From Normality to Abnormality

Don't be surprised if you recognize aspects of yourself in these descriptions of the compulsive personality. This pattern, in particular, is prevalent in developed societies, where traits such as efficiency, punctuality, a willingness to work hard, and orientation to detail are valued as necessary prerequisites to social and financial well-being. Self-discipline and organization are personality features encouraged by many modern societies. It is almost a prerequisite, for example, to possess at least a few compulsive traits when seeking an advanced graduate degree. How else could you be diligent and motivated enough to do all the reading and write all the papers necessary to get through school? Many professors have strong compulsive traits, as well. Running subjects, managing effective research, and writing papers for peer review all require precision and a detailed knowledge of the field. Compulsive traits are often a key to excelling in such endeavors.

Several normal-range variants of the compulsive personality have been proposed. Each emphasizes a slightly different constellation of traits. The conscientious style (Oldham & Morris, 1995) is characterized by a dedication to hard work, deeply held convictions of conscience and moral principle, a need to do things perfectly and in a socially approved manner, perseverance in pursuits, preference for orderliness and detail, cautious consideration of alternatives before acting, and the need to save or collect things. Conscientious individuals tend to emphasize work more than any other aspect of their lives. For example, they may spend long hours at the office to bring a project to completion or strive hard to eliminate some minor imperfection that most people would simply gloss over. They enjoy detail, thrive on accomplishment, set high standards, and just seem to keep on going long after others have called it a day. With such self-discipline, it is not surprising that many become top managers. Emotionally, they tend to be somewhat reserved, distant, and rather unromantic.

In contrast, the conforming style (Millon et al., 1994) is constructed around conventionality, a preference for following established rules and standards. Conforming individuals are proper, conventional, orderly, and perfectionistic. They respect tradition and authority, uphold established rules and standards, and follow regulations closely. They seldom exhibit spontaneity and can be rather rigid and inflexible in their relationships. Moreover, they are intolerant of deviance and tend to be judgmental of those who are not as earnest. Ever diligent in their responsibilities, they dislike having work pile up and worry about finishing projects. Because of these characteristics, others perceive them as highly dependable and industrious. Though they always attempt to think things through before acting, they are sometimes given to dogmatic thinking, perceiving the world around them and controversial issues in terms of black-and-white, right-or-wrong extremes.

Donald has most of the preceding characteristics, though in a much more exaggerated form. In fact, most of his life is about being in control, the real source of his somatic concerns. Work is the core of his life, and his need for control is most clearly expressed there. In somewhat prideful and stilted language, he "maintains an efficient operation in the workplace." He requires the approval of his superiors, to whom he presents an image of industriousness and diligence. Like the conforming style, he has a respect for tradition and values, though he is more dogmatic and rigid. He favors intellectualism over emotionality and reservedness over spontaneity. It would be difficult to imagine Donald ever stopping by the florist on his way home from work on a whim and bringing a bouquet of roses home to his wife. If he would, that otherwise charming act would likely be done so rigidly as to neatly remove any hint of spontaneity from the gift. This rigidity follows Donald throughout his romantic life, including making love. He is likely to have that act divided into stages, so as to keep control and reduce discomfort arising from any unexpected deviations in the routine.

As with other personality patterns, normal and pathological variants of the compulsive personality may be seen as existing on a continuum; more normal variants will typically display lesser frequency and intensity of the disordered traits described in the DSM-IV, and some of those more balanced traits may serve the individual well (see Sperry, 1995). Whereas the disordered individual becomes so preoccupied with rules and lists that the big picture is lost (see criterion 1), the more balanced individual with this style takes pride in the finer points of an accomplished work, without overwhelming the self and without letting some detail dominate the overall plan or final production. Although the compulsive personality disorder is characterized by a constant emphasis on perfectionism in every single task (see criterion 2), individuals with a compulsive style know where to draw the line. They simply do the best possible job they can within the constraints of time, resources, and, more important, their own desires. Whereas the disordered person is so rigidly devoted to work that fun, friends, and family fall by the wayside (see criterion 3), a person possessed of the style is able to work hard and consistently but recognizes the importance of intimacy in relationships.

For each of the preceding contrasts, Donald falls more toward the pathological side. He is happy to tell you that he takes pride in his work, but he probably doesn't really understand what that means. People like Donald tend to bombard themselves with information before beginning a job. They try to work everything out in advance, and they hate to make accommodations along the way. Accommodations mean that they've failed to anticipate something, which is an uncomfortable state for people who must work with the known rather than the unknown. In fact, they detail themselves endlessly so that they can diminish the influence of uncertainty to the very margins of what rationality allows. What Donald feels when he completes something that has challenged him is not so much a sense of pride and fulfillment as it is a sense of relief. He got through it without incurring the wrath of someone he's accountable to, perhaps a boss or just his own severe superego.

It is these qualities that drive Donald's perfectionism, as well as the side effect of his inability to make time for his wife or family. They don't stand over him, and they're not really part of his conscience. Donald acquired the dictum, somewhere in his development, that a good husband should spend time with the family. But even then, it's not quality time generated from a sense of genuine love and desire for connection. Rather, it's an obligation, a duty to the family to be performed like any other duty. Odds are his family knows this at some level. He can cover it up in a variety of ways, perhaps by making a virtue of being a "good provider" or insisting that times are tough and he has to work hard to get ahead, but it's a loss for everyone, including Donald.

The remaining diagnostic criteria of the compulsive personality can also be put on a continuum with normality (Sperry, 1995). Dogmatic attitudes rigidly devoted to moral, ethical, and religious principles (see criterion 4) lie on the disordered end of the spectrum; a personal sense of integrity and recognition of life's complexity are examples of more balanced personality features. Individuals who are more in line with the style recognize that individual values and situations must sometimes trump the blanket application of rigid moral absolutes. Whereas the disordered individual is unable to discard what is worn out or worthless (see criterion 5), most people with conscientious or conforming styles recognize that these things might come in handy someday, but draw the line when saving them becomes too inconvenient. Another feature of the disordered personality is the inability to delegate tasks to others (see criterion 6) or rigidity in insisting that things be done a certain way. Those with the more normal style recognize that others may have valuable contributions and are then flexible enough to shift their mindset to make room for new ideas. The disordered side of the spectrum often features stinginess (see criterion 7), whereas the more flexible personality style is savings-conscious, but not at the cost of relationships or occasional episodes of spontaneity. Finally, disordered persons are stubborn and rigid (see criterion 8), while normals are capable of weighing the facts dispassionately and having a change of mind.

Again, when we compare Donald to the preceding contrasts, he usually falls more toward the pathological side of the continuum. From the information contained in the case, Donald does seem dogmatic with respect to morality (see criterion 4), ethics, and values. First, he is offended by examples of moral impropriety, and he pursues important lifestyle choices with radical religious zeal. His emphasis on health, for example, is not only a reaction to his somatic concerns, but also an example of how he makes lifestyle choices into absolutes. As noted, Donald finds it nearly impossible to delegate tasks to other workers (see criterion 6). When he does, he finds that his own anxiety level begins to increase. He starts thinking about all the ways things might go wrong, and he wonders whether his coworkers will anticipate this or safeguard against that. He has to be absolutely sure they follow his flowchart because he needs a sense of control to protect himself against the uncertainty of what he fears might happen. As for miserliness, the case notes that Donald has "always been a good saver," a characteristic of the compulsive style, but not extreme enough for the disorder. Finally, as Donald's wife says, "Once his mind is made up, it stays made up," an example of black-and-white thinking typical of compulsive patterns. He can't change his mind because he hates the thought that he might have been wrong, and he can't give ground because he rarely, if ever, sees shades of gray.

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