Not Everyone is a Narcissist, Maybe It’s OCPD

Narcissistic Personality Disorder (NPD) only makes up about 0.5% of the US population (DSM-5, 2013). NPD is also one of the personality disorders most confused with Obsessive Compulsive Personality Disorder (OCPD). OCPD Makes up about 2.1-7.9% of those with personalities disorders (APA). That means in 2024, around 8-28 million people or up to 1 in 12 people in the US meet criteria for OCPD.

Many loved-ones and mental health professionals may mistakenly label someone as “narcissistic” based on colloquial definitions or media-depictions of narcissism, while the person most likely may have clinical OCPD.  Let’s take a moment to explore the differences.

Narcissism

Individuals with NPD tend to be obsessed with self-importance. They exaggerate achievements and are preoccupied with fantasies of wealth, success, power, brilliance, beauty, or ideal love. They believe they are special, thus entitled to special treatment. Individuals with NPD struggle to feel empathy towards others and frequently take advantage of others to achieve their own ends (DSM-5, 2013).

OCPD

OCPD is the quintessential personality disorder of overcontrol. Overcontrol is “characterized by excessive inhibitory control” and other traits such as the ability to persist at a task for long periods of time, to stop emotional expressions and cease actions relatively easily (Lynch 2018, p1). People with OCPD tend to be very rigid in their thinking and inflexible in their actions. Sometimes people with OCPD are so unyielding that they are labeled as a “narcissist,” but more likely these individuals don’t see themselves as “special,” rather they believe there is a right and wrong way to do something which is more in alignment with OCPD. This way of behaving can be seen as selfish and stubborn.  

What’s the Difference Between Narcissism and OCPD?

It may be helpful to use the following table to differentiate the disorders more clearly. It looks at biology, coping, emotional expressions, and impulsivity (or lack thereof).

	OCPD	NPD
Bio-temperament	Overcontrolled	Undercontrolled
Impulsivity Spectrum	High ability to stop impulses	Low ability to stop impulses
Emotional Expression Externally	High inhibition of emotions	High expressiveness of emotions
Behavioral-Emotional Interaction	Rule dependent behaviors – behaviors are governed by morals or the consequences of doing or not completing a behavior	Mood dependent behaviors – behaviors are governed by current emotions
Distinct language used to describe people with the disorder	Stubborn, self-righteous, rigid, hyper-competitive, “my way or the highway”, inflexible, scary, domineering, non-emotional	Out-of-control, self-promoting, self-centered, vain, conceited, egomaniac, “look at me,” “always brings it back to themselves,” needs attention
Similar negative language used to describe both disorders	Bully, selfish, arrogant	Bully, selfish, arrogant
Values and Goals	Status seeking (money, job, achievement/ perfectionism) Desires agreement and appreciation Recognition of achievements when they believe they have done well Winning	Social approval Social status Desires validation (to be understood) and admiration Praise for anything they are involved in regardless if it’s deserved recognition Likability
Big Emotional Displays	Emotional Leakage – holds emotions in until one “breaks” from exhaustion of using impulse control Ex. Blowing up in anger after asking spouse to do something multiple times	Large emotional displays occur often and are based on impulsivity and mood dependence

In summary, it’s much more likely that people have OCPD than Narcissism. Also getting the correct treatment of RO DBT can help people with OCPD change at the personality level to become more flexible, open, and socially connected. Unfortunately Narcissism does not have a research-based effective treatment as of yet.