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OCD in Monica Geller-Binger
Obsessive-Compulsive Personality Disorder in Monica Geller-Bing From
F.r.i.e.n.d.s
Rhonda Murphy
Helms School of Government, Liberty University
Assessment Report
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REFERRAL Monica Geller-Bing is a 33 year old, caucasian, female,
chef, and wife who was referred by her husband, Chandler Bing,
for a diagnostic intake interview due to concerns regarding her
excessive fixation on doing things the “right way” as well as her
rigidity. She is overly particular about where items in her home
should be placed and how they should be placed, according to her
husband. Chandler explained how his wife spends most of her
time cleaning, organizing, and making sure everything is “perfect”.
He explains how once she attempted to leave her shoes in the
living room to prove to everyone that she did not have a burning
need to be organized and orderly. She was wide awake all night
thinking about the shoes in the living room. She went back and
forth about it in her head, he explained that she was “obsessing”
over it. He further explained how Monica has a difficult time with
spontaneity, she loves order, schedules, and lists. Monica explained
how she finds it hard to delegate tasks to others because she feels
like others will do them incorrectly, so she feels like she has do
them herself. Monica is described as being work oriented and is
very rigid about what she does outside of that. Monica is also
described as being “emotionally shallow”, not feeling or
understanding things deeply. She struggles understanding the
feelings of others. Monica did not appear to have any obsessions or
compulsions. Based on the information given, Monica seems to
display characteristics of Obsessive-Compulsive Personality
Disorder. An Assessment technique that would be helpful for
Monica is behavioral observation, which would assess the defining
features in Obsessive-Compulsive Personality Disorder as
described by her and her husband. Behavioral observation can be
used to observe, describe, explain, predict, and even correct
Monica’s behaviors that prohibit her from living a normal life.
Further, the Five-Factor Obsessive-Compulsive Inventory (FFOCI)
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was designed to assess ObsessiveCompulsive Personality Disorder
that is based on the five-factor model (FFM) of personality. The
FFOCI contains 12 subscales that assess the aspects of the five-
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assess OCPD in Monica Geller-Bing. BACKGROUND INFORMATION
Prior Mental Health History Monica has no prior known mental
health issues or diagnosis. Family History Monica explained how
she grew up with her two parents, Jack and Judy Geller, as well as
her older brother Ross Geller. Ross was the first born and is seen as
the “miracle child” due to their mother’s fertility complications.
Monica explained how there is no history of mental disorders in
her family, no one in her family has ever been diagnosed. Monica
was upset when explaining how her mother constantly puts Ross
on a pedestal and believes he could do not wrong. She continues
by explaining how her mother expects her to fail. She tells a story
of when her mother asked her to cater a party at their parents
house, Monica was surprised her mother would allow her to take
on that task and she knew she could not mess it up. However,
Monica wore fake nails that day because she tends to bite her nails
when she is nervous and in order not to do that she wore press on
nails. Monica discovered that she had a nail missing and knew she
had to tell her mother. Her mother said it was okay because she
bought frozen lasagnas incase she “pulled a Monica”. Her mother
criticizes most of what she does, says, wears, etc. Social History
Monica has a tight knit group of friends which include Rachel
Green who she was best friends with in high school and whom she
did not reconnect with until their early to mid twenties. Chandler
Bing is in this friends group, he attended college with Ross and
were roommates as well as best friends. Monica and Chandler had
a fling one night, but then began to grow to love one another and
at this current point in time, they are married. She has a friend
named Phoebe Buffay, but Monica could not recall how she met
her. Joey Tribbiani became Chandler’s roommate through an ad in
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the paper. Monica’s brother is also included in this friend group.
Monica explained how she used to have an eating disorder when
she was younger, she was extremely overweight. She explains how
she decided to lose weight when Chandler called her “fat” one
Thanksgiving when Ross brought him over for dinner. She decided
to lose weight, in order to get him back when he would see her
the following Thanksgiving. Although these individuals seem
important to Monica, she and her friends seem to have unhealthy
habits at times. They lie to each other, do things without asking,
make sexual passes at one another, etc. Work History Monica has
always aspired to be a chef, she has worked at plenty of
miscellaneous restaurants and even attempted to have a catering
business. However, her real dream was to be a head chef of a
restaurant, which she currently is, at Alessandro's. In this work
position, she gets to call the shots and she is able to make sure
everything is done “the right way” and ultimately, Monica’s way.
Daily Activities Monica’s fixations have resulted in sleep
deprivation most nights, meaning she is receiving an insufficient
amount of sleep, less than 7 hours of sleep per night. Monica eats
at specific times of the day and does not stray away from those
ti
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making sure her apartment is “perfect” before she leaves. She eats
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Monica also has the same patterns pertaining to exercising, she
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point in time and she does not have any medical conditions that
might impact her mental health up to this point. OBSERVATIONS
Monica arrived promptly, she was exactly on time, she was not a
minute early nor a minute late. She appeared to be well kept but
she also appeared to be tired. Monica brought a list she made of
the activities she engages in that appears to be a problem in her
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life, she numbered them and wanted to discuss them in the same
order she had written them. Monica took a few moments to talk
after being talked to, she appeared to be gathering her thoughts
in a particular manner. She spoke for the majority of the
assessment, making sure to stick to her list and being careful not
to stray away from it. She failed to answer majority of the questions
because her focus was on her list. She shows little to no affection
but instead focuses diligently at the task at hand, e.g. going
through her list. Throughout the assessment, Monica did not
appear to have any obsessions or compulsions. RELEVANT DSM-V
CRITERIA Obsessive-Compulsive Personality Disorder is
categorized as a type of Personality Disorder, under Cluster C,
along with Avoidant Personality Disorder and Dependent
P
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:
1.
I
s
preoccupied with details, rules, lists, order, organization, or
schedules to the extent that the major point of the activity is lost.
2. Shows perfectionism that interferes with task completion (e.g., is
unable to complete a project because his or her own overly strict
standards are not met). 3. Is excessively devoted to work and
productivity to the exclusion of leisure activities and friendships
(not accounted for by obvious economic necessity). 4. Is
overconscientious, scrupulous, and inflexible about matters of
morality, ethics, or values (not accounted for by cultural or religious
identification). 5. Is unable to discard worn-out or worthless
objects even when they have no sentimental value. 6. Is reluctant
to delegate tasks or to work with others unless they submit to
exactly his or her way of doing things. 7. Adopts a miserly spending
s
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yl
e to
w
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to
be hoarded for future catastrophes. 8. Shows rigidity and
stubbornness. In order to be diagnosed with Obsessive-
Compulsive Personality Disorder, patients must have a persistent
as well as an excessive pattern of fixation with order, perfectionism,
control of self, others, and situations. Monica shows clear signs of
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h
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car, etc. has a specific place and Monica spends a lot of her time
ensuring that. She evidently strives for perfection, making her
inefficient majority of the time. She makes sure she is exactly on
time everywhere she goes. In order for Monica to have control over
situations, she often delegates herself as leader. Monica is
unwilling to delegate tasks because to others because she fears
they will do them wrong, as individuals with OCPD do. Monica is
the head chef at a restaurant and this allows her to have immense
control. OCPD individuals are emotionally shallow, making it hard
for the individual to have deep emotions and lacking empathy.
Monica has a difficult time understanding the point of view of
others and struggles to understand emotions that are more
complex. She appears to have restricted emotional expression.
OCPD individuals have difficulty with spontaneity. Monica
expressed how she can’t do anything spontaneously, she
explained how she must write out a list of her day every morning
between her morning jog and breakfast. OCPD individuals often
have interpersonal problems as Monica does amongst her friends.
Due to these characteristics within Monica, her friends have
learned what are appropriate and inappropriate actions around
her. They have learned to not move around the furniture, put
everything back in it’s exact place, and volunteer themselves as
leader of any task. Further, individuals who are diagnosed with
OCPD rarely have obsessions and compulsions. Monica does not
have repeated thoughts, urges, or mental images that cause
anxiety. She also does not repeat behaviors in response to
repeated thoughts, urges or mental images.These individuals lack
flexibility, openness, and efficacy. Although Monica is strict on
herself with lists and schedules, she is not very efficient
throughout the day due to the lack of flexibility within her daily
tasks. She must stick to her schedule exactly, this restricts her from
being open and flexible. Also, due to her strictness her schedule
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lacks room to do other activities. So, Monica ends up doing the
same thing day after day, affecting her efficacy. INTEGRATION
There appears to be a moderate genetic contribution to
Obsessive-Compulsive Personality Disorder. Although some
people may be predisposed to favor a certain amount of structure
in their lives, Monica experienced unintentional parental
reinforcement pertaining to the constant need to be perfect.
Monica’s mother constantly made her feel anything except perfect
and Monica has fixated on that, she says she often feels
inadequate. Jack and Judy Geller constantly glorified her older
Ross and were constantly demeaning Monica. Monica is persistent
and dedicated to her work, but her preoccupation with details
prevents her from completing much of anything. This may be due
to her mother constantly pointing out the smallest details about
her appearance and actions. The exact cause of OCPD is unknown,
but it is known that OCPD has a certain genetic component and
can be due to childhood experiences to some extent, like the ones
Monica experienced. It would be helpful to diagnose Monica
Geller-Bing with Obsessive-Compulsive Personality Disorder
because she has the identifying features of OCPD and with this
understanding she can get the appropriate treatments to improve
the current state of her disorder. TREATMENT
PLAN/RECOMMENDATIONS Although there is little data on
treatment, there are treatments used for Obsessive-Compulsive
Personality Disorder. Recommended treatment for Monica is
Cognitive-Behavioral Therapy (CBT) for OCPD that addresses fears
related to the need for orderliness, it targets rumination,
procrastination, and feelings of inadequacy. Cognitive-Behavioral
Therapy will examine Monica’s thought processes and how those
thoughts out affecting them. This will allow Monica to become
more aware of her own thought patterns. Further, cognitive
reappraisal techniques will help the individual to refrain from
having fixated thoughts. Cognitive reappraisal includes addressing
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the negative pattern of thinking that the patient has fallen into
and attempting to change that pattern into a more positive one.
OCD iDifferent ways of thinking elicit different emotional
responses. So, in Monica’s case, cognitive reappraisal will attempt
to make her thoughts less fixated. Another therapeutic technique
used for individuals with OCPD is Psychodynamic Therapy that is
based around insight, helping the individual with OCPD identify
their perceptions of particular situations and assess why lack of
control causes problems for the individual. Psychodynamic
Therapy will help Monica become more self-aware and strive to
correct her fixated thoughts.
References
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psychology-an-integrative-approach-7e-barlow/9781285755618/
