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November 16, 2006 - 2:06 p.m.

The One With Monica's Disorder

At the intersection of Bree's work in the study of psychology and her obsession with the television show "Friends" we bring you this case vignette of Monica Geller-Bing. (Try to) enjoy!

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Monica Geller, a rail-thin but attractive woman in her early thirties, admits herself to the outpatient support group at the behest of her husband Chandler, her best friends Joey, Phoebe, and Rachel, and her older brother Ross. She is well-groomed, cheerful, and seems pleasant at first, but support group members quickly become annoyed with her. From the moment she arrives, she monopolizes the therapy session by raising her hand at every question or comment posed to the group. Monica is extremely competitive, ensuring her reign over every detail of conversation, and she is reluctant to give up control of the discussion. She seems motivated not by a desire to perform or be the center of attention as much as to make sure other group members are not "doing it wrong." Her close friends stick by her, but when it comes down to it, Monica has a problem making relationships outside her very tight circle. In her role as head chef at Alessandro's, an upscale Manhattan restaurant, she runs a tight ship built upon unreasonable expectations of perfection and cleanliness to the point that her employees have grown to loathe her and have even locked her in the walk-in refrigerator.

Monica describes herself as "passionate and exacting" about all aspects of her life. She "never gives up" on important issues or even the most trivial games or contests. She recalls a football game played with her friends one Thanksgiving which she "definitely won." The last play of the game involved both Monica and Ross (obviously a colluding presence) clutching onto the ball at the goal line, side by side, their faces down on the ground for several hours, well passed dinner time, both insisting they'd won. Their friends had long since retired to eat the Thanksgiving meal that she had meticulously prepared for them.

Monica's stubbornness is only the tip of the iceberg for this obsessively orderly, controlling young woman. According to testimony given by her friends, Monica is so compulsive about cleaning, she will notice instantly and become extremely anxious if even the most minute object is out of place in the living room. If a spill occurs, she must clean it immediately and thoroughly, wearing rubber gloves to attend to the most mundane water rings under glasses. Monica has been known to vacuum not only her rugs and hardwood floors, but to use a Dustbuster after the chore is completed to vacuum the vacuum cleaner itself. On at least one occasion she was observed making a jocular comment to the inanimate Dustbuster "Now if only I had a smaller one to vacuum you!" In arguably the most graphic example of her obsession with cleanliness and order, Monica once showed up at the home of a rather sloppy woman her brother had recently stopped dating because she couldn't sleep, thinking about cleaning her messy apartment. When the woman closed the door on her in disbelief, Monica proceeded to sponge down the door frame.

Chandler and Monica have been trying to conceive, unsuccessfully, for over a year. Monica's strict character structure drives her to put Chandler on an irrational schedule of love making, both in synch with her menstrual schedule and despite it. This has led Chandler to "faking it" in bed with Monica. Compounding the frustrated attempts at conceiving was Chandler's recent discovery of a "secret" closet in their apartment packed from floor to ceiling with junk that Monica has refused to get rid of for years. Monica felt intense shame at his revelation of her "hoarder" side and this was the direct antecedent to her friends' encouragement for Monica to seek support at the clinic.

Discussion and Diagnosis:

Monica is a classic obsessive-compulsive personality type. She is persistently preoccupied with all aspects of perfectionism: order, rules, cleanliness, and being "the best" at everything, often at the expense of seeing "the bigger picture" in activities that are meant to be enjoyable. Her chronic behavior is commensurate with most of the necessary criteria to fulfill a diagnosis for obsessive-compulsive personality disorder: she is preoccupied with rules, details and organization to the exclusion of the point of activities, her perfectionism often interferes with completing tasks and alienates her from co-workers and most interpersonal relationships outside her small friendship circle, she is unable to discard worthless objects, she will never delegate a task for fear that the job won't get done correctly, and she is rigid and stubborn in most aspects of her life. While she functions at a relatively high level in career and home life, and she'd be a good pick for your touch football game, would you really want Monica on your team?

Multiaxial Assessment:

Axis I None
Axis II 301.4 Obsessive-Compulsive Personality Disorder
Axis III None
Axis IV Problems conceiving; discovery of her "secret closet"
Axis V Global Assessment of Functioning: 74

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