Our Gemara on amud aleph describes a person who refuses to accept a slightly eroded coin as a “nefesh ra’ah” - “an evil soul.”  What does this term mean?  The term “ayin ra’ah” connotes stinginess, for example see Bechoros 11a.  The Maharal relates “nefesh ra’ah” with “ayin ra’ah”, except that ”nefesh ra’ah” is the inner manifestation and state, while “ayin ra’ah” is the behavior (see Derech Chaim 2:19).

If so, we may say that the Gemara is commenting that a person who is so particular about a small imperfection in a coin that is otherwise fully legal tender has a trait of extreme miserliness.  

People who are stingy often make poor financial choices, as they are too risk averse. For example, they will not put savings in even moderate risk investments, so that their savings do not keep pace with inflation. Or, they might not take a risk to try a new job, and instead “play it safe” and stay in a current job with less earning potential. It also can lead to loneliness and isolation even if the person is married and has a family, as the strain on the relationship from the various forms of control and stinginess leads to others being distant, avoidant and not honest. 

Misers have a particular psychology, and often suffer from OCPD Obsessive Compulsive Personality Disorder, which is not the same as OCD.  People with OCPD are often:

• Rigid
• Need to control
• Are impatient with others 
• Pedantic
• Hoard 
• Perfectionistic 
• Fixated on lists and rules
• May abuse religion to rationalize their demands 
• Show an inability to express or allow for emotions.  

Treatment is possible, but since it is rooted in personality, the person does not usually own the behavior. Rather, he assumes that everyone else has the problem.  If the person is “forced” into treatment, usually as a result of failed familial relationships and/or to save their marriage, it still does not bode well for treatment, as there can be layers of self-justification.  They might try to accommodate the other person, just to make peace or save the relationship, but not fully accept how anxious they become at loss of control in matters that others allow for emotional or actual risk, such as spending money, showing feelings, and being forgiving and flexible. Many of the changes will be superficial, with days of “good behavior” and then angry outbursts coming from all the frustration and energy trying to work against his own nature. It will be a long haul for the person to come to enough realization that he truly is the problem.  After that, successful treatment involves:

• Insight
• Trauma work, if there are childhood deprivations and insecurities, and 
• Ego strengthening psychology to learn self-awareness, self-regulation and the ability to emotionally differentiate between others and self

This will eventually allow for more vulnerability, empathy and attunement.