Theodore Millon considers the obsessive-compulsive personality as essentially “conflicted.” They are divided in their orientation, possessing internally contradicting states. Whereas pleasure-deficient personalities and interpersonally imbalanced personalities reside on either the dependent or independent side of the spectrum, those with OCPD are ambivalent and internally conflicted. Millon refers to the OCPD individual as ambivalently conflicted, “beset by severe internal schisms that they can neither escape (because they are an intrinsic part of themselves) nor resolve through external manipulation.”
According to Millon, the OCP consists of an internally contradictory set of personality impulses: the dependent and antisocial personalities. On the one hand, the antisocial component consists o a strong desire to assert themselves and act independently, whereas their more conscious set of behaviors are similar to the dependent. While not being overly obedient, they nonetheless internalize societal strictures and suppress their individuality.
“Inwardly, they churn with defiance like the antisocial personality; consciously and behaviorally, they submit and comply like the dependent. To bind their rebellious and oppositional urges, and to ensure that these do not break through their controls, compulsives become overly conforming and overly submissive. Not only do they adhere to societal rules and customs, but they vigorously espouse and defend them. As a consequence, they are often seen as moralistic, legalistic, and self-righteous. Their insistence that events and relationships be systematized and regulated becomes a caricature of the virtues of order and propriety. Proceeding meticulously through daily routines, they are likely to get lost in the minutiae, in the form and not the substance of everyday life. These rigid behaviors are necessary if compulsives are to succeed in controlling their seething, i repressed, antagonisms. Moreover, they cling grimly to the rules of society because these help restrain and protect them from their own impulses. They dare not risk deviating from an absolute adherence to these injunctions lest their anger burst out of control, and lest they espouse to others and themselves the resentment they really feel.”
Millon is critical of the DSM labeling of this syndrome as “obsessive-compulsive,” partially because there is the danger of confusing it with obsessive-compulsive disorder, which is an anxiety disorder rather than a personality disorder. The first descriptions of OCPD took place in the 19th century. Kraff-Ebing first used the term “compulsion” in 1867, although Millon says it was used of the constricted thinking of depressives. In a paper by Griesinger, published in 1868, the term was used in a manner more similar to that of its contemporary usage. Such individuals were described as engaging in compulsive questioning, doubt and curiosity. The late 19th century involved a debate as to whether compulsions indicated the existence of hidden emotions. In 1877, Westphal rejected this position whereas Kraepelin, in 1887, affirmed their existence. Donath, writing in 1897, affirmed Kraepelin’s view. “Anankast” began to be popularly applied to this syndrome, although this label has typically been more popular in Europe than in America, where the term “obsessive-compulsive” is more commonly used.
It was because of the writings of Freud and Abraham that a tendency towards the obsessive-compulsive came to be conceived in terms of pervasive personality styles. It is from them that we get the colloquial word “anal” to describe such individuals. K. Schneider, writing in 1923, brought together different clinical observations under the term “anakast”:
“[This personality] is always trying to hide a nagging inner uncertainty under various forms of compensatory or overcompensatory activity, especially where the inferiority feelings are of a physical or social character. Outer correctness covers an imprisoning inner insecurity…To the onlooker anankasts appear as carefully dressed people, pedantic, correct, scrupulous and yet with it all somehow exceedingly insecure. The compensations they reach often seem unnatural and constrained…Severe anakasts with their compulsion to control…are extremely constricted people and indeed at times become reduced to almost complete immobility.”