Doctor's Notes: Diagnosis Two: Obsessive Compulsive Personality Disorder
Symptoms: antagonism, perfectionism, rigidity, and orderliness. Interpersonally, stiff, controlling, workaholicism, and stubbornness. Many of his behaviors are motivated by a fear of loss of control. The central underlying affect and/or emotional experience with OCPD is anxiety.
His pattern of behavior functions to manage his excessive anxiety. His avoidant dismissive control style also assists in keeping his anxiety out of sight to the casual observer.
It has been noted on several occasions by this therapist an excessive amount of fist clenching, pacing and repetitive pattern calming rituals.
However, his OCPD is high functioning enough where it does not itself affect his ability to perform his duties.
OCPD types want to control their environments. An easy way to accomplish this is in a task that you have complete control over. As a leader, a fighter and a cleaner OCPD fits his personality.
Rather than feel anxious about his compulsions about cleanliness, as a typical OCD personality would; OCPD types see their behaviors and thoughts as being okay.
I feel a lot of his OCPD stems from the filth and darkness he was forced to grow up in. Everything must be clean and orderly. Although he does not display ritualistic patterns of OCD, he does display the need for control and order of an OCPD type.
An example of the difference between the two is ritual. An OCD person may for example, have a very particular hand washing ritual, where everything is performed systematically and exactly the same every time.
They might use counting as a way to ensure it is done correctly. If the ritual is deviated from, the OCD individual absolutely must restart their ritual as anxiety is likely to occur.
Levi shows none of these behaviors as typical of OCPD, and has a better handle on situations where deviation from ritual is unavoidable. A good example is Isaiah, a 7-yr old patient whom Levi has come into contact with on multiple occasions.
Though uncomfortable, Levi displayed none of the typical behaviors as an OCD type would when Isaiah hugged him at their first meeting. Fear of getting dirty seemed not to trouble him enough to feel the need to excuse himself and clean per ritual.
Further to note, Levi has developed a strong bond with the child since beginning therapy. Isaiah never takes off the scouting cloak Levi gave him.
He has taken the child under his wing, and taught him hand to hand to defend himself against the bullies that live in his neighborhood. He has also learned sign language to better communicate with the child.
For Levi, in all aspects of his personality this is a huge step and beautiful progress. Completed Hours: 70/180 Dr. Y/N, L/N