Having described the pure compulsive in some detail, we now move on to variations of the basic pattern. The compulsive combines with several other personality disorders, giving a different coloration to the resulting pattern. A brief guide to the subtypes of the compulsive personality is given in Figure 7.1. Actual cases may or may not fall into one of these combinations.
More than any other variant, the conscientious compulsive exhibits a conforming dependency, compliance to rules and authority, and a willing submission to the wishes, values, expectations, and demands of others. Conscientious compulsives see themselves as considerate, thoughtful, and cooperative. They often voice a strong sense of duty, which masks underlying feelings of personal inadequacy. As such, they tend to minimize their accomplishments, underplay their abilities, and grade their success in terms of how well the expectations of others are fulfilled. Though they are usually described as earnest, hardworking, and thorough, these characteristics compensate for deep feelings of self-doubt and hesitation and serve to keep them in the good graces of those they rely on for esteem.
You may note from the preceding description that conscientious compulsives exhibit insecurity in a manner similar to the dependent, although they still compensate for feelings of inadequacy much like the typical compulsive. They hold fast to the belief that they will be cared for, valued, and loved in direct proportion to their hard work and monumental accomplishments. This belief structure comes with a significant liability: They fear that failure to perform perfectly will provoke both abandonment and condemnation, which creates considerable inner sensations of tension and guilt. So dreadful is the thought of making mistakes or taking even the smallest risk that they perpetually rework their efforts, never attaining a true sense of satisfaction for a job well done, all the while feeling perennially anxious over their perceived inadequacy to handle any unanticipated hitch. This blend of dependent and compulsive features gives rise to a distinct submissive interpersonal manner with superiors and an air of propriety and restraint with all others. This is in direct conflict with intense contrary feelings that frequently lurk beneath this veneer, and on occasion, these more primitive qualities sneak through their tightly controlled coping skills. Their occasional experience with such security breaches teaches them to hold even tighter to self-control, thereby creating an existence that is overorga-nized, devoid of spontaneity, and dramatically upset by any deviation in routine. Understand, however, that this is primarily a private battle and is usually masked by a front of equanimity and social agreeableness.
Like the other variants, conscientious compulsives do sometimes attach themselves to institutions or religious organizations, both for interpersonal support and as a means of participating vicariously in a social aura of respect or holiness. In general, however, the conscientious variant is the most sublimated of the compulsive subtypes, jettisoning some of the more self-righteous and forceful qualities that produce interpersonal discomfort. This subtype tends to shade much more readily into normality than the other variants described next.
As originally emphasized by analytic authors (e.g., Rado, 1959) and later expanded by object-relations and interpersonal theorists, all compulsives experience a deep ambivalence between obedience and defiance, which they resolve through sublimation, reaction formation, and displacement. Those who sublimate this conflict seem more normal, those who displace their aggression seem more forceful, and those who react strongly against their internal anger become self-righteous. W. Reich (1933) wrote that over the course of development, each person's defensive operations settle into a defensive style that armors him or her against the world. Using Reich's metaphor, we might say that the drives and impulses lurking within puritanical compulsives are so strong, yet so strongly reacted against, that these individuals seek the armor of God's righteousness to purify, transform, and contain them. Most feel the persistent press of irrational and repugnant aggressive and sexual drives and adopt an ascetic and austere lifestyle to prohibit their dark impulses and fantasies.
All variants of the compulsive pattern experience a conflict between obedience and defiance on some level, but the puritanical variant experiences this much more intensely than any other. Though sharing aspects of zealous defensiveness and guardedness with the paranoid, the puritanical subtype presents as an exaggeration of the basic compulsive pattern. Their hostility, then, is also greater and more likely to be vented through vicious displacements, which usually identify a common enemy or seek to scapegoat the weak. Dichotomous thinking reinforces these urges: In their mind, the world is composed of the all good and the all bad, us versus them, the justified and the unjust, the saved and the sinners, along with the saints (i.e., the compulsives themselves).
Naturally reviled by perceived moral laxity, puritanicals use their wrath as a "vengeful sword" of righteousness bestowed with a sacred mandate to dispel sin and iniquity. Most are pleased to be this instrument through which justice is administered. In fact, puritanicals naturally gravitate toward radical fundamentalism, as the literalism inherent in such beliefs creates a clear picture, not only of who deserves punishment, but who deserves absolute punishment. Thus, injustice is made just and they are free of any residual guilt. Many of these puritanical compulsives secretly enjoy punishing others, as they are strengthened by this judgment of their superego.
People respond in very diverse ways to such a personality. A large part of our society admires the seeming combination of strength and purity that such individuals project. Moreover, puritanical compulsives are not limited to religious dogma. Over the course of history, and even in current politics, they have been an influential force in stirring nationalistic fervor. On a smaller scale, they can be found in virtually any institution, large or small, assuming the mantle of righteousness, preaching the transgressions of their associates, and demanding purges. In fact, excessive interpersonal control may be geared toward eliciting behaviors of defiance from others, so that the enemy can be uncloaked. Some succeed in their pursuit, but eventually, most come to view them as harsh, demanding, abrasive, irritating, and prudish. Some are simply exceptionally straitlaced. Here, the function of the straight and narrow path is transparent, intended to contain and civilize drives that would otherwise be almost uncontrollably intense.
Although this description does not neatly match Donald, he does have a streak of this variation in him. His high contempt for "lazy" subordinates gives a glimpse of this tendency. His indignant tone when he says, "People don't understand that work is a virtue" also has an element of this. Indignation and allegiance to absolute principles are closely connected.
Bureaucratic compulsives ally themselves with traditional values, established authorities, and formal organizations. Most other compulsive subtypes feel conflicted, angered, and even oppressed by these influences, although their overt awareness of this conflict is suppressed. Bureaucratic compulsives are somewhat more aware of this conflict than their counterparts, and instead of allowing their feelings to cause even the slightest difficulty, they wholeheartedly embrace the order and structure inherent in recognized institutions, authorities, and social mores. They flourish in organizational settings, feeling comforted, strengthened, and empowered by clearly defined superior and subordinate relationships, definite roles, and known expectations and responsibilities. Once established, they function loyally and dependably. In effect, these individuals use highly developed and formalized external structures to compensate for the internal sense of ambivalence and indecisiveness that plagues the average compulsive pattern. Many fuse their identity with the system as a means of achieving place, purpose, and protection, and this frees them from any anxiety related to making independent decisions. Their superiors know them as trustworthy, diligent, and faithfully committed to the goals and values of the institution, which fortifies their self-esteem and gives them a direction. Be it church, police, union, university, or business, without the organization most would feel lost or aimless in life. Punctual and meticulous, they adhere to the work ethic like worker ants in a colony, appraising their own and others' tasks with black-and-white efficiency, as done or not done.
The status gained by their alliance with their "greater cause" offers these generally rigid and constrained individuals better than a modicum of pride and self-importance. Deeply committed to all of the trifling and inconsequential directives of their beloved institutions, bureaucratic subtypes gain a sense of status by fusing their identity with a much larger force and becoming an indispensable part of this important structure. As such, they often share hallmarks with the narcissistic personality, although these more inflated qualities are but skin-deep. Like the conscientious compulsive, the bureaucratic compulsive often shades gently into normality, but individual differences run the spectrum from nearly normal to wholly forceful. At a moderately disordered level, their rigid adherence to policies and rules makes them seem officious, high-handed, close-minded, and petty. At a severely disordered level, they may use their knowledge of the rules, effectiveness with red tape, and ingratiating attitude with superiors to terrorize subordinates or anyone else who crosses their path without paying them the proper dues and respect. Donald has some traits of the bureaucratic compulsive in that he is obviously a company man, but he doesn't derive pleasure from control. As a middle-level manager, he could potentially exert a great amount of control over his underlings, but he does not take advantage of this opportunity. Holden, in Case 7.2, is a better example. Notice his relationships with his superiors and with his students.
The parsimonious compulsive resembles Fromm's hoarding orientation (1947). For these individuals, miserliness takes on an almost symbolic significance. Ever wary of the possibility of loss, they are selfish and niggardly and keep a tight, self-protective grip on everything they possess, lest it somehow be wrested from them. Here, the concern shifts from identification with authority or organizational codes to the security value of material goods. Having been deprived of so many wishes and desires in childhood, they nurture and protect what little they have, ever suspicious that others might scavenge their few prized possessions. They draw sharp boundaries and behave with an unnecessary stinginess. In effect, their behavior says, "What is mine is mine, and what is yours is yours."
Fromm's (1947) conceptualization suggests that as children, such individuals were often deprived of wishes and desires. Their basic needs were not necessarily neglected by their parents, but perhaps few if any of their wants were fulfilled in a manner that seemed reasonable to them. Perhaps under the best of intentions, the caregivers attempted to instill a deep sense of duty and self-responsibility by radically avoiding any measure that could potentially spoil the child. Undoubtedly, it is far healthier to allow children to experience a modicum of unfulfilled wishes than it is to indulge them with everything they could ever imagine. However, when this otherwise healthy approach to child rearing is taken to an illogical extreme, an orientation evolves wherein individuals seem to have an almost one-dimensional focus on nurturing and protecting anything earned or achieved. They become self-sufficient to a fault, disallowing anyone who may potentially deprive them of their resources and acting as if any loss in their nest egg could not be replenished. This miserliness also masks a deeper need. By effectively shutting out anyone else from permeating their world of possessions, they are, in effect, guarding against any discovery of the barrenness of their attainments and competencies. Even more important, this is a safeguard shared with other variants of the compulsive personality, in that keeping an air of propriety and privacy staves off any possible unearthing of their dreaded rebellious urges or irrational anger. This cool distancing from others and this protection of monetary and material possessions from external intrusions are qualities shared with the schizoid personality.
Holden reported self-doubt, guilt, and prolonged periods of diffuse anxiety. Though not overwhelming, these feelings had become more difficult to control. He now had trouble sleeping at night and experienced growing indecisiveness at work.
The immediate problem was a coming change of academic position. A new administration asked that he resign his deanship and return to teaching history. In the initial sessions, he focused on the details of the transition.1 He was particularly concerned about facing students in the classroom again, worried about organizing his materials, and doubted his ability to interest and discipline students. Though he had been a competent teacher before, he kept reviewing old lecture notes again and again, but with little comfort.
No mention was made about any anger regarding his demotion, or the fact that Holden had poured his life into the position, working long hours and coordinating personally with the various department heads on matters that other deans would have assigned to their secretaries. Instead, he voiced his "complete confidence in the rationality of the process" that had led to the choice of another dean. Nevertheless, he stuttered and trembled whenever he engaged members of the administration.
The second of two sons, Holden was younger than his older brother by three years. Both parents held high-level positions, and both were regarded as efficient, strict, and orderly. Life at home was always "well-planned," with charts and schedules posted in common rooms detailing cleaning responsibilities, appointments, and even yearly physicals. Nothing was left to chance. Holden and his brother knew what they could count on in life and what was expected in return. If they failed to meet expectations, it would be treated almost as misbehavior: punishment would be swift and severe. Neither parent would tolerate expressions of anger in the family. Holden felt his brother "got away with" everything, but could only vent his feelings by tattling, which he derived great pleasure from. Not until after many sessions did Holden recognize that this was not a matter of "sticking to the rules," but a means of dealing with his jealously of his older brother.
At 27, Holden completed his Ph.D., married a "stable girl from a good home," and began teaching at a small college. His "fine work" in advising freshmen led to his becoming dean of freshmen, and eventually dean of students. Although he conscientiously "kept the rules," he was accused of being a stuffed shirt lacking real human compassion. Moreover, the department heads were often angered by his refusal to bend the rules. Anyone without an earnest attitude could become an object of his wrath, to be reined in with burdensome forms and guidelines. Because of his lack of warmth and occasional harsh decisions with students, he was asked to step down.
1Numbers mark aspects of the case most consistent with DSM criteria, and do not necessarily indicate that the case "meets" diagnostic criteria in this respect.
A pervasive pattern of preoccupation with orderliness, perfectionism, and mental and interpersonal control, at the expense of flexibility, openness, and efficiency, beginning by early adulthood and present in a variety of contexts, as indicated by four (or more) of the following:
(1) is preoccupied with details, rules, lists, order, organization, or schedules to the extent that the major point of the activity is lost
(2) shows perfectionism that interferes with task completion (e.g., is unable to complete a project because his or her own overly strict standards are not met)
(3) is excessively devoted to work and productivity to the exclusion of leisure activities and friendships (not accounted for by obvious economic necessity)
(4) is overconscientious, scrupulous, and inflexible about matters of morality, ethics, or values (not accounted for by cultural or religious identification)
(5) is unable to discard worn-out or worthless objects even when they have no sentimental value
(6) is reluctant to delegate tasks or to work with others unless they submit to exactly his or her way of doing things
(7) adopts a miserly spending style toward both self and others; money is viewed as something to be hoarded for future catastrophes
(8) shows rigidity and stubbornness
Reproduced with permission from the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition. Copyright 1994 American Psychiatric Association.
The bedeviled compulsive is blended with the negativistic personality. For average compulsives, the strategy of self-denial works reasonably well, allowing them to submerge their oppositional desires and put forth a proper and correct front. The bedeviled variety, however, appears on the surface to be maintaining a controlled and austere front but struggles incessantly with a desire to conform to the wishes or agendas of others one minute and the desire to subvert others and assert their own interests the next. When expected to act decisively, they vacillate and procrastinate, feel tormented and confused, become cautious and timid, and use complex rationales to delay making decisions as long as possible. Unable to crystallize their own identity and feeling wave upon wave of ambivalence, they may express their dissatisfaction by becoming exhausted, grumpy, and discontent. Many feel caught between heart and head, between what one part of them sees as reasonable and another part as emotionally satisfying.
Perpetually overwhelmed by the conflict between the will and better decisions, the bedeviled variant's existential experience is that of being caught between a rock and hard place. Painfully aware of their inner impulses, many engage in a form of self-torture, an act of punitive resolution that symbolically undoes that which bedevils them. In this context, the obsessions and compulsions that emerge signify a futile attempt to control that which is illogical, irrational, or even abstract about themselves and their desires. Unfortunately, this is not all that such attempts signify. Generally, the more extreme the obsessions and compulsions, the more the individual's routine coping skills are failing. Their inner ambivalence is the inability to confront what is upsetting to them, and outward behaviors such as compulsions are an outlet for their contradictory feelings. As individuals become more severely disordered, they may see themselves as driven by ego-alien forces, perhaps demons. Helpless, in their perspective, to escape the clutches of corruption, the more decompensated individuals may come to feel as though they are on the edge of psychic dissolution.
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