ALTHOUGH the compulsive personality style is one of the most common, it is least adaptable to the emotional accessibility and centrality of focus desirable for effective brief therapy (Malan 1979; Sifneos 1966). The characteristic rigidity of this style may also conceal a considerable degree of vulnerability to deflation of self-esteem. The therapist will generally try to probe beneath the shell of overcontrolled emotions, but this effort may well have negative effects if it is perceived as criticism by the patient. In contrast, a therapist who is very sensitive to this issue may approach such patients so gingerly that after a brief therapy they are left untouched. This is the dilemma illustrated by the case that will be discussed in this chapter.
The cluster of behaviors typifying this style have often been referred to as "obsessional," but we will use the current nomenclature of compulsive personality. The following statements are part of the standard, generalized definition of the disorder as it appears in DSM-III: