This post is a summary of Nancy McWilliam's chapter on Obsessive and Compulsive personalities in her book Psychoanalytic Diagnosis.
These personalities are organized around thinking and doing and therefore are very common in Western societies that, well, obsess, about people being productive and solving intellectual problems. The main problem with this type of being in the world is that it cuts us off from our bodies, our feelings, and our interconnectedness. Not everyone who obsesses also has compulsive behaviors. Some people just love being in their heads and interacting with their thoughts. It also works the other way around.
People who we think of as perfectionists fit the obsessive-compulsive personality structure. They can be meticulous and punctual, but may also suffer from fear of failure and subsequently may disengage and procrastinate. Wilhelm Reich described the obsessive-compulsive personality as a "living machine." What makes the compulsive behavior maladaptive is that it is futile, if not injurious and costs the person time and emotional well-being. These types might be concerned about contamination, time and money. The obsessions and compulsions exist to help the person maintain a sense of control in a chaotic environment. During childhood, the parents of the obsessive-compulsive person may have created a sense of powerlessness in the child. The rumination and acting out serve as coping mechanisms.
Rage and fear are the dominant psychodynamics. There is rage at the authority figures controlling them and also fear of being punished. However, most people suffering from an OCD personality structure are disconnected from those feelings which contributes to the rigid personality adaptations. Intellectualization is typically a dominant defense mechanism along with other "thinking" defenses such as rationalization, moralization, etc. People with this personality type have high standards which the therapist might experience as also being projected onto them. As a result, a countertransference of shame or not being good enough might be commonly experienced by a therapist working with a person with an OCD-type personality.
Displacement is another defense used by people with OCD. The anger that they feel is put into something safe like compulsive hand-washing. Isolation of affect is a closely related defense used by those with OCD. This means that a lot of control is used to manage emotions and feelings. This is important to them because they were taught that their feelings are childish, without value, and/or too frightening to be expressed. People with OCD might thrive in our culture in public and at work, but fail miserably in their private lives.
Undoing is another defense mechanism used by those with OCD. The compulsions are a way to atone for the "bad feelings." Lady Macbeth, for example, when compulsively washing her hands of blood was engaged in undoing. They might also entail a sort of "magical protection." There is also an element of the defense of omnipotent control within the compulsions of someone with OCD. The underlying false belief is that the person is in total control of what happens to them not the whims and randomness of an indifferent natural world.
Freud also saw reaction formation (reversing a psychological process into its opposite) in the compulsions of someone with OCD. He believed that many people who were frugal, fastidious and organized actually wanted to be the opposite and engage in carefree messiness. He saw this reaction formation in instances where someone with OCD intensely rationalizes their behavior as a form of reaction formation against the underlying magical thinking that is present. For example, an exhausted driver with OCD might insist upon being the one in control versus relenting the wheel to an alert passenger. The reaction formation exists with many with OCD on both poles of conflicts. For example, perfectionists who don't accomplish much because of procrastination are expressing both sides of a reaction formation driven process.
One study examined those with contamination OCD. It found that underlying it was separation anxiety created by parents who are overinvolved and overprotective. The child then has to resort to magical thinking to navigate life since they didn't undergo typical developmental challenges that lead to internalized mastery.
There are two orientations to obsessive psychodynamics. One is introjective and the other is anaclitic. Introjective types try to live up to the standards of an intense superego. They may be serious about their morals and ethics (very religious people or political activists). They get their self-esteem by living up to these high standards. Anaclitic types are more obsessed about external things like making decisions that others see as perfect and without reproach. Anaclitic types then can also suffer from decision paralysis since they feel too much pressure. People who are anaclitically obsessed might postpone decision-making until life decides for them. This of course can have many unwanted side-effects such as missing out opportunities to select someone when dating and losing both potential partners, or just the preferred one.
For more compulsive people, they have the opposite problem. Rather than being paralyzed by perfectionistic thinking, they rush into things. Both are driven by shame and guilt. Where obsessional people get their self-esteem by thinking perfectly, compulsive people get it from acting a certain way. Both value control and therefore are challenged in areas of play, sexual expression, and spontaneity.
Personality Analysis of the Obsessive and Compulsive Personality References
McWilliams, N. (2011). Psychoanalytic diagnosis: Understanding personality structure in the clinical process (2nd ed.). Guilford Press.