A perfectionistic proposal to the personality disorders committee for DSM-6 on the wording of the Obsessive Compulsive Personality Disorder criteria.

Dear APA,

The Diagnostic and Statistical Manual of Mental Disorders (DSM) is currently in its fifth edition and with each revision changes are made in response to scientific consensus and other concerns to make the DSM more usable in real world settings. The difficulty classifying and describing mental disorders is evident in the need to continually refine and revise the DSM. Each new edition has its strengths and shortfalls that have been well documented.

Recently we have become aware of a shortcoming of the current edition that to our knowledge has not been discussed in the literature to date and it is this that we propose to pontificate about and have prepared a possible solution to the problem. Whilst giving a podcast on the application of the DSM-5 personality disorder criteria to the various persons in the books and films of Harry Potter (by J.K. Rowling) or in the ‘Potterverse’ (https://www.twoshrinkspod.com/podcasts/2019/2/18/41-harry-potter-amp-the-pathological-personalities) it became clear there is a problem in the way the criteria for Obsessive Compulsive Personality Disorder is written.

Currently the criteria are described as such:

“A pervasive pattern of preoccupation with orderliness, perfectionism, and mental and interpersonal control….”

Clearly those who are reading the DSM-5 about this disorder will be either working with someone who has this particular trait or disorder level pattern of problems. Or will be interested in this disorder because they themselves exhibit traits or full-blown symptomology of this disorder. As such we take issue with the placement of ‘orderliness’ and ‘perfectionism’ and suggest that it will be less upsetting or distressing to the reader/listener with OCPD traits/symptoms if all the words starting with ‘P’ are placed together.

 Specifically reversing the order so it reads:

“A pervasive pattern of preoccupation with perfectionism, orderliness and mental and interpersonal control…”

This would be a particularly minor change but clearly would be a far more satisfying state of affairs for any sufferers of OCPD when reading about the disorder. It would also perhaps give others who do not suffer from this disorder but have to read out such a preposterous prose an understanding of the perfectionistic pressures people with personality problems experience, particularly when having to listen to people perform in public or in a psychology/psychiatry practice.

 We also suggest that a working group be formed to identify other “P” words that could be substituted in the other parts of the OCPD criteria.

Pleasingly the first three criteria contain ‘p’ words (1. Preoccupied, point, 2. Perfectionism, 3. Productivity). But there is a perverse absence of “P” words in the remaining 5 criteria.

Kind regards

Amy Donaldson & Hunter Mulcare

Two Shrinks Pod