Obsessive-Compulsive Personality Disorder

 

“I told my client that I may now be able to provisionally diagnose Obsessive-Compulsive Personality Disorder simply by listening to a teenager’s voice for one minute. There is an emotionally alert but empty energy to it, without nuance, where all thoughts and words are driven by a baseline anxiety converted into peremptory control. This casual theory was based on her and one other OCPD teen I’ve worked with, who has the exact same vocal quality.”

I would not try to sell and make money on this theory. It may not answer all comers. I guarantee, though, that it does serve as a goad to my sense of challenge and frustra­tion. That voice, which talks a lot, like a juggernaut, is the result of a childhood-lifetime of anxiety and con­trol. One client lived with a constantly “yelling” (anxio­genic) mother who invoked God and His quote about “your days are (or will be) num­bered.” In fear, she became moral. And from there, the rest of the OCPD symptom­atology. The other girl was controlling and ordering of her life by the time she was five. Her mother wrote that “she has always been very particular and sets ‘rules’ for herself. We worked on her being more flexible as a young child, which helped, but it was always her go-to coping mechanism.” Both parents had anxiety and the father had OCD.

(I should mention that the above college-level diagnostic explanation is one that both girls could easily understand without pause or error. Is sinister intelligence a feature of teen OCPD? I’ll have to research that [google].)

This disorder is an all-or-none monster. The child has left her frightened, sloppy and spontaneous body and has ascended into the hermetically sealed space capsule of her head, her thinking and knowing. To slip would be to melt in the crib, to burn up in fear and tears, to descend to shape­less­ness and chaos. The question – What makes a young­ster not merely anxious with her futile OCD rituals but fallen into a cast iron, ego-syntonic shell of control? – could be expanded to include other personality dis­orders. What makes one person a defensive braggart and another a full, depres­sion-free Nar­cissistic Personality? Or, a person who would like not to be depressed into a Depressive Personality, who is in positive sync with his bleak present and future outlook? The first, you could say, remain vulnerable and human while the second have left humanity to become ideational objects. These girls, and other OCPDs I’ve known, are heart­breaking in their rigid unreality. They may never feel their bare feet on the earth.