"Night wind hawkers" sold stock on the streets during the South Sea Bubble. (The Great Picture of Folly, 1720)A satirical "Bubble card"
Extraordinary Popular Delusions and the Madness of Crowds is an early study of crowd psychology by Scottish journalist Charles Mackay, first published in 1841 under the title Memoirs of Extraordinary Popular Delusions. The book was published in three volumes: "National Delusions", "Peculiar Follies", and "Philosophical Delusions". Mackay was an accomplished teller of stories, though he wrote in a journalistic and somewhat sensational style.
In later editions, Mackay added a footnote referencing the Railway Mania of the 1840s as another "popular delusion" which was at least as important as the South Sea Bubble. In the 21st century, the mathematician Andrew Odlyzko pointed out, in a published lecture, that Mackay himself played a role in this economic bubble; as a leader writer in The Glasgow Argus, Mackay wrote on 2 October 1845: "There is no reason whatever to fear a crash".
Volume I: National Delusions
Economic bubbles
The first volume begins with a discussion of three economic bubbles, or financial manias: the South Sea Company bubble of 1711–1720, the Mississippi Company bubble of 1719–1720, and the Dutch tulip mania of the early seventeenth century. According to Mackay, during this bubble, speculators from all walks of life bought and sold tulip bulbs and had even declared futures contracts on them. Allegedly, some tulip bulb varieties briefly became the most expensive objects in the world during 1637.
Mackay's accounts are enlivened by colorful, comedic anecdotes, such as
the Parisian hunchback who supposedly profited by renting out his hump
as a writing desk during the height of the mania surrounding the Mississippi Company.
Two modern researchers, Peter Garber and Anne Goldgar,
independently conclude that Mackay greatly exaggerated the scale and
effects of the Tulip bubble,
and Mike Dash, in his modern popular history of the alleged bubble,
notes that he believes the importance and extent of the tulip mania were
overstated.
Mackay describes the history of the Crusades as a kind of mania of the Middle Ages, precipitated by the pilgrimages of Europeans to the Holy Land.
Mackay is generally unsympathetic to the Crusaders, whom he compares
unfavourably to the superior civilisation of Asia: "Europe expended
millions of her treasures, and the blood of two millions of her
children; and a handful of quarrelsome knights retained possession of the Kingdom of Jerusalem for about one hundred years!"
Witch trials in 16th- and 17th-century Western Europe are the primary
focus of the "Witch Mania" section of the book, which asserts that this
was a time when ill fortune was likely to be attributed to supernatural
causes. Mackay notes that many of these cases were initiated as a way
of settling scores among neighbors or associates, and that extremely low
standards of evidence were applied to most of these trials. Mackay
claims that "thousands upon thousands" of people were executed as
witches over two and a half centuries, with the largest numbers killed
in Germany.
Sections
The Crusades
The Witch Mania
The Slow Poisoners
Haunted Houses
Volume III: Philosophical Delusions
An alchemist, from the 1841/1852 editions of Extraordinary Popular Delusions.
The section on alchemysts focuses primarily on efforts to turn
base metals into gold. Mackay notes that many of these practitioners
were themselves deluded, convinced that these feats could be performed
if they discovered the correct old recipe or stumbled upon the right
combination of ingredients. Although alchemists gained money from their
sponsors, mainly noblemen, he notes that the belief in alchemy by
sponsors could be hazardous to its practitioners, as it wasn't rare for
an unscrupulous noble to imprison a supposed alchemist until he could
produce gold.
Books
Book I: The Alchemysts
Book II: Fortune Telling
Book III: The Magnetisers
Influence and modern responses
The
book remains in print, and writers continue to discuss its influence,
particularly the section on financial bubbles. (See Goldsmith and Lewis,
below.)
Financier Bernard Baruch credited the lessons he learned from Extraordinary Popular Delusions and the Madness of Crowds with his decision to sell all of his stock ahead of the Wall Street Crash of 1929.
Neil Gaiman borrows from the title in an issue of his popular comic series, The Sandman, in a story featuring a writer whose novel is titled "... And the Madness of Crowds".
Author and executive coach Marshall Goldsmith discussed the book in depth in BusinessWeek, drawing extensive parallels between the financial bubbles Mackay wrote about and financial bubbles today. Other writers also frequently point to the book to explain recent financial bubbles.
Author and journalist Will Self writes a column for New Statesman, "Madness of Crowds", which takes its title from Mackay's book.
James Surowiecki, in The Wisdom of Crowds
(2004), takes a different view of crowd behavior, saying that under
certain circumstances, crowds or groups may have better information and
make better decisions than even the best-informed individual.
Canadian author Louise Penny used MacKay as an inspiration for her 2021 novel "The Madness of Crowds."
American synthpop band Information Society released a song titled after the book in 2021. Its vocals are mostly samples of cult leader Jim Jones.
In psychoanalysis, psychosexual development is a central element of the sexual drive theory. According to Freud,
personality develops through a series of childhood stages in which
pleasure seeking energies from the child become focused on certain
erogenous areas. An erogenous zone is characterized as an area of the body that is particularly sensitive to stimulation. The five psychosexual stages are the oral, the anal, the phallic, the latent, and the genital.
The erogenous zone associated with each stage serves as a source of
pleasure. Being unsatisfied at any particular stage can result in fixation.
On the other hand, being satisfied can result in a healthy personality.
Sigmund Freud proposed that if the child experienced frustration at any
of the psychosexual developmental stages, they would experience anxiety that would persist into adulthood as a neurosis, a functional mental disorder.
Sigmund Freud
(1856–1939) observed that during the predictable stages of early
childhood development, the child's behavior is oriented towards certain
parts of their body, for example the mouth during breast-feeding or the anus during toilet-training. In psychoanalysis, the adult neurosis
(functional mental disorder) is thought to be rooted in fixations or
conflicts encountered during the developmental stages of childhood
sexuality. According to Freud, human beings are born "polymorphous perverse":
infants can derive sexual pleasure from any part of their bodies and
any object. Over time the socialization process channels the (originally
non-specific) libido into its more fixed mature forms.
Given the predictable timeline of childhood behavior, he proposed
"libido development" as a model of normal childhood sexual development,
wherein the child progresses through five psychosexual stages – the
oral; the anal; the phallic; the latent; and the genital – in which the
source pleasure is in a different erogenous zone.
Freudian psychosexual development
Sexual infantilism: in pursuing and satisfying their libido
(sexual drive), the child might experience failure (parental and
societal disapproval) and thus might associate anxiety with the given
erogenous zone. To avoid anxiety, the child becomes fixated,
preoccupied with the psychological themes related to the erogenous zone
in question. The fixation persists into adulthood and underlies the
personality and psychopathology of the individual. It may manifest as
mental ailments such as neurosis, hysteria, "female hysteria", or personality disorder.
Orally aggressive: chewing gum and the ends of pencils, etc. Orally passive: smoking, eating, kissing, oral sexual practices Oral stage fixation might result in a passive, gullible, immature, manipulative personality.
Oedipus complex (in boys and girls); according to Sigmund Freud. Electra complex (in girls); according to Carl Jung. Promiscuity and low self-esteem in both sexes.
Latency
6–puberty
Dormant sexual feelings
Immaturity and an inability to form fulfilling non-sexual relationships as an adult if fixation occurs in this stage.
Genital
Puberty–death
Sexual interests mature
Frigidity, impotence, sexual perversion, great difficulty in forming a healthy sexual relationship with another person
Id, Ego, and Superego
Agency
Description
Functions
Principles and Development
Id
The most primitive part of the mind, it contains instinctual drives and is the source of psychic energy.
Seeks immediate gratification of all desires, wants, and needs.
Operates according to the pleasure principle, which aims to reduce
tension, avoid pain, and gain pleasure. Present from birth and is the
reservoir of the libido.
Ego
The part of the id that has been modified by the direct influence of the external world.
Regulates the drives of the id to suit the demands of reality.
Governed by the reality principle, it seeks to please the id's drive
in realistic ways that will benefit in the long term. Emerges from the
id and is responsible for reality testing and a sense of personal
identity.
Superego
The part of the personality that represents the internalization of parental and societal values.
Upholds societal standards, imposes moral behavior, and mediates between the id and ego.
Guided by moralistic and idealistic principles, it strives for
perfection over mere pleasure or reality. Forms during the resolution of
the Oedipus complex and represents the internalized ideals of parents
and society.
The first stage of psychosexual development is the oral stage,
spanning from birth until the age of one year, wherein the infant's
mouth is the focus of libidinal gratification derived from the pleasure
of feeding at the mother's breast, and from the oral exploration of
their environment, i.e. the tendency to place objects in the mouth. The
child focuses on nursing, with the intrinsic pleasure of sucking and
accepting things into the mouth. Since the ego is not developed beyond the most rudimentary form at this stage, every action is based upon the pleasure principle of the id. Nonetheless, the infantile ego is in the process of forming during the oral stage. In developing a body image,
infants are aware of themselves as discrete from the external world;
for example, the child understands pain when it is applied to their
body, thus identifying the physical boundaries between body and
environment. The experience of delayed gratification leads to
understanding that specific behaviors satisfy some needs; for example,
crying gratifies certain needs.
Weaning
is the key experience in the infant's oral stage of psychosexual
development, their first feeling of loss consequent to losing the
physical intimacy of feeding at their mother's breast. The child is not
only deprived of the sensory pleasures of nursing but also of the
psychological pleasure of being cared for, mothered, and held. However,
weaning increases the infant's self-awareness, through learning that
they do not control their environment. The experience of delayed gratification leads to the formation of capacities for independence (awareness of the limits of the self) and trust (behaviors leading to gratification). Thwarting of the oral-stage – too much or too little gratification of desire – might lead to an oral-stage fixation,
which can be the root of neurotic tendencies in the developed
personality. In the case of too much gratification, the child does not
adequately learn that they do not control the environment, and that
gratification is not always immediate, thereby forming an immature
personality.
In the case of too little gratification, the infant might become
passive upon learning that gratification is not forthcoming, despite
having produced the gratifying behavior.
The second stage of psychosexual development is the anal stage, spanning from the age of eighteen months to three years, wherein the infant's erogenous zone changes from the mouth (the upper digestive tract) to the anus
(the lower digestive tract), while ego formation continues. Toilet
training is the child's key anal-stage experience, occurring at about
the age of two years. It involves conflict between the id (demanding
immediate gratification) and the ego (demanding delayed gratification)
in eliminating bodily wastes, and handling related activities (e.g.
manipulating excrement, coping with parental demands). The child may
respond with defiance, resulting in an 'anal expulsive character'—often
messy, reckless, and defiant—or with retention, leading to an 'anal
retentive character'—typically neat, precise, and passive-aggressive.
The style of parenting influences the resolution of the conflict, which
can be either gradual and psychologically uneventful, or which can be
sudden and psychologically traumatic.
The ideal resolution of the conflict is that the child adjusts to
moderate parental demands that teach the value and importance of
physical cleanliness and environmental order, thus producing a
self-controlled adult. The outcome of this stage can permanently affect
the individual's propensities toward possession and attitudes toward
authority. If the parents make immoderate demands of the child, by too
strictly enforcing toilet training, it might lead to the development of a
compulsive personality,
a person too concerned with neatness and order. If the parents
consistently allow the child to indulge the impulse, the child might
develop a self-indulgent personality characterized by personal
slovenliness and environmental disorder.
The third stage of psychosexual development is the phallic stage, spanning the ages of three to six years, wherein the child's genitalia are their primary erogenous zone.
It is in this third infantile development stage that children become
aware of their bodies, the bodies of other children, and the bodies of
their parents; they gratify physical curiosity by undressing and
exploring each other as well as their genitals, and so learn the physical
(sexual) differences between male and female and their associated
social roles. In the phallic stage, a boy's decisive psychosexual
experience is the Oedipus complex—his son–father competition for possession of his mother. The name derives from the 5th-century BC Greek mythologic character Oedipus,
who unwittingly killed his father and sexually possessed his mother. In
the young male, the Oedipus conflict stems from his natural love for
his mother, a love which becomes sexual as his libidinal energy
transfers from the anal region to the genital. The boy observes that his
father stands in the way of his love and desire for possession of his
mother. He therefore feels aggression and envy towards his father, but
also a fear that his (much stronger) rival will strike back at him. As
the boy has noticed that women, his mother in particular, have no
penises, he is particularly struck by the fear that his father will
remove his penis too. This castration anxiety
surpasses his desire for his mother, so the desire is repressed.
Although the boy sees that he cannot possess his mother, he reasons that
he can possess her vicariously by identifying with his father and
becoming as much like him as possible: this identification is the
primary experience guiding the boy's entry into his appropriate sexual
role in life. A lasting trace of the oedipal conflict is the superego,
the voice of the father within the boy. By thus resolving his incestuous
conundrum, the boy passes into the latency period, a period of
libidinal dormancy.
Initially, Freud applied the theory of the Oedipus complex to the
psychosexual development of boys, but later developed the female
aspects of the theory as the feminine Oedipus attitude and the negative Oedipus complex.
The feminine Oedipus complex has its roots in the little girl's
discovery that she, along with her mother and all other women, lack the
penis which her father and other men possess. Her love for her father
then becomes both erotic and envious, as she yearns for a penis of her
own. She comes to blame her mother for her perceived castration, and is
struck by penis envy, the apparent counterpart to the boy's castration anxiety.
Freud's student–collaborator, Carl Jung, coined the term Electra complex in 1913. The name derives from the 5th-century BC Greek mythologic character Electra, who plotted matricidal revenge with her brother Orestes, against their mother and stepfather, for the murder her father. (cf. Electra, by Sophocles).
According to Jung, a girl's decisive psychosexual experience is her
daughter–mother competition for psychosexual possession of her father.
Freud rejected Jung's term as psychoanalytically inaccurate: "that what
we have said about the Oedipus complex applies with complete strictness
to the male child only, and that we are right in rejecting the term
'Electra complex', which seeks to emphasize the analogy between the
attitude of the two sexes".
The resolution of the feminine Oedipus complex is less clear-cut
than the resolution of the Oedipus complex in males. Freud stated that
the resolution comes much later and is never truly complete. Just as the
boy learned his sexual role by identifying with his father, so the girl
learns her role by identifying with her mother in an attempt to possess
her father vicariously. At the eventual resolution of the conflict, the
girl passes into the latency period, though Freud implies that she
always remains slightly fixated at the phallic stage.
Despite the mother being the parent who primarily gratifies the
child's desires, the child begins forming a discrete sexual identity –
"boy", "girl" – that alters the dynamics of the parent and child
relationship; the parents become the focus of infantile libidinal
energy. The boy focuses his libido (sexual desire) upon his mother, and
focuses jealousy and emotional rivalry against his father – because it
is he who sleeps with the mother. Seeking to be united with his mother,
the boy desires the death of his father, but the ego, pragmatically
based upon the reality principle,
knows that the father is the stronger of the two males competing to
possess the one female. Nevertheless, the boy remains ambivalent about
his father's place in the family, which is manifested as fear of
castration by the physically greater father; the fear is an irrational,
subconscious manifestation of the infantile Id.
'Penis envy' in the girl is rooted in anatomic fact: without a penis,
she cannot sexually possess the mother, as the infantile id demands. As a
result, the girl redirects her desire for sexual union toward the father; thus, she progresses towards heterosexual femininity that ideally culminates in bearing a child who replaces the absent penis.
After the phallic stage, the girl's psychosexual development includes
transferring her primary erogenous zone from the infantile clitoris to the adult vagina.
Freud considered a girl's Oedipal conflict to be more emotionally
intense than that of a boy, potentially resulting in a submissive woman
of insecure personality.
In both sexes, defense mechanisms
provide transitory resolutions of the conflict between the drives of
the Id and the drives of the ego. The first defense mechanism is repression, the blocking of anxiety-inducing impulses and ideas from the conscious mind. The second defense mechanism is Identification,
by which the child incorporates, to their ego, the personality
characteristics of the same-sex parent. The boy thus diminishes his
castration anxiety, because his identification with the father reduces
the rivalry and suggests the promise of a future potency. The girl
identifies with the mother, who understands that, in being females,
neither of them possesses a penis, and thus they are not antagonists.
The fourth stage of psychosexual development is the latency stage (from the age of 6 until puberty),
wherein the child consolidates the character habits they developed in
the three earlier stages. Whether or not the child has successfully
resolved the Oedipal conflict, the instinctual drives of the child are
inaccessible to the ego, because they have been subject to the mechanism
of repression during the phallic stage. Hence, because the drives are
latent (hidden) and gratification is indefinitely delayed, the child
must derive the pleasure of gratification from secondary
process-thinking that directs the energy of the drives towards external
activities, such as schooling, friendships, hobbies, etc. Any neuroses
established during the latent stage of psychosexual development might
derive from the inadequate resolution of the Oedipus conflict, or from
the ego's failure in attempts to direct the energies towards socially
acceptable activities.
The fifth stage of psychosexual development is the genital stage
(from puberty through adult life) and usually represents the greater
part of a person's life. Its aim is the psychological detachment and
independence from the parents. In the genital stage the person confronts
and seeks to resolve their remaining psychosexual childhood conflicts.
As in the phallic stage, the genital stage is centered upon the
genitalia, but the sexuality is consensual and adult, rather than
solitary and infantile. The psychological difference between the phallic
and genital stages is that the ego is established in the latter; the
person's concern shifts from primary-drive gratification (instinct) to
applying secondary process-thinking to gratify desire symbolically and intellectually by means of friendships, a love relationship, family and adult responsibility.
Criticisms
Scientific
According to Frank Cioffi,
a criticism of the scientific validity of the psychoanalytical theory
of human psychosexual development is that Freud was personally fixated
upon human sexuality.
Freud stated that his patients commonly had memories and fantasies of childhood seduction. According to Frederick Crews, critics hold that these were more likely to have been constructs that Freud created and forced upon his patients.
Some feminists criticize Freud's psychosexual development theory as being sexist and phallocentric, arguing that it was overly informed by his own self-analysis. In response to the Freudian concept of penis envy in the development of the feminine Oedipus complex, the German Neo-Freudian psychoanalyst Karen Horney, counter-proposed that girls instead develop "Power envy" rather than penis envy. She also proposed the concept of "womb and vagina envy",
the male's envy of the female ability to bear children. Some
contemporary theorists suggest, in addition to this, the envy of the
woman's perceived right to be the kind parent.
Contemporary cultural considerations have questioned the normative
presumptions of the Freudian psychodynamic perspective that posits the
son–father conflict of the Oedipal complex as universal and essential to human psychologic development.
The anthropologist Bronisław Malinowski's studies of the Trobriand islanders
challenged the Freudian proposal that psychosexual development (e.g.
the Oedipus complex) was universal. He reported that in the insular
matriarchal society of the Trobriand, boys are disciplined by their
maternal uncles, not their fathers (impartial, avuncular discipline). In
Sex and Repression in Savage Society (1927), Malinowski reported that boys dreamed of feared uncles, not of beloved fathers, thus, power
– not sexual jealousy – is the source of Oedipal conflict in such
non–Western societies. Furthermore, contemporary research confirms that
although personality traits corresponding to the oral stage, the anal
stage, the phallic stage, the latent stage, and the genital stage are
observable, they remain undetermined as fixed stages of childhood, and
as adult personality traits derived from childhood.
Obsession
with rules and order; perfectionism; excessive devotion to
productivity; inability to delegate tasks; zealotry on matters of
morality; rigidity and stubbornness
Obsessive–compulsive personality disorder (OCPD) is a cluster Cpersonality disorder
marked by a spectrum of obsessions with rules, lists, schedules, and
order, among other things. Symptoms are usually present by the time a
person reaches adulthood, and are visible in a variety of situations. The cause of OCPD is thought to involve a combination of genetic and environmental factors, namely problems with attachment.
The disorder is the most common personality disorder in the United States, and is diagnosed twice as often in males as in females; however, there is evidence to suggest the prevalence between men and women is equal.
Signs and symptoms
Obsessive–compulsive personality disorder (OCPD) is marked by an excessive obsession with rules, lists, schedules, and order; a need for perfection that interferes with efficiency and the ability to complete tasks; a devotion to productivity that hinders interpersonal relationships and leisure time; rigidity and zealousness on matters of morality and ethics;
an inability to delegate responsibilities or work to others; restricted
functioning in interpersonal relationships; restricted expression of emotion and affect; and a need for control over one's environment and self.
Some of OCPD's symptoms are persistent and stable, whilst others
are unstable. The obsession with perfectionism, reluctance to delegate
tasks to others, and rigidity and stubbornness are stable symptoms. On
the other hand, the symptoms that were most likely to change over time
were the miserly spending style and the excessive devotion to
productivity.
This discrepancy in the stability of symptoms may lead to mixed results
in terms of the course of the disorder, with some studies showing a
remission rate of 58% after a 12-month period, whilst others suggesting
that the symptoms are stable and may worsen with age.
Attention to order and perfection
People
with OCPD tend to be obsessed with controlling their environments; to
satisfy this need for control, they become preoccupied with trivial
details, lists, procedures, rules, and schedules.
This preoccupation with details and rules makes the person unable
to delegate tasks and responsibilities to other people unless they
submit to their exact way of completing a task because they believe that
there is only one correct way of doing something. They stubbornly
insist that a task or job must be completed their way, and only their
way, and may micromanage people when they are assigned a group task.
They are frustrated when other people suggest alternative methods. A
person with this disorder may reject help even when they desperately
need it as they believe that only they can do something correctly.
People with OCPD are obsessed with maintaining perfection. The
perfectionism and the extremely high standards that they establish are
to their detriment and may cause delays and failures to complete
objectives and tasks. Every mistake is thought of as a major catastrophe
that will soil their reputation for life. For example, a person may
write an essay and, believing that it fell short of perfection,
continues rewriting it, missing the deadline or even failing to complete
the task. The subject may remain unaware that others become frustrated
and annoyed by repeated delay and inconvenience so caused. Work
relationships may then become a source of tension.
Devotion to productivity
Individuals
with OCPD devote themselves to work and productivity at the expense of
interpersonal relationships and recreation. Economic necessity, such as
poverty, cannot account for this behavior.
They may believe that they do not have sufficient time to relax because
they have to prioritize their work above all. They may refuse to spend
time with friends and family because of that. They may find it difficult
to go on a vacation, and even if they book a vacation, they may keep
postponing it until it never happens. They may feel uncomfortable when
they do go on a vacation and will take something along with them so they
can work. They choose hobbies that are organized and structured, and
they approach them as a serious task requiring work to perfect. The
devotion to productivity in OCPD, however, is distinct from work
addiction. OCPD is controlled and egosyntonic, whereas work addiction is uncontrolled and egodystonic, and the affected person may display signs of withdrawal.
Rigidity
Individuals
with OCPD are overconscientious, scrupulous and rigid, and inflexible
on matters of morality, ethics and other areas of life. They may force
themselves and others to follow rigid moral principles and strict
standards of performance. They are self-critical and harsh about their
mistakes. These symptoms should not be accounted for or caused by a
person's culture or religion.
Their view of the world is polarised and dichotomous; there is no grey
area between what is right and what is wrong. Whenever this dichotomous
view of the world cannot be applied to a situation, this causes internal
conflict as the person's perfectionist tendencies are challenged.
People with this disorder are so obsessed with doing everything
the "right and correct" way that they have a hard time understanding and
appreciating the ideas, beliefs, and values of other people, and are
reluctant to change their views, especially on matters of morality and
politics.
Restricted emotions and interpersonal functioning
Individuals
with this disorder may display little affection and warmth; their
relationships and speech tend to have a formal and professional
approach, and not much affection is expressed even to loved ones, such
as greeting or hugging a significant other at an airport or train
station.
They are extremely careful in their interpersonal interactions.
They have little spontaneity when interacting with others, and ensure
that their speech follows rigid and austere standards by excessively
scrutinising it. They filter their speech for embarrassing or imperfect
articulation, and they have a low bar for what they consider to be such.
They lower their bar even further when they are communicating with
their superiors or with a person of high status. Communication becomes a
time-consuming and exhausting effort, and they start avoiding it
altogether. Others regard them as cold and detached as a result.
Their need for restricting affection is a defense mechanism used
to control their emotions. They may expunge emotions from their memories
and organize them as a library of facts and data; the memories are
intellectualized and rationalized, not experiences that they can feel.
This helps them avoid unexpected emotions and feelings and allows them
to remain in control. They can view self-exploration as a waste of time
and have a patronising attitude towards emotional people.
Interpersonal control
Individuals
with OCPD are at one extreme of the conscientiousness continuum. While
conscientiousness is a desirable trait generally, its extreme
presentation for those with OCPD leads to interpersonal problems. OCPD
individuals present as over-controlled and this extends to the
relationships they have with other people. Individuals with OCPD are
reverential to authority and rules. OCPD individuals may therefore
punish those who violate their strict standards. The inability to accept
differences in belief or behaviors from others often leads to high
conflict and controlling relationships with coworkers, spouses, and
children.
Cause
The cause of OCPD is thought to involve a combination of genetic and environmental factors.
There is clear evidence to support the theory that OCPD is genetically
inherited; however, the relevance and impact of genetic factors vary
with studies placing it somewhere between 27% and 78%.
A twin study on the influence of genetics on the development of
personality disorders over multiple personality disorders found that
OCPD had a 0.78 heritability correlation, thus demonstrating that the
development of OCPD can be strongly linked to genetics.
Other studies have found links between attachment theory and the development of OCPD. According to this hypothesis, those with OCPD have never developed a secure attachment style, had overbearing parents, were shown little care, and/or were unable to develop empathetically and emotionally.
Diagnosis
DSM-5
The fifth edition of the Diagnostic and Statistical Manual of Mental Disorders, a widely used manual for diagnosing mental disorders,
places obsessive–compulsive personality disorder under section II,
under the "personality disorders" chapter, and defines it as: "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". A diagnosis of OCPD is only received when four out
of the eight criteria are met.
The eight criteria of OCPD described in the DSM-5 (of which four are required to be present in a patient for a diagnosis) are:
Preoccupation with details
Perfectionism interfering with task completion
Rigidity and stubbornness
Reluctance to delegate
Excessive conscientiousness and pedantry (excessive concern with minor details and rules)
Workaholic behavior
Miserliness (excessive desire to save money)
Inability to discard worn-out or worthless objects
The list of criteria for the ICD-10 is similar, but does not include the last three criteria in the above list, and additionally includes the symptoms "intrusive thoughts" and "excessive doubt and caution" as criteria for diagnosis.
Alternative model for diagnosis
The DSM-5 also includes an alternative set of diagnostic criteria as per the dimensional model
of conceptualizing personality disorders. Under the proposed set of
criteria, a person only receives a diagnosis when there is an impairment
in two out of four areas of one's personality functioning, and when
there are three out of four pathological traits, one of which must be
rigid perfectionism.
The patient must also meet the general criteria C through G for a
personality disorder, which state that the traits and symptoms being
displayed by the patient must be stable and unchanging over time with an
onset of at least adolescence or early adulthood, visible in a variety
of situations, not caused by another mental disorder, not caused by a
substance or medical condition, and abnormal in comparison to a person's
developmental stage and culture/religion.
Differential diagnosis
There are several mental disorders in the DSM-5 that are listed as differential diagnoses for OCPD. They are as follows:
Obsessive–compulsive disorder.
OCD and OCPD have a similar name which may cause confusion; however,
OCD can be easily distinguished from OCPD: OCPD is not characterized by
true obsessions or compulsions.
Hoarding disorder.
A diagnosis of hoarding disorder is only considered when the hoarding
behavior exhibited is causing severe impairment in the functioning of
the person, such as an inability to access rooms in a house due to
excessive hoarding.
Narcissistic personality disorder.
Individuals with a narcissistic personality disorder usually believe
that they have achieved perfection (especially compared to other people)
and cannot get better, whereas those with OCPD do not believe that they
have achieved perfection, and are self-critical. Those with NPD tend to
be stingy and lack generosity; however, they are usually generous when
spending on themselves, unlike those with OCPD who hoard money and are
miserly on themselves and others.
Antisocial personality disorder.
Similarly, individuals with antisocial personality disorder are not
generous, but miserly around others, although they usually over-indulge
themselves and are sometimes reckless in spending.
Schizoid personality disorder.
Schizoid personality disorder and obsessive–compulsive personality
disorder may both display restricted affectivity and coldness; however,
in OCPD, this is usually due to a controlling attitude, whereas, in SPD,
it occurs due to a lack of ability to experience emotion and display
affection.
Other personality traits.
Obsessive–compulsive personality traits may be particularly useful and
helpful, especially in productive environments. Only when these traits
become extreme and maladaptive and cause clinically significant
impairment in several aspects of one's life should a diagnosis of OCPD
be considered.
Personality change due to another medical condition.
Obsessive–compulsive personality disorder must be differentiated from a
personality change due to a medical condition, which affects the central
nervous system, and may cause changes in behavior and traits.
Substance use disorders.
Substance use may cause the advent of obsessive–compulsive traits. It
is necessary that this is distinguished from underlying and persistent
behavior, which must occur when a person is not under influence of a
substance.
Insistent and unwelcome thoughts or impulses that do not attain the severity of an obsessive–compulsive disorder.
Millon's subtypes
In his book, Personality Disorders in Modern Life, Theodore Millon describes five types of obsessive–compulsive personality disorder, which he shortened to compulsive personality disorder.
Those with conscientious compulsivity view themselves as helpful,
co-operative, and compromising. They downplay their achievements and
abilities and base their confidence on the opinions and expectations of
others; this compensates for their feelings of insecurity and
instability. They assume that devotion to work and striving for
perfection will lead to them receiving love and reassurance. They
believe that making a mistake or not achieving perfection will lead to
abandonment and criticism. This mindset causes perpetual feelings of
anxiety and an inability to appreciate their work.
They have strong internal impulses that are countered vociferously
through the use of religion. They are constantly battling their impulses
and sexual drives, which they view as irrational. They attempt to
purify and pacify the urges by adopting a cold and detached lifestyle.
They create an enemy which they use to vent their hostility, such as
"non-believers", or "lazy people". They are patronizing, bigoted, and
zealous in their attitude toward others. Their beliefs are polarized
into "good" and "evil".
The bureaucratic compulsive displays signs of narcissistic
traits alongside the compulsivity. They are champions of tradition,
values, and bureaucracy. They cherish organizations that follow
hierarchies and feel comforted by definitive roles between subordinates
and superiors, and the known expectations and responsibilities. They
derive their identity from work and project an image of diligence,
reliability, and commitment to their institution. They view work and
productivity in a polarized manner; either done or not. They may use
their power and status to inflict fear and obedience in their
subordinates if they do not strictly follow their rules and procedures,
and derive pleasure from the sense of control and power that they
acquire by doing so.
The parsimonious compulsive is hoarding and possessive in nature; they behave in a manner congruent with schizoid
traits. They are selfish, miserly, and are suspicious of others'
intentions, believing that others may take away their possessions. This
attitude may be caused by parents who deprived their child of wants or
wishes but provided necessities, causing the child to develop an extreme
protective approach to their belongings, often being self-sufficient
and distant from others. They use this shielding behavior to prevent
having their urges, desires, and imperfections discovered.
This form of compulsive personality is a mixture of negativistic
and compulsive behavior. When faced with dilemmas, they procrastinate
and attempt to stall the decision through any means. They are in a
constant battle between their desires and will, and may engage in
self-defeating behavior and self-torture in order to resolve the
internal conflict. Their identity is unstable, and they are indecisive.
Comorbidity
Obsessive–compulsive disorder
OCPD is often confused with obsessive–compulsive disorder
(OCD). Despite the similar names, they are two distinct disorders. Some
OCPD individuals do have OCD, and the two can be found in the same
family, sometimes along with eating disorders.
The rate of comorbidity of OCPD in patients with OCD is estimated to be around 15–28%. However, due to the addition of the hoarding disorder
diagnosis in the DSM-5, and studies showing that hoarding may not be a
symptom of OCPD, the true rate of comorbidity may be much lower.
There is significant similarity in the symptoms of OCD and OCPD,
which can lead to complexity in distinguishing them clinically. For
example, perfectionism is an OCPD criterion and a symptom of OCD if it
involves the need for tidiness, symmetry, and organization. Hoarding is
also considered both a compulsion found in OCD and a criterion for OCPD
in the DSM-5. Even though OCD and OCPD are seemingly separate disorders
there are obvious redundancies between the two concerning several
symptoms.
Regardless of similarities between the OCPD criteria and the
obsessions and compulsions found in OCD, there are discrete qualitative
dissimilarities between these disorders, predominantly in the functional
part of symptoms. Unlike OCPD, OCD is described as invasive, and
stressful. Time-consuming obsessions and habits are aimed at reducing
obsession-related stress. OCD symptoms are at times regarded as egodystonic because they are experienced as alien and repulsive to the person. Therefore, there is a greater mental anxiety associated with OCD.
In contrast, the symptoms seen in OCPD, although repetitive, are
not linked with repulsive thoughts, images, or urges. OCPD
characteristics and behaviors are known as egosyntonic, as people with this disorder view them as suitable and correct. On the other hand, the main features of perfectionism
and inflexibility can result in considerable suffering in an individual
with OCPD as a result of the associated need for control.
The presence of OCPD in patients with OCD has been linked to a worse prognosis of OCD, especially when cognitive behavioral therapy
was used. This may be due to the egosyntonic nature of OCPD which may
lead to the obsessions becoming aligned with one's personal values. In
contrast, the trait of perfectionism may improve the outcome of
treatment as patients are likely to complete homework assigned to them
with determination. The findings with regards to pharmacological
treatment has also been mixed, with some studies showing a lower
reception to SRIs in OCD patients with comorbid OCPD, with others showing no relationship.
Comorbidity between OCD and OCPD has been linked to a more severe presentation of symptoms, a younger age of onset, more significant impairment in functioning, poorer insight, and higher comorbidity of depression and anxiety.
Autism spectrum
There are considerable similarities and overlap between autism spectrum disorder (ASD) and OCPD,
such as list-making, inflexible adherence to rules, and obsessive
aspects of ASD, although the latter may be distinguished from OCPD
especially regarding affective behaviors, worse social skills, difficulties with Theory of Mind and intense intellectual interests, e.g. an ability to recall every aspect of a hobby. A 2009 study involving adult autistic people found that 32% of those diagnosed with ASD met the diagnostic requirements for a comorbid OCPD diagnosis.
Eating disorders
Perfectionism has been linked with anorexia nervosa
in research for decades. A researcher in 1949 described the behavior of
the average "anorexic girl" as being "rigid" and "hyperconscious",
observing a tendency to "[n]eatness, meticulosity, and a mulish
stubbornness not amenable to reason [which] make her a rank
perfectionist."
So common are such traits as perfectionism and rigidity among
anorectics, that they have been referred to in clinical literature as
"classical childhood features of patients with anorexia nervosa" or
"classical premorbid personality descriptors of anorexia nervosa".
Regardless of the prevalence of the full-fledged OCPD among
eating disordered samples, the presence of this personality disorder or
its traits, such as perfectionism, has been found to be positively
correlated with a range of complications in eating disorders and a
negative outcome, as opposed to impulsive features—those linked with histrionic personality disorder, for example—which predict a better outcome from treatment. OCPD predicts more severe symptoms of anorexia nervosa, and worse remission rates,
however, OCPD and perfectionistic traits predicted a higher acceptance
of treatment, which was defined as undergoing 5 weeks of treatment.
People with anorexia nervosa who exercise excessively display a
higher prevalence of several OCPD traits when compared to their
counterparts who did not exercise excessively. The traits included
self-imposed perfectionism,
and the childhood OCPD traits of being rule-bound and cautious. It may
be that people with OCPD traits are more likely to use exercise
alongside restricting food intake in order to mitigate fears of
increased weight, reduce anxiety, or reduce obsessions related to weight
gain. Samples that had the childhood traits of rigidity, extreme
cautiousness, and perfectionism endured more severe food restriction and
higher levels of exercise and underwent longer periods of underweight
status. It may be that OCPD traits are an indicator of a more severe
manifestation of AN which is harder to treat.
Gambling disorder
A
majority of those with lifelong gambling disorder have some sort of
personality disorder, and the most common personality disorder amongst
them is obsessive compulsive personality disorder. OCPD has a strong
comorbidity with individuals who have gambling disorder.
A study of data collected in the 2001-2002 National Epidemiologic
Survey on Alcohol and Related Conditions looked at pathological gambling
and psychiatric conditions as defined by the DSM-IV. Of the surveyed
population consistent with gambling disorder, 60.8% also had a
personality disorder, with OCPD appearing most frequently at 30%.
About 300,000 U.S citizens have both a gambling disorder and obsessive
compulsive personality disorder; and yet, there is little research on
the comorbidity of the two disorders. Those with gambling disorders and
OCPD do, indeed, exhibit different behavioral patterns than those with
gambling disorders alone. More research on the relationship between the
disorders is thought to help uncover causes and develop treatments for
patients.
Mental fatigue
Recently,
in 2020, the connection between mental fatigue and OCPD was published
for the first time, even though mental fatigue has been previously
associated with identified characteristics of OCPD such as workaholic
behavior and perfectionism.
OCPD is also linked to hypochondriasis, with some studies estimating a rate of co-occurrence as high as 55.7%.
Moreover, OCPD has been found to be very common among some medical conditions, including Parkinson's disease and the hypermobile subtype of Ehler-Danlos syndrome.
The latter may be explained by the need for control that arises from
musculoskeletal problems and the associated features that arise early in
life, whilst the former can be explained by dysfunctions in the
fronto-basal ganglia circuitry.
The best-validated treatment for OCPD is cognitive therapy (CT) or cognitive behavioral therapy (CBT), with studies showing an improvement in areas of personality impairment, and reduced levels of anxiety and depression. Group CBT is also associated with an increase in extraversion and agreeableness and reduced neuroticism. Interpersonal psychotherapy has been linked to even better results when it came to reducing depressive symptoms.
Epidemiology
Estimates for the prevalence of OCPD in the general population are 3%,
making it the most common personality disorder. Current evidence is
inconclusive as to whether OCPD is more common in men than women, or in
equal rates among sexes. It is estimated to occur in 8.7% of psychiatric outpatient settings.
A study of data collected in the 2001-2002 National Epidemiologic
Survey on Alcohol and Related Conditions looked specifically for seven
personality disorders as defined by the DSM-IV. The study concluded the
most prevalent personality disorder of the survey's population to be
OCPD, at 7.88%. This study also concluded there were no gender differences in prevalence and that OCPD was not a predicter of disability.
In 1908, Sigmund Freud named what is now known as obsessive–compulsive or anankastic personality disorder "anal retentive character". He identified the main strands of the personality type as a preoccupation with orderliness, parsimony (frugality), and obstinacy (rigidity and stubbornness). The concept fits his theory of psychosexual development.
Freud believed that the anal retentive character faced difficulties
regulating the control of defecation, leading to repercussions by the
parents, and it is the latter that would cause the anal retentive
character.
Aubrey Lewis, in his 1936 book Problems of Obsessional Illness,
suggests that anal-erotic characteristics are found in patients without
obsessive thoughts, and proposed two types of obsessional personality,
one melancholy and stubborn, the other uncertain and indecisive.
In the book Contributions to the theory of the anal character,Karl Abraham
noted that the core feature of the anal character is being
perfectionistic, and he believed that these traits will help an
individual in becoming industrious and productive, whilst hindering
their social and interpersonal functioning, such as working with others.
The DSM-II
(1968) changed the name to "obsessive–compulsive personality", and also
suggested the term "anankastic personality" in order to reduce
confusion between OCPD and OCD, but the proposed name was removed from
later editions. The symptoms described in the DSM-II closely resembled
those in the original DSM.
In 1980, the DSM-III
was released, and it renamed the disorder back to "compulsive
personality disorder", and also included new symptoms of the disorder: a
restricted expression of affect, and an inability to delegate tasks.
Devotion to productivity, perfectionism, and indecisiveness were the
other symptoms included. The DSM-III-R
(1987) renamed the disorder again to "obsessive–compulsive personality
disorder" and the name has remained since then. A diagnosis of OCPD was
given when 5 of the 9 symptoms were met, and the 9 symptoms included
perfectionism, preoccupation with details, an insistence that others
submit to one's way, indecisiveness, devotion to work, restricted
expression of affect, excessive conscientiousness, lack of generosity,
and hoarding.
With DSM-IV,
OCPD was classified as a 'Cluster C' personality disorder. There was a
dispute about the categorization of OCPD as an Axis II anxiety disorder.
Although the DSM-IV attempted to distinguish between OCPD and OCD by
focusing on the absence of obsessions and compulsions in OCPD, OC
personality traits are easily mistaken for abnormal cognitions or values
considered to underpin OCD. The disorder is a neglected and
understudied area of research.
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