A rav very close to Rav Elyashiv, zt”l, told me a terrible story where a baby, rachmana litzlan, passed away. It is a story involving a little-known illness, and it would be very important for our community to be aware of it—because awareness of it can save lives.
The story was of a baby that had a form of cancer. It was a cancer that was quite treatable. The problem was that one of the baby’s parents had a psychiatric condition that can best be described as “my way or the highway” thinking. No one wanted to take on the parent, although Rav Elyashiv himself had tried. Ultimately, the child passed away.
What was this little-known illness?
It is called “OCPD” and is very very different from OCD. Many people confuse the two—thinking even that it is a type of OCD. It is not.
What follows is primarily based on information from the Cleveland Clinic.
Understanding Obsessive-Compulsive Personality Disorder (OCPD)
OCPD is a mental health condition where people become extremely focused on being in control. It is a “my way or the highway” method of doing things—even to ridiculous extremes and to their own deficit and losses. It’s actually much more common than most people realize. Many times, when someone refuses to let their spouse or children—or even themselves—get important medical treatment, OCPD might be the hidden cause.
While some people are born with tendencies toward OCPD, it can also develop later in life. Someone might not show these behaviors until they’re an adult, which can be confusing for family members.
Living with someone who has OCPD can be really hard. Spouses often feel like they have to give up their own personality and ways of doing things. This happens because the person with OCPD has such strict rules about how everything must be done that there’s no room for anyone else’s preferences or ideas.
People with OCPD have very strict beliefs about the “right way” to do things. They can’t be flexible or compromise, which makes completing tasks and keeping relationships really difficult. The tough part is that most people with OCPD don’t realize their thinking and behavior are causing problems.
It may also appear as being strictly observant or frum. “Chalila for me to use the internet for a Zoom doctor’s appointment! I do not care if it will delay my treatments!”—is the thinking.
OCPD is different from OCD (Obsessive-Compulsive Disorder). OCD is an anxiety disorder where people have unwanted thoughts that make them repeat behaviors, like washing hands over and over, or ruminating on certain thoughts. People with OCD usually know something is wrong and want help. People with OCPD usually don’t think anything is wrong with them.
OCPD typically starts in the late teenage years or early 20s, or even later. People with anxiety disorders, mood disorders like bipolar disorder or mild substance use problems are more likely to develop OCPD.
Sometimes, a spouse with OCPD can be so controlling that their mindset also affects the other spouse.
When combined with another psychiatric disorder, OCPD can be significantly worse and far more devastating. Although there are ways to mitigate and lessen the repercussions of OCPD, it is hard to do because the individual often will not admit they are dealing with any issues. Those who are living with someone who suffers from it probably needs encouragement themselves. Helping them is a manifestation of the important mitzvah of veahavta lereyacha kamocha.
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