Wednesday, May 11, 2011

Character Diagnosis, Parker Fadley: Obsessive Compulsive Personality Disorder

Cracked Up To Be, by Courtney Summers, is about Parker Fadley, who used to be popular and perfect. But now her parents are watching her. School personnel are watching her. The perfect boyfriend she dumped is watching her. All of them are pretty much scratching their heads because she fell apart in a truly spectacular way, and the real reason why is something she can't even admit to herself.

Cracked Up To Be is about the aftermath of something BIG, but as I read the book, I was struck with how much Parker was already dealing with before that event. She was obsessed with being perfect. No one could do things right, so she had to do them herself. It enraged her when anyone suggested she should lighten up and relax her standards.

According to the DSM-IV, the diagnostic criteria for Obsessive Compulsive Personality Disorder are as follows:

A pervasive pattern of preoccupation with orderliness, perfectionism, and mental and interpersonal control, at the expense of flexibility, openness, and efficiency. Symptoms must emerge by early adulthood, be present in a number of settings, and manifest in four or more of the following ways:
  1. preoccupation with lists, rules, order and organization (to the point that the major purpose of the activity is lost)
  2. perfectionism that interferes with task completion
  3. excessively devoted to work to the exclusion of leisure activities and friendships
  4. overly conscientious, scrupulous, and inflexible on matters of morality, ethics, or values
  5. inability to discard seemingly worthless objects, even if they have no sentimental value
  6. reluctance to delegate tasks or to work with others unless they submit to exactly his/her way of doing things
  7. adopts a miserly spending style toward both self and others
  8. shows rigidity and stubbornness
Remember, to be diagnosed with this or any disorder, there has to be significant impairment. In addition, to be diagnosed with this personality disorder, there can't be another Axis I disorder that better accounts for the symptoms (like depression or anxiety).

Now, Parker's clinical presentation is quite complex. First, she's got this pattern of rigid, perfectionistic behavior, as characterized by (in my opinion) symptoms 2, 3, 6, and 8 above. Symptom 4 is debatable as well. And there's no doubt these patterns of behavior and thinking were causing significant conflict in her relationships. After the inciting event, she's got other symptoms, too, including the aforementioned panic attacks and other anxiety symptoms (like repetitive snapping), substance abuse, and some depressive symptoms (which may be explained by something else, but I won't spoil this book for you!). If she went to see a mental health professional, that person could administer a measure like the Structured Clinical Interview for DSM Disorders to sort all the diagnoses out.

Please keep in mind: Obsessive Compulsive Personality Disorder IS NOT THE SAME THING AS Obsessive Compulsive Disorder! OCD is an anxiety disorder--an Axis I disorder--and it involves having obsessions and compulsions, including rituals like the ones Jake Martin has in Heidi Ayarbe's Compulsion, which I blogged about a few weeks ago. Obsessive Compulsive Personality Disorder is a personality disorder, an Axis II disorder. If a person has obsessions or compulsions, OCD is probably more appropriate to diagnose than OCPD.

In addition, people with OCD tend to seek therapy because they're distressed by their symptoms, while people with OCPD seek therapy because of conflict in relationships caused by the perfectionism and rigidity.

Parker does have a somewhat unusual profile--people with OCPD are actually at less risk for substance abuse than those with other personality disorders, because of their need for control. However, it's clear throughout Cracked Up To Be that Parker's obsessed with being perfect, and she even says she has to mess her life up "perfectly" and completely.

Cracked Up To Be is an excellent book to read if you're wondering how to make a potentially unsympathetic character understandable, palatable, and relatable. Have no doubt: Parker can be hard to take. But Courtney Summers does such a beautiful job of showing the reader how Parker is suffering--even when Parker is unable to admit it to herself--which I think takes real skill and discipline. You may not agree with the choices Parker makes and you might cringe at the way she treats people, but you understand it, and you root for her to find her way through. Also, OCPD does not define Parker; she's a lot more complex than that, and Cracked Up To Be makes for a fascinating character-study.

The treatment for OCPD is effective psychotherapy. OCPD is considered one of the more treatable personality disorders, and for obvious reasons, individuals with this disorder are often relatively high-functioning (apart from conflict-filled relationships and inefficiency).

Have I answered your questions about Obsessive Compulsive Personality Disorder? For those of you who have read Cracked Up To Be, do you agree with my "diagnosis"?

It's Wednesday, Sisterhood of the Traveling Blog day, so head on over to Lydia's blog to see how she answers the question, "what do you do when you lose your writing mojo?" Laura gave her answer last week, and I'll be up next week.

20 comments:

  1. I've read the book but never thought about her having a personality disorder. I knew she was going to through some pretty hard stuff, but I figure that had more to do with the mysterious event that happened to her. I guess I more like your typical YA reader without a psychology background. ;)

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  2. huh, I hadn't realized this was an actual personality disorder either, but then again, anything having to do with someone's 'personality' is difficult to nail down. I'd love to hear what you have to say about extreme narcisistic characters!

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  3. It's quite a challenge to make an unsympathetic character someone about whom the reader wants to know more.

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  4. Ooh, another great analysis. Yes, it's funny how OCPD and OCD are interchanged in our culture all the time. In some ways, we praise OCPD (like in medicine--we all want an OCPD doctor taking care of us) and can't stand it (like when it's your mother).
    I haven't heard of this book. I'll have to keep an eye out for it.

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  5. I no longer have OCD (I didn't quite agree with that anyway), I have this. THIS is me. And I'm downloading this book to my kindle as I type. Perfect.

    ~JD

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  6. Yep, I'm another person who didn't realize there was a difference between OCD and OCPD. Thanks for clarifying. Do you know if there's a correlation between having OCD and having OCPD? Are people with one more likely to have the other?

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  7. I read the book (loved it)but it never occured to me she had a problem before the event. But you're probably right. I wonder what the author intended?

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  8. I love these posts where you analyze books and the psychology behind them! :)
    But I have a question: Could it be said that OCPD is just an extreme Melancholy personality type? Where would the line be drawn between basic personality traits and an actual disorder?
    Thanks! :)

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  10. Great info, thank you! The distinction between the OCD dx and the personality disorder is fascinating.

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  11. sorry for the double comment! the above had some turrible typos (meaning changing ones eeks!) so, we'll try it again...

    ooooh! YES!!! this sounds EXACTLY right! the way she responds to the big occurence is just so unusual (to me) and i couldn't quite figure it out!
    there is someone i love who told me fairly recently that her psychologist diagnosed her with ocpd and i didn't know the difference between it and ocd, but i don't think that gal knew the difference either, because she thought the diagnosis was crazy wrong because she doesn't have hand washing rituals and whatnot. now that you've explained this, i can explain it to her a little better the next time we talk (if she seems in the mood!). i still don't know what i think about someone's personality being a disorder... i can see ocd being one (ish), and i can see how ocpd could make life more difficult, but still... disorder? i love that ocpd gal i know to bits! but i can't even imagine her without her perfectionist traits... i can't image them taking that out of her... how will she even be herself? i don't know. i probably just don't get it yet. i'll have to noodle on it some more!

    sorry for the tangent! i think you are completely spot-on about parker! now, have you ever read BREAK by hannah moskowitz??? that's an interesting one to me... :)

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  12. Huh. There's more to OCD/OCPD than I realized. Very interesting.

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  13. I seriously love your blog. I swear it's like going to school for free.:)

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  14. So interesting. I'm going to start taking notes when I come here. Thanks so much!

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  15. Great post! I have OCD...long story that I'm sure no one wants to be bothered by...but am sure glad it's not OCPD.

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  16. I really enjoyed the post and happy I came across your blog. Very informative through a story, if the makes sense ;)

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  17. First of all, I LOVED this book!

    The only thing that I don't understand is how she walked away from her disorder. When the traumatic event occurs, she basically gives up on being perfect and buries herself in alcohol instead. I suppose she is still anxious but she is definitely no longer obsessed with being perfect. Is this normal? Can a traumatic event change this disorder this much?

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  18. Awesome post as always. I especially appreciated the distinction between OCD and OCPD, which I find most interesting. With all of these books you have to admit whether they were spot on with the DSM criteria or not, they've done well just by making the character "real" enough to try and diagnose. :D

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  19. I have always had some OCPD traits - not enough to ever have gotten the diagnosis in therapy. I would agree with your distinction between the two. In fact, I believe my mother (the doorlocker, handwashing, hysterical type) has suffered from OCD for years and I would suggest that OCPD can arise from growing up in an OCD environment. That is, it's not about my perfectionism even, it's about being in an environmental setting where even perfect was never enough. It's maladaptive (or perhaps adaptive depending on the circumstances).

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  20. Fascinating. I am curious, however, what the differences are between an anxiety disorder and a personality disorder. And of course you've made me completely curious about Cracked Up To Be!

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