Pure Schmaltz

While the following entry from the Project Manager’s Desk Reference might seem like a parody of a
serious psychological disorder, the author assures the reader that it is not simply a parody.
Obsessive-Compulsive Planning Disorder (OCPD) is a very real and present threat to project
success. Planning might be best partaken in moderation, mindful of the limited capacity humans
have for foreseeing the future. The OCPD sufferer engages in planning as if it enables access to
what no human has ever had access to; the future. Extended exposure to those suffering from
OCPD is commonly believed to produce the mother of all root causes, and the only problem for
which science will never devise a solution: The Certainty Problem. Skepticism is the only reliable
treatment for OCPD. D. Schmaltz

Obsessive-Compulsive Planning
Disorder
Basics

Obsessive-Compulsive Planning Disorder (OCPD) is a psychiatric disease

characterized by obsessions about the future, repetitive (usually
unpleasant) “risk-avoidance” thoughts and compulsions, and ritualistic
“methodological” behaviors. Obsessive-Compulsive Planning Disorder
(OCPD) usually starts in childhood or early adulthood. It is characterized
by anxiety-provoking thoughts, images, or ideas (obsessions) and/or
ritualistic behaviors such as counting, repeated checking, or brainwashing
(compulsions). People with OCPD engage in compulsive behaviors to try
to rid their future of disturbing possibilities.

Symptoms can sometimes be brought under control with medications or

behavioral therapy. Even with appropriate treatment, most people with the
disorder experience symptoms that wax and wane throughout life.

OCPD is the most common psychiatric disorder found in organizations. In

the US, nearly 60% of the project manager population suffers from OCPD.
Most people experience their first symptoms around age 20, when first
exposed to quantitative analysis. Few people have an initial episode of
OCPD after the age of 35.

Causes

While the exact cause of OCPD is unknown, in some cases genetics may
be involved. If you have a co-worker with OCPD, you are more likely to
develop OCPD yourself [Table 1].

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Table 1.  Possible Causes of OCPD

Genetics

Infection (e.g. advanced technical degrees, professional certifications,

seductive software applications, mandated methodologies)

Lesions in specific areas of the brain

Oversensitive or malfunctioning brain circuits

Head trauma (occasionally)

Drug effects (especially caffeine)

Anxiety

Issues of control, aggression, and paranoia resulting from excessively

strict managing

A large percentage of planners develop OCPD after joining a government

organization. Sometimes, in a bureaucracy, a planner’s immune system
will attack normal healthy cells (autoimmune response). It is thought that
this response causes OCPD symptoms. An episode of OCPD that begins
this way may disappear within a few months, or may persist longer.

People with OCPD have abnormal levels of brain chemicals and abnormal
activity in certain areas of the brain [Figure 1]. Certain areas of the brain
that are associated with anxiety, habit formation, and skill learning (called
the limbic lobe, the caudate nucleus, and the orbital frontal cortex) are
abnormal in people with OCPD.

In addition, levels of the brain chemical serotonin are thought to be

responsible for OCPD. Most medications used to treat OCPD have an
effect on serotonin levels.

Some theories point to psychological reasons for

OCPD.

Figure 1. Areas of Abnormal Brain Activity in

OCPD

Individuals with OCPD have abnormal metabolic activity in the limbic

lobe, the caudate nucleus, and the orbital frontal cortex. These areas are
associated with anxiety, acquiring and maintaining habits, and skill
learning.

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Symptoms

People with OCPD have obsessions and/or compulsions [Table 2 ] when

considering the future. If you have OCPD, you will have obsessions, and/
or compulsions when envisioning future possibilities, when “planning.”
These obsessions and compulsions are curiously satisfying, though usually
accompanied by high levels of anxiety. Obsessions are ideas, thoughts,
and images that occur over and over. Common examples include fears of
contamination by viruses, fear that career options will be limited, or
worries that things—especially anticipated things—are not in order; “well-
planned.”

Compulsions are behaviors that people perform in order to get rid of their
obsessions. These may manifest as frequent brainwashing, repeatedly
checking to make sure that methods are adhered to, or mental exercises
such as habitual counting (especially uncountable things), praying, or
repeating special phrases: i.e. “back on track”, “on time, on budget, on
spec”, “update”, and “estimate”.

Table 2.  Common Obsessions and Compulsions

Obsessions
Type Characteristics Percent of cases

Contamination Incessant worries about

unscrubbed schedules, 37.8%
viruses, and “contagion”

Fear of harming Recurrent thoughts that

yourself or others something has not been
done properly, even 54.7%
when you know it has

Methodological Feelings that certain

Symmetry things must always be in
95%
a certain place, position,
or order
Somatic Worries about the shapes
of cost/benefit curves or
about bodily functions 77.2%
(shit hitting imagined
fan)

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Religious Evangelistic behaviors

when speaking about
methods or excessive 5.9%
concern about right and
wrong
Hoarding Urge to collect estimates
that have no inherent or 4.8%
sentimental value

Unacceptable urges Often of a violent

nature: Desires to
strangle co-workers or 4.3%
over-please senior
management

Compulsions

Type Characteristics Percent of cases

Checking rituals Checking schedules,

actuals to estimates,
28.2%
spreadsheets, or other
objects
Washing/cleaning Excessive brainwashing,
rituals scrubbing, scrumming,
tidying, schedule 26.6%
grooming, or workshop
attendance
Miscellaneous e.g., compulsion to
compulsions perform every task very 110.8%
quickly
Repeating Re-baselining, asking
the same question over
and over again, 74.1%
convening meetings
“because it’s Tuesday”
Mental rituals Repetitive thoughts
regarding obsessions,
such as silently re-
80.9%
baselining or calculating
schedule impacts in
one's head

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Ordering Placing tasks into a

certain pre-determined 95.7%
structure
Hoarding/collecting Acquiring and
collecting objects that
have no inherent or 39.5%
sentimental value,
planning “for” others
Counting 1.1.1, 1.1.2, 1.1.3, ... 25.1%

Adults with OCPD rarely realize that their thoughts or behaviors are
irrational or excessive. Most adults with OCPD are unaware that their
obsessions and compulsions are extreme and unrealistic. This feature does
little to distinguish people with OCPD from those who are psychotic and
cannot differentiate fantasy from reality. People with OCPD are rarely
ashamed of their problem, are proud of their irrational fears and behaviors,
and brag about their symptoms to others.

Obsessions or compulsions are time-consuming, or significantly interfere

with normal daily life. Activities associated with obsessions and
compulsions take up more than one hour a day, or significantly interfere
with work, social activities, relationships, or a normal daily routine.

Other psychiatric conditions have symptoms similar to those of OCPD,

but are different in important ways. People with depression, generalized
anxiety disorder, and hypochondria also have obsessive thoughts.
However, unlike individuals with OCPD, others usually do not consider
these worries to be absurd or unreasonable, and have no rituals to attempt
to block such behaviors.

People with anorexia nervosa may have obsessions which they know are
unreasonable, and may also have rituals surrounding eating. However,
because these symptoms are specific only to this one issue, anorexia
nervosa is not considered to be a generalized problem like OCPD.

Obsessive-Compulsive personality disorder is another disorder that has

overlapping traits with OCPD. People with both personality disorders tend
to be workaholics, and are preoccupied with orderliness, rules, and
perfectionism. They need orderliness and exactness in every aspect of their
life, and usually do not have the insight to recognize that they may have a
problem.

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Risk Factors

Younger professionals are more at risk for OCPD. OCPD usually first
appears during childhood or young adulthood. Boys usually get OCPD
earlier than girls. The average age for boys is between 6 and 15 years of
age. Girls usually begin having symptoms in puberty. Both sexes
frequently have their first professional episode in their early twenties.

Diagnosis

Your doctor will ask you questions about your health history, perform a
physical exam, and may ask you to fill out a standard questionnaire. It is
important that you tell your doctor about all of your symptoms. People
with OCPD are often unaware that their obsessions and compulsions are
irrational, and are rarely reluctant to admit having them because they seem
normal and hardly worth mentioning. For them, the rest of the world
seems crazy, so they might obsess at some length about how others are
lazy, irresponsible, or simply stupid for not obsessively and compulsively
planning. Therefore, people sometimes go for years before being
diagnosed or treated appropriately.

One tool sometimes used during diagnosis is the Yale-Brown Obsessive

Compulsive Scale and Symptom Checklist, which is a questionnaire
designed to diagnose and evaluate the severity of your OCPD.

Your doctor will also look for physical signs of OCPD that may reflect
nervous tics. For example, your doctor might look for bald patches or dry
and chafed skin that suggests excessive head scratching.

Treatment
Urgent Care

Contact your doctor if your symptoms worsen or don't respond to

treatment. OCPD typically has periods when symptoms become worse for
no apparent reason. Seek help at such times to adjust your medication or
for help in modifying your behavior.

If your symptoms don't respond to treatment, you may need to be

hospitalized. Many psychiatric facilities provide varying levels of care,
such as day care, evening care, and residential programs.

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Self Care

You and your organization should learn as much as possible about OCPD.
OCPD sufferers may wish to join the Obsessive-Compulsive Foundation
or a local support group if available. Many books are available can offer
insight into the disease as well as strategies for coping.

Obsessive-Compulsive Foundation, Inc.

P.O. Box 70

Milford, Connecticut 06460-0070

USA

1-203-878-5669

http://www.ocfoundation.org

Obsessive-Compulsive Information Center

2711 Allen Boulevard

Middleton, Wisconsin 53562

USA

1-608-836-8070

Drug Therapy

Your doctor is the best source of information on the drug treatment

choices available to you.

Other Therapies

Behavioral and cognitive therapies against OCPD help you learn to cope
with and reduce obsessions and compulsions. Cognitive behavioral
therapy has been shown to be effective in treating OCPD, and can be used
in addition to or instead of medication. Behavioral techniques involve
gradually bringing you into contact with your fears, either through actual
or imaginary exposure. Cognitive therapy helps you to examine and
evaluate fears, and consider other ways of dealing with anxiety.

Behavioral therapy typically takes place over a 10-week period. Intensive

therapy involving two- to three-hour sessions daily for three weeks is
another alternative. This form of therapy can be done individually or in-

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group sessions. While cognitive and behavior therapies provide long-

lasting benefits, many people find them too anxiety-provoking, and prefer
using medication exclusively.

Surgery

For severe cases of OCPD that don't respond to medical or behavioral

therapy, surgery may be an option. Surgery for OCPD involves removing
part of the brain. Depending on the part removed, the procedures are
called cingulotomy, subcaudate tractotomy, limbic leucotomy, or
capsulotomy. Recent surgical techniques involve creating a lesion on the
brain with gamma irradiation. About 25% to 30% of patients who have
undergone surgery have benefited from it. Possible side effects, however
uncommon, include infection, hemorrhage, epileptic seizures, and weight
gain.

Special Circumstances

Pregnant patients should try behavioral therapy before taking medications

for OCPD. If medication is necessary, pregnant women should discuss the
safest drug choices with their physicians.

Patients with other co-existing diseases, such as depression, require

tailored drug treatment regimens.

Elderly patients require modified drug treatments. Lower doses of

medication may be used, and clomipramine may be avoided because of its
effects on the heart and tendency to cause constipation.

Prognosis

Symptoms of OCPD are rarely completely eliminated; most people

experience occasional flare-ups of the disorder throughout life. OCPD
seldom goes away on its own. Even with treatment, most people have
symptoms that improve and worsen. Symptoms tend to worsen during
times of stress, although many report that they also seem to appear out of
nowhere. Even with appropriate treatment, symptoms rarely disappear
completely, but can often be considerably reduced.

Between 50% and 80% of patients improve with anti-obsessive-

compulsive drugs. On average, symptoms of obsessions and compulsions
improve from 30% to 70%.

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Follow-up

Consult your doctor if you anticipate stress that may worsen your
symptoms. For some people with OCPD, stress invariably makes
symptoms worse. Times of high stress, such as pregnancy, a relationship
breakup, a career change, or a move to a new location warrant discussion
with a doctor about coping strategies or medication needs.

Seek help whenever problems arise, and get annual check-ups. Even with
appropriate treatment, symptoms may worsen unexpectedly. Medications
can be temporarily adjusted, or your doctor may recommend new
behavioral coping strategies. If OCPD symptoms are under control, check
in with your doctor once a year.

©2010 by David A. Schmaltz - all rights reserved

David A. Schmaltz is a recovering OCPD sufferer, a Projects@Work

Editorial Board Member, and author of The Blind Men and the Elephant,
Mastering project Work (Berrett-Koehler 2003), which has just been
released as an e-book. david@projectcommunity.com

http://www.PureSchmaltz.com

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