ASD and Borderline Personality Disorder?

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The obsessions a person with OCD experiences are not obsessions in the typical sense of the word (which usually entails profound interest in something). Are intrusive thoughts which the individual finds disturbing (it's usually very counter to the person's character), or intense, irrational fears, and they tend to fall into specific categories which are consistent across cultures. Common "obsessions" are....

1. Unwanted intrusive imagery of a sexual or violent nature.
2. The fear that the person will act on these thoughts.
3. The fear that an unrelated action will bring harm or injury to someone.
4. A sense that something is contaminated or dirty, whether it actually is or not.
5. A sense that something was done improperly or is "unbalanced", even if it is known that this is not the case.
6. Fear of divine punishment, whether the person is religious not.

In most instances, the person knows these things are illogical or irrational, but such knowledge is not enough to abate the obsessions. To relieve themselves of these things, the person often performs "compulsions" which can be small little nothings to elaborate rituals. Common compulsions are...

1. Hand washing. Usually done to relieve the sense of contamination of one's hands. However the person might have to do this some certain number of times in a certain manner. For example, they might count to some number or move their hands under the water in a certain way, and they might have to dry their hands a certain way, and if any part of this is not completed "properly" they will feel compelled to start over. A person with OCD might wash their hands more than 100 times per day in extreme cases.

2. Checking. This is done when the intrusive thought or fear was that the person forgot to lock a door or turn a stove off, and is often coupled with a sense of incorrectness. The person might go back and unlock and relock the door, or test the knob, until they get the sense that it was done the "right" way, even if they do remember locking it the first time.

3. Touching. A person with OCD might have to touch something a certain way a certain number of times to balance things or to rid themselves of the feeling that something bad will happen if they don't. For example, if the person touches the left side of a doorway, they might also have to touch the right side of the door way. Maybe they have to touch the left and right side three times.

4. Avoidance. Some people with OCD will indeed avoid stepping on cracks on the sidewalk because they have the sense that if they do, it will indeed break their mother's back, even though they know it actually won't.

So you see, the name is actually very misleading. It should really be called "Intrusive Compulsive Disorder", or "Intrusive Ritualistic Disorder".

It's vastly different from interest based obsessions, because it doesn't really entail actual obsessions at all, and it's different from schizophrenia because it doesn't entail delusions. The person with OCD KNOWS their "obsessions" and compulsions are irrational, and just can't shake the sensation they cause.

OCD is though to arise due to white matter abnormalities that disrupt the communication between the frontal lobe, and more primitive parts of the brain such as the basal ganglia, the same part of the brain involved in Tourette's Syndrome, and Parkinson's Disorder. A person with verbal Tourette's will say the thing they least want to say, and a person with OCD will think of the thing they least want to think of. To that end, the intrusive thoughts with OCD are sometimes called "thought ticks". Even so, actual comorbidity of these conditions is not very common because they arise from different regions of the basal ganglia.

Schizophrenia on the other hand, which there are now thought to be around 8 different types, in some forms at least, can entail gross structural changes that are easily identifiable on an MRI.

I think this idea of overlap and spectruming will fall away the more we learn about the actual pathologies of these disorders.

Some of my obsessive Autistic traits are :

1. Buying up to several boxes of antiquarian books (at the same time) for my collection
2. Buying up to several dozen DVDs (at the same time) for my collection
3. Programming for +10 hours straight
4. Watching movies for +10 hours straight

Some of my OCD traits are :

1. Pushing the door of the fridge or freezer about three times to ensure it's closed.
2. Opening / closing the car the least two times to ensure it's closed.
3. Opening the toilet seat with my foot to avoid having to touch the seat with my hands.
4. Being frequently reminded of a handful of books in my collection that I harmed, in some cases more than a decade ago.

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On an average day, my mind is constantly occupied by a backlog of activities that need to be done, ranging from (1) activities that I constantly need to remind myself of in order not to forget to (2) activities that I don't want to do but that I can't stop my mind from focusing my attention on.

This latter category (activities I can't stop my mind from focusing) usually involves my Autistic obsessions, but it is often as unwanted and annoying as a common OCD trait, as it prevents me from both engaging in and focusing on activities of the first category (activities that I constantly need to remind myself of).



I have that only in specific cases, like when my hands have been fully or partially covered by a fatty/oily substance.
No matter how often I wash them, I never get the sensation of oiliness from my hands.



I have that consistently only with a fridge or freezer and the car door, which probably results from failing to close the fridge and car door properly in the past.

I have it inconsistently with eg. other doors, items in my backpack or items in my pockets.

I can't speak for others, but in my case ritualistic checking routines tend to prevent the need from re-checking. For example, it helps to just count the number of items in my pockets whenever I leave the house to ensure nothing that should be in my pockets is left out.



In my case, there's no different between checking and touching. When I close the fridge and don't tap the door at least two times extra after closing it, I generally feel uncomfortable.

I used to touch my books or DVDs as well to check whether they were placed perfectly, but I stopped doing that a while ago.



I did that as a child. I stopped doing that as an adult.



Based on your detailed descriptions of OCD, I would argue that have very mild (but nevertheless real) OCD along with my ADD and my Autism.

Based on your detailed descriptions of OCD, I don't think the name OCD is poorly chosen, as the C in OCD ("compulsiveness") pretty much covers its key trait.

Based on your detailed descriptions of OCD, I would still argue that the line between OCD and Autistic obsessions is a very thin line, as my Autistic obsessions often come to me in a way no less compulsive and unwanted than the OCD desire to check a door or wash one's hand.



IMO the idea of overlap will gradually be replaced by a spectrum description, as a spectrum is a much better way to describe the often subtle differences between behavior and cognitive styles in different diagnoses.

This sounds remarkably like what Aspies (particularly girls) do to "pass as normal".
Watch and copy. I've done it all my life and I've been told that it's partly because Aspie girls often have identity issues and need to do this to fit in.
However, I now believe I'm a "quiet borderline" so maybe it's to do with that.

Here, I don't think you can really say it's particularly girls. Male Aspies also "watch and copy" IF they care about fitting in... but only IF they care.



Here, I do believe the gender difference is real. While you can't generalize, it is my perception that male Aspies are less likely to care about not fitting in and less likely to suffer from identity issues when failing to fit in.

When a male Aspie feels disconnected from the rest of the world, he is more likely to blame the rest of the world (instead of himself) and develop a strong sense of identity in spite of it, it seems.



That's not surprising. Identity issues often result in BPD traits during adolescence. So, with identity issues being pretty common in ASD women, it should be obvious that BDP traits are common in female adults with ASD.