned above, may not have this type of personality).
2. These individuals may be “workaholics” – they are generally preoccupied with details, lists and schedules, and excessively concerned with morality and ethics.
3. They may be “hoarders” who cannot dispose of unneeded objects without a great deal of anxiety and worry.
4. This personality may lose sight of productive goals and balance in life due to their rigid standards.
The Many Faces of OCD
o The Perfectionist – Charlene was indeed a perfectionist. She worked long hours and was never quite satisfied with the results. She told me once that when she entered a room at home she would immediately inspect the floor to see if there were specks of dirt or dust to be picked up. She rarely enjoyed her beautifully decorated home because of her “OCD”. She constantly experienced anxiety and worry about making mistakes or being seen as less than perfectly well put-together.
o The Control Freak – Charlene’s husband referred to her as a Control Freak – and she agreed with him. She washed the dishes immediately after every use and rarely used the dishwasher – the knowledge of soiled dishes in there made her nervous. She required a level of organization and cleanliness that was disturbing to her husband.
o The Worrywart – This version of OCD is similar to Generalized Anxiety Disorder, but these individuals stay in their heads with obsessive worry while they struggle to work out solutions that are evasive and usually impossible to achieve. The worrywart doesn’t discriminate – he or she worries about everything, regardless of the level of importance.
o The Fanatic – Ironically, Charlene’s husband had his own OCD tendencies. He was an admitted fanatic about politics and sports. Charlene said he was a bore. He was obsessively focused on national politics and watched hours of cable TV news shows. He knew all of the NFL players and statistics, and at social gatherings he would monopolize conversations with his knowledge and opinions. Sports and politics were always on his mind and he would become antsy if he was away from his computer or TV for more than a few hours.
o The Nag – aka The Complainer – It looks and sounds like chronic complaining or incessant nagging. But when you look below the surface, there may be OCD tendencies or traits. The Nag may be someone who struggles with anxiety and worry – and distressing obsessive thoughts that result in a compulsive need to complain.
o The Anal Retentive – This type of OCD is characterized by rigidity, a need to keep things orderly and excessively organized, and a personality that’s fussy, scrupulous, and fastidious to a fault.
OCD in Relationships
Individuals with OCD – either the formal anxiety disorder itself or a personality type – struggle with anxiety and worry that can be very distressing, even overwhelming at times. And it can be equally difficult and challenging to live with someone who suffers from OCD. Patterns of emotional reactivity can develop in this type of relationship, leading to a great deal of relationship distress. Charlene’s husband would be triggered by her anxiety and her controlling, perfectionistic tendencies. He would react with sarcastic comments and he resisted her attempts to involve him in her compulsive tendencies. Charlene felt unsupported by him, and she reacted to his frustration with anger and withdrawal. During those times when Charlene was the most anxious and obsessive compulsive, the reactive patterns and distress in her marriage became unbearable.
Couples may be unaware of the underlying causes – obsessive thoughts and beliefs; the anxiety associated with them; the controlling, complaining behavior that follows – and partners react emotionally out of frustration. On the surface, it looks like tension and arguments about the kids, money, chores, or even an affair in the past. And those can be troubling issues to be sure. However, the OCD process takes over at times, and becomes a primary source of relationship distress.
Coping Skills for OCD
o Mindfulness and acceptance – Awareness without judgement. Observe and identify the distressing, obsessive thoughts, while letting go of any negative judgments. The judgments create more anxiety and worry which exacerbates the OCD.
o Letting go of the struggle – Don’t argue with the obsessive thoughts. Don’t try to find a rational explanation. It’s like trying not to think about a pink elephant – the more you try the more it feeds the pastel beast in your mind.
o Identify and label the thought as obsessive, annoying, or unproductive (without any judgment). It’s just an annoying thought, and that’s all it is. It’s not about the content of the thought. We get lost believing in the content (my finances, my spouse and what he/she did, the problems with work, the house, the kids). But it’s not about the content – it’s about the OCD, the ruminations, and the anxiety we feel because of the thoughts.
o Thought stop and refocus – Gently tell your mind to stop it, and immediately refocus onto something manageable in the present moment. Keep repeating this process as necessary.
o Exercise and yoga – Proven to reduce anxiety and worry, along with the obsessive thoughts.
o Therapy and medication – If you continue to struggle and there’s no improvement, seek professional help. Counseling and therapy, along with certain medications when necessary, can be highly effective with all forms of OCD.
Shiva Chinsmy
This article was a good one. I can relate to Charlene so much.
Melissa
My brother worried about whether or not his son had put out the trash the whole time he visited me. He frequently checked his doorbell cam When it became evident that the teen had not done so, he tried to call him and left texts. It was obvious that not putting the trash out was an act of defiance to the micromanagement. I told my brother to just let it go, but he complained for hours. Now I understand his behavior better.
Justin Miles
I think I may be of a perfectionist, judgemental, OCD type and am worried how it affects my ability to have relationships with others. Strangely, I am not massively tidy, I can handle a little dust and a little clutter as long as it regularly gets put in organised piles but I cannot stand untidy/cluttered kitchens, bathrooms or thoroughfares within the home. I also have a massive hatred of bad manners, thoughtlessness and disrespect of property and people which is stopping me from caring about or getting on with my girlfriends children, I feel like I am becoming a nag because they have no boundaries and am being accused of OCD. Is it possible I am that bad without realising? I am thinking of spending the rest of my life alone instead.
Ramon
I’m leaving a comment on my related experience to OCD as a means to help cope with it/ heal/ understand it, as well as to potentially help others. I used to have OCD as a young teenager with really weird, unimportant things like writing “neatly” in a notebook, or spelling a video game character with “proper capitalization”, or if the packaging on something I bought was “damaged/ imperfect” then it would drives me insane, like scratching at my brain. It’s strange as I know logically this is so stupid and embarrassing even at times, but I do my best not to be angry at myself and even be somewhat intrigued that such a thing could exist. It makes me wonder if there is an underlying issue that my OCD is trying to tell me (maybe I don’t feel ‘complete’ or ‘fulfilled’ in some way deep down or have fooled myself into thinking so. Just some food for thought. I truly hope this helps someone and I wish everyone the best of health, happiness and what you wish to come true for yourselves. Thanks for the article!
Vienna
I have been a “clean freak” since I was a young girl, around 7 or 8. In recent years though, I have seen tendencies about OCD in my self more often. I am controlling, I worry about small things often, and see my self triple checking the stovetop, the locked doors, etc. It is hard for me to understand how other people can not keep everything clean, or keep the house clean. It is gross to me that no one cares as much as I do. I share a bathroom with my younger teenage sister, and it is a nightmare. The smallest things set me off, and if it is not done perfectly, I go into a rage for 20 minutes or more. I feel terrible and I don’t know what to do. She stopped fighting back because she knows I won’t stop. I am so lost, and I am only 17.
Tre Scialdone
Hello Vienna, thank you for your reply and for sharing your experience. It’s very brave for you to do so and it’s very helpful for others to know that they’re not the only ones who go through this. Please know that there is help available out there! Please be sure to let your parents or another adult in your family about how you are feeling and how it is affecting you. You are not alone. Here’s a link to some resources that can also be helpful! https://iocdf.org/ocd-finding-help/supportgroups/online-and-phone-ocd-support-groups/ You should also be able to find some additional resources in your area by searching online for “Help with OCD Near Me”. A lot of people feel the same way you do and there is definitely help out there. It’s important that you reach out to those who love you, to let them know what you’re going through. You can do this! You’ve already shown yourself to be brave and helpful to others. Take good care of yourself. We believe in you!
Helen
Am I OCD I have a horrible obsession with wanting to dress, buy cloths, cut the hair of all of my family members, I want them to look well dressed and tidy, I tend to buy my grand children cloths to put on whilst we are at the shopping centre because I don’t like what they have been dressed in. I am sitting here feeling really distressed and upset because my adult son has gone out in cloths that I don’t think match, and he looks a bit scruffy, I am very upset by that, I have started grumbling at my husband because he has a cold and rarely covers his mouth when he coughs, he has now left the room, I feel I upset everyone around me because they don’t look or behave the way I want them to.When my daughter calls into my house before going to work I try to give her cloths because I think she doesn’t have any dress sense, I tell her she looks nice but this would go well with what you are wearing and try to encourage her to change.
I am watching the clock because the function my son has gone to in the horrible cloths, ends in 2 hours and then it won’t matter how he looks, I am already planning the new shoes and trousers I have to buy him so this won’t happen again. I just can’t stand my family looking scruffy or un fashionable, I also track my sons cloths as he looses them or leaves them at his friends houses I continually ask him about them until they are returned (nagging) I think I have a problem after writing this, and I still feel upset about my sons appearance .
Tre Scialdone
Wishing you the best, Helen. Stay brave, stay strong.