As I mentioned in my previous article; First of all, we need to know about personality; Every person has a pattern of certain personality traits, and personality traits range from healthy/normal levels to pathological levels. The personality type mentioned in this article, obsessive-compulsive personality, can often be confused with obsessive-compulsive disorder (OCD). Of course, people with OCD may have obsessive-compulsive personality traits. However, obsessive-compulsive personality or obsessive-compulsive personality disorder is different from obsessive-compulsive disorder (OCD). Obsessive-compulsive disorder is a type of disorder consisting of obsessions and compulsions (such as the obsession with being dirty and the compulsion to constantly wash hands), and it is not the subject of this article. In this article, 'obsessive-compulsive personality' will be explained.
In summary, obsessive-compulsive personality is a personality type that is extremely focused on rules, details, morality and order, is a perfectionist, has high self-criticism and is inflexible. 'Workaholic' and 'Type A Personality' types, as well as eating disorders, are also mentioned as examples of obsessive-compulsive structuring (McWilliams, 2013, pp. 340 - 350). As is known, personality that meets the criteria in DSM-5 (American Psychiatric Association, 2014, p. 336) is diagnosed as obsessive-compulsive personality disorder. Obsessive-compulsive personality, like all other personalities, has a wide spectrum from personality trait to disorder.
When we look at the defense mechanisms in obsessive-compulsive personality (read the article about defense mechanisms); Defense mechanisms such as isolation, manipulation, intellectualization, counter-reaction, and displacement are often mentioned. Some people use the isolation defense mechanism so intensely that they give the impression that the situation they are in does not belong to them. For example, when the client's feelings are questioned about the memory of sexual intimacy with the opposite sex that he experienced in childhood and for which he feels intense guilt, he can often proceed with cognitive answers. The client with obsessive-compulsive personality may use the isolation mechanism (acting as if a situation does not belong to him) and express his feeling of guilt with the sentence "in such a situation, guilt is felt." Client's emotion He had placed it so far from himself that it was quite obvious that he had difficulty accepting that it was his own feeling, even though he was the one feeling it. When we proceed with EMDR sessions with these clients, we can similarly observe that they often go through the cognitive channel and do not want to enter the emotional channel. Another defense mechanism seen especially in compulsive people is making and unmaking. It is thought that compulsive behaviors actually represent the unconscious committing a crime (McWilliams, 2013 p. 346). During the therapy process we conduct with this group of clients, it becomes clear that there is an underlying feeling of guilt and an associated trauma. As it turned out, with their compulsions, the clients were actually relieving the guilt in their unconscious.
In general, obsessive-compulsive people are self-critical, moral, hard-working, anxious and indecisive people. They may criticize themselves with their constantly talking inner voice. In fact, these inner voices we are talking about are the voice of the critical parent in childhood. It is very common for them to remain indecisive and worry excessively in situations where they need to make a decision (McWilliams, 2013, p. 352). I have often experienced that both my clients in the process and new clients with obsessive-compulsive features experience difficulties in making decisions even on daily life issues. As a result of inner voices such as "I did wrong, if I do wrong it will be a disaster, I should not make mistakes", the person becomes an over-controlling, extreme perfectionist, unable to make decisions and actually harms himself.
There is also a difference between obsessive and compulsive personality. There are obvious differences. While the obsessive person experiences intense anxiety and delays in making decisions, the compulsive person, on the other hand, is behavior-oriented, so they can take action before the decision-making phase occurs. The difference emerges when viewed from the perspective of keeping their self-esteem up to date. It is seen that self-esteem is supported by thinking in obsessive structuring, and by action in compulsive structuring.
As I mentioned before, guilt and shame are very basic emotions in obsessive people. In obsessive-compulsive people, the guilt is sometimes so intense that acting or thinking makes them feel guilty, while additionally Even feeling them makes them feel guilty. Oftentimes, the natural emotions that many people feel can create intense guilt in obsessive people. The most intense emotion in both obsessive and compulsive people is guilt. Even though they are not always aware of this underlying feeling, the unconscious guilt can sometimes appear as a feeling of shame at the level of awareness. However, there may be clients with obsessive-compulsive personality who have difficulty even feeling the feeling of shame and even feel guilty for this. While thinking and doing is already a guilty feeling, feeling something, that is, emotions, also creates a feeling of guilt. The obsessive-compulsive person criticizes his emotions and of course, "How can I experience these?" Therefore, according to the obsessive person, one must be able to control oneself, one must have self-control. According to people with obsessive-compulsive structuring, self-control is actually essential for the formation of self-esteem. Characteristics such as being reliable, honest, following the rules, being disciplined and committed in relation to self-control are very important for these people (McWilliams, 2013 p. 353, 354).
Another feature is that obsessive people have a hard time seeing the whole. . It is also possible to see in related personality tests such as Rorschach that obsessive-compulsive people have difficulty seeing the whole. They focus so much on the details that they may not see the obvious object that everyone else sees in the whole. Perhaps this basic object that is expected to be seen in the whole will again arouse a feeling of guilt in the obsessive person. For this reason, it can be thought that he tries to cope with guilt by avoiding the whole and focusing on the details (McWilliams, 2013, p. 355).
When looking at the reasons for the formation of obsessive-compulsive personality, it is of course inevitable to talk about family dynamics. We know very well the impact of family attitudes on personality formation. Both our clinical observations and the theoretical information in our sources support this.
It is known that parents' overly interventionist, demanding, meticulous, excessive moralizing, and guilt-inducing attitudes are effective in the formation of obsessive-compulsive personality. In addition, on the other hand, a completely different family from this family pattern is also mentioned. There are also family models that do not have basic family standards, have inadequate parenting, and neglect or abuse the child. It can be a factor in the formation of obsessive-compulsive personality (McWilliams, 2013, p.348-351).
As can be seen, it is not necessary to be raised in a family with a very strict superego for the superego to be very strict. This situation can actually be explained by the individual overcompensating for his own family model. Generally, overcompensation behavior is done to repair past experiences that we are not happy with. A child who grew up with an inadequate and uncaring parent may become an obsessive parent when he becomes an adult. Because he compensated for his own childhood experience and traumas by changing his own parenting. As can be understood from here, a role model is not always needed for the formation of obsessive-compulsive personality. In addition to all this information, it will be useful to remind again that there are bio-psycho-social reasons in the formation of the pathology, considering that we focus too much on family attitudes and past experiences in the formation of obsessive-compulsive personality.
Obsessive and compulsive people are compatible clients compared to many other diagnostic groups. We know they are. However, as can be predicted, the obsessive person's transference to the therapist will be the judgmental, strict parent from his past experiences. In this respect, the therapist must be careful when working with obsessive-compulsive personality. From the therapist's perspective, countertransference will be shaped according to the therapist's personality and his own past life experiences. According to the information we have obtained from the sources, it has been observed that the client with obsessive-compulsive personality can generally make the therapist feel impatience, boredom, distance and sometimes anger (McWilliams, 2013 p. 357).
The most important issue that the therapist should pay attention to during the therapy process is transference. is that it may not be completely controllable. However, it will be effective if the therapist does not act like the person to whom the client is transferring. This may enable us to partially control the transfer issue. On the other hand, the issue of countertransference is very important when working with all personalities. For this reason, as therapists, it is important for us to look into our own backyard and get therapy if necessary, both for the therapy process and for our own safety.
In order to pay attention to the transference issue, the therapist must look to the strict parental profile in the client's past. I shared the important information not to eat. While remaining silent can be good in many therapy processes, when working with obsessive people, our decision to remain silent should be shaped according to the client. Because some obsessive clients may be seriously worried about this silence in therapy. With transference, they may interpret this silence as a judgmental parent. In general, it is an important approach for the therapist not to be controlling and rigid regarding the transference issue. In other words, the obsessive-compulsive client must experience that he will not be judged in therapy. But on the other hand, some exceptional cases; For example, when working with compulsive people with intense substance addiction, it is also important to set certain duties and conditions.
During the therapy process, it will be necessary to work with isolation and mentalization defenses, which are defense mechanisms frequently used by obsessive clients. When working with obsessive-compulsive personality, the main goal in therapy will be to work with feelings of guilt and shame, and also to show that the obsessive client who avoids emotions and feels shame can actually enjoy emotions. In addition, the use of humor at appropriate times may be effective in therapy to relieve the intensity of the feeling of guilt (McWilliams, 2013 pp. 378, 361).
In the clinic, obsessive-compulsive personality and narcissistic personality with obsessive-compulsive defenses, as if they have obsessions, can also be effective. It has been stated that it can be confused with apparent organic brain damage and also with schizoid patient groups (McWilliams, 2013, p. 362,363). Accordingly, in order to make a differential diagnosis, the obvious defense mechanisms of obsessive-compulsive personality should be evaluated in detail with clinical observation.
As a result, information is given about the distinctive features of obsessive-compulsive personality. Every individual has personality traits in certain proportions. In addition, each individual uses defense mechanisms to a certain extent and has functionality. However, if defense mechanisms are used at a pathological level, the person will experience social functional impairments. Such an impairment must be present for a diagnosis of obsessive and compulsive personality disorder.
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