Charlotte white, October 2024

A common misconception about obsessive-compulsive disorder (OCD) is that it’s primarily about neatness and order. Many individuals casually claim to be "a little OCD" because they prefer an organised environment or exhibit perfectionist traits. However, these characteristics are more aligned with obsessive-compulsive personality disorder (OCPD), which differs significantly from OCD (Fineberg et al., 2022).

OCD is characterised by intrusive, distressing thoughts (obsessions) that compel repetitive behaviours (compulsions) to reduce the associated anxiety. For example, someone might need to wash their hands multiple times within a short period or repeatedly check if the door is locked (Abramowitz et al., 2021). Initially classified under anxiety disorders in the DSM, OCD is now recognised as a distinct category due to its complex cognitive underpinnings (American Psychiatric Association, 2013). While OCD often co-occurs with anxiety disorders, I have also observed it in combination with attention-deficit/hyperactivity disorder (ADHD) among students (Toro-Martínez, 2014).

In young students, both OCD and OCPD traits can present challenges in their daily routines. Although diagnostic criteria require that these traits significantly impair functioning, many practitioners are cautious about diagnosing children due to ongoing developmental changes (McKay & Abramowitz, 2016). Though not a specialist, I have worked with both students and family members to implement strategies that help them manage these behaviours within a school environment.

OCPD often manifests as a need to control surroundings, possibly driven by a fear of failure or being judged negatively (Cain et al., 2020). This issue seems to be exacerbated by increasing academic and societal pressures to excel. As educators, we must be mindful not to contribute to this stress. Emphasising the learning value of mistakes is crucial; I frequently highlight examples from figures like Albert Einstein and Kobe Bryant, who viewed failure as a pathway to success. This can encourage students to take more appropriate risks without fear.

It is equally important to discuss the uncontrollability of one's environment and to model that imperfection is a part of life. Regularly practicing these ideas helps students become more adaptable. When working with students with OCD, open conversations about their thoughts can be transformative. Gradually delaying compulsive behaviours, such as taking longer to respond to an obsession or reducing the number of repetitions, is a strategy I have seen work well. Cognitive-behavioural approaches, particularly Exposure and Response Prevention (ERP), have also been proven effective in helping individuals reduce compulsive behaviours over time (McKay et al., 2015). This needs to be worked on however, with an expert in this area; ensuring a tailored and appropriate intervention plan is followed.

In addition, providing structured routines and a supportive classroom environment can also assist students with OCD and OCPD in managing their symptoms. For instance, predictable schedules can reduce anxiety and minimise triggers for compulsive behaviours. Collaborative efforts with parents and mental health professionals are crucial to ensuring a consistent approach both at school and home (Piacentini & Langley, 2004).

Understanding the nuances between OCD and OCPD is essential for educators working with students who display these traits. By fostering a supportive learning environment, celebrating mistakes as opportunities for growth, and implementing tailored strategies, we can help students manage their symptoms more effectively. With the right support and interventions, students can learn to navigate their challenges and experience greater success both academically and personally.

References

Abramowitz, J. S., Jacoby, R. J. (2014). Treating obsessive-compulsive disorder: A cognitive-behavioral therapy approach. APA Publishing. Retrieved from APA PsycNet PsycBooks-TOC

Abramowitz, J. S., Taylor, S., McKay, D. (2021). Obsessive-compulsive disorder. Lancet, 397(10291), 1277-1287. Retrieved from Obsessive-compulsive disorder - The Lancet

American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders (5th ed.). Retrieved from Diagnostic and Statistical Manual of Mental Disorders | Psychiatry Online

N. M., Ansell, E. B., Simpson, H. B. (2020). Personality disorders and obsessive-compulsive disorder: A comparative review. Current Psychiatry Reports, 22(12), 65. Retrieved from Interpersonal Functioning in Obsessive-Compulsive Personality Disorder - PMC (nih.gov)

Fineberg, N. A., Hollander, E., Pallanti, S., et al. (2022). OCD and OCPD: A comprehensive review. World Journal of Biological Psychiatry, 23(3), 223-246. Retrieved from How to manage obsessive-compulsive disorder (OCD) under COVID-19: A clinician's guide from the International College of Obsessive Compulsive Spectrum Disorders (ICOCS) and the Obsessive-Compulsive and Related Disorders Research Network (OCRN) of the European College of Neuropsychopharmacology - PMC (nih.gov)

McKay, D., Abramowitz, J. S. (2016). Obsessive-compulsive spectrum conditions: A critical review of the evidence. Journal of Clinical Psychology, 72(7), 736-749. Retrieved from A New Look at the Factor Structure of the MHC‐SF in Iran and the United States Using Exploratory Structural Equation Modeling - Joshanloo - 2016 - Journal of Clinical Psychology - Wiley Online Library

McKay, D., Taylor, S., & Abramowitz, J. S. (2015). Exposure and response prevention in the treatment of obsessive-compulsive disorder: A review and new directions. Behavior Research and Therapy, 55, 1-9. Retrieved from Long-term stability of cognitive behavioral therapy effects for panic disorder with agoraphobia: A two-year follow-up study - ScienceDirect

Piacentini, J., & Langley, A. K. (2004). Cognitive-behavioral therapy for children who have obsessive-compulsive disorder. Journal of Clinical Psychology, 60(11), 1181-1193. Retrieved from Understanding and treating incompleteness in obsessive‐compulsive disorder - Summerfeldt - 2004 - Journal of Clinical Psychology - Wiley Online Library

Toro-Martínez, E. (2014). Trastorno obsesivo compulsivo y trastornos relacionados: Un nuevo capítulo en el DSM-5. Vertex, 25(113), 63-67.