Obsessive-Compulsive Personality Disorder (OCPD)

Obsessive-compulsive personality disorder (OCPD), not to be confused with obsessive-compulsive disorder (OCD), is a Diagnostic and Statistical Manual, DSM-5, recognized personality disorder characterized by rigid adherence to personal rules, difficulty with a loss of control, and fixation with tradition. 

This condition not a common personality disorder and is believed to be present in around 1% to 2% of the general population, though it may be more due to a lack of research on the condition. Understanding OCPD, and the nature of a person with an obsessionable personality, may help you know whether screening for this condition could benefit you and how to distinguish the symptoms from those of similar conditions like OCD.

Obsessive-compulsive personality disorder is a cluster C disorder within the DSM-5. Personality disorders including schizoid personality disorder, borderline personality disorder, and OCPD, are all mental disorders or illnesses that impact one's personality. Due to the nature of these disorders, they may cause dysfunction in multiple areas of life including interpersonal relationships, careers, education, organization, and others. This condition may begin as a child or in early adulthood and is associated with themes of control, rigidity, difficulty letting go, and obsession with hard work or self-sufficiency. 

Obsessive-Compulsive Personality Disorder (OCPD): Exploring Symptoms

In the DSM-5, the criteria for OCPD involve a pervasive pattern or preoccupation with perfectionism, control, and orderliness. These fixations must cause significant impairments in multiple areas of life and impact one's sense of identity. 

Other symptoms in the DSM-5's criteria list for obsessive-compulsive personality disorder (OCPD) include the following: 

• Forming identity around work, rules, and self-belief
• Impairments in empathy or intimacy 
• Rigid perfectionism 
• Persistence to complete tasks even when dysfunction has occurred
• Compulsive behaviors oriented around perfectionism 
• Difficulty letting go of control 
• A lack of trust in the ability of others
• Inflexibility
• Reluctance to work in a team
• Devotion to a career at the expense of romantic, platonic, or familial relationships 
• Extreme moral beliefs that feel "unmovable" 
• A preoccupation with details, rules, lists, organization, or schedules 
• Anger when a situation doesn't go as planned
• Difficulty transitioning from one activity to the next 
• Difficulty showing affection 

If you are struggling with substance use, contact the SAMHSA National Helpline at (800) 662-4357 to receive support and resources. 

OCPD Vs. OCD: The Differences And Similarities 

Both OCD and OCPD are oriented around obsessive-compulsive behaviors. To understand this meaning, it can be helpful to know the psychological definitions of the words. According to the American Psychological Association, obsessions are persistent thoughts, images, or impulses that are intrusive or inappropriate that cause anxiety. The APA defines compulsions as behaviors intended to reduce the anxiety caused by these obsessions or to prevent a perceived threat. 

These behaviors can be present in both OCD and OCPD. However, obsessive-compulsive personality disorder (OCPD) is a personality disorder, whereas OCD is listed in the "obsessive-compulsive and related disorders" category in the DMS-5. Personality disorders directly impact personality traits, including the ability to feel empathy, how one interacts in relationships, and the way people see themselves compared to others. 

Someone with obsessive-compulsive personality disorder (OCPD) may struggle more with separating their identity from their symptoms, believing that their way of life is a part of who they are and not a sign of a mental health concern. Contrarily, people with OCD often feel extreme distress from their symptoms, trying to separate themselves from them as much as possible. 

Obsessive-compulsive personality disorder (OCPD) involves traits primarily related to seeking control, difficulty seeing a "grey area," and rigid beliefs about the world. These beliefs may be related to organization, cleanliness, or one’s career, among other challenges. OCD, on the other hand, can have many themes. Some people with OCD may struggle with relationship OCD, whereas others might struggle with harm OCD. These two individuals may not fear the other person's themes but experience deep distress when exposed to their own.  

OCPD is associated more with behavioral patterns than the causes behind them. For example, whether someone associates their identity with their career or with raising a family, both individuals may be experiencing the primary theme of difficulty forming an identity and an internal sense of responsibility over the occurrences encountered in these situations. With OCD, themes are more specific and oriented around compulsions and the topics within a person's thoughts, often related to fears surrounding immorality. 

Although obsessive-compulsive personality disorder (OCPD) is not as heavily studied as other personality disorders or mental health conditions, hundreds of thousands of people live with this condition in the US. Below are a few statistics to keep in mind about the condition:

• OCPD can be co-morbid with other mental illnesses, like OCD, depression, eating disorders, and anxiety disorders.
• Although no cause has been confirmed, genetics and environmental factors are often considered the leading causes of OCPD. 
• People with OCPD may experience hostile social behaviors and a lack of an empathetic perspective 
• Cognitive-behavioral therapy may be an effective form of treatment for distressing OCPD symptoms 

The Most Effective Treatments For OCPD

Treatments for obsessive-compulsive personality disorder (OCPD) can differ from those that might be suggested for OCD. Below are options you can consider if you or a loved one has been diagnosed. 

Radically Open Dialectical Behavior Therapy (RO-DBT) 

Inspired by dialectical behavior therapy (DBT), radically open dialectical behavior therapy (RO-DBT) was developed by Thomas R. Lynch to address symptoms of OCPD and other causes of control-oriented behaviors. According to 2020 research, RO-DBT is one of the most effective therapeutic modalities for OCPD and has been associated with reduced symptoms in those with treatment-resistant symptoms. 

RO-DBT takes place in a group format, prompting clients to start working through social skills that may be difficult due to their condition. Relating with the symptoms of others may be favorable for those who try this type of group therapy, as they can share the perspective of people who may understand where they're coming from. 

How Does An RO-DBT Session Work? 

In an RO-DBT session, each client receives a workbook with official RO-DBT worksheets, skills training, and lessons. The therapist of the session may teach each person in a structured format, slowly working with the group to help them take more risks, try new activities, or discuss uncertainty. The modules within the RO-DBT workbook include the following: 

• Interpersonal effectiveness
• Emotional regulation 
• Mindfulness
• Distress tolerance
• Radical openness

These modules cover the following behavioral targets: 

• Lessening rigidity and rule governance 
• Restructuring ideas of "correctness" 
• Reducing compulsive behavior 
• Learning to socialize healthily 
• Coping with vulnerability
• Unmasking inner feelings
• Reducing comparison, envy, and bitterness
• Practicing self-care
• Rejecting structure and order
• Embracing openness 
• Embracing healthy risk and novelty
• Considering feedback
• Reducing distrust and suspicion 
• Increasing empathy 
• Practicing forgiveness and compassion 

RO-DBT may also be attractive to those who enjoy following rules because they often take place in a structured format, with prior agreement of which lessons you'll learn and the ability to take notes. You can also graduate from RO-DBT after finishing the workbook, which can offer a sense of success and accomplishment. 

Cognitive-Behavioral Therapy (CBT) 

Cognitive-behavioral therapy (CBT) has been proven effective in treating multiple mental illnesses and symptoms, including depression, anxiety, OCD, post-traumatic stress disorder (PTSD), and some personality disorders. CBT may also be effective in treating OCPD, as it works with patterns of thought that can underline behaviors like those exhibited in this condition. 

How Does A Cognitive-Behavioral Therapy Session Work?

In CBT, clients can work with their providers to develop a treatment plan based on their goals. The therapist can help them restructure their thoughts to serve their current circumstances. In addition, they can work together to develop a way that the individual can put the positive sides of their personality traits to use while still ensuring compassion, self-care, empathy, and rest. 

For example, average levels of determination, detail orientation, and ambition may be helpful and admirable. However, when these personality traits become someone's entire outlook and negatively impact relationships and personal life, they might benefit from moderation strategies. A CBT therapist can offer these and help the individual set realistic goals.

Counseling Options 

You're not alone if you think you might be living with obsessive-compulsive personality disorder (OCPD) or have previously been diagnosed. There are many options for treatment, and counseling can be a practical first step for addressing symptoms. If you believe your behavior has started to impact your life, even if you don't understand why, consider talking to a compassionate counselor in your area or over an online platform like BetterHelp. Through BetterHelp you may find a therapist who specialized in CBT, RO-DBT, or other forms of counseling like psychodynamic therapy or exposure therapy.

Studies have found that internet-based counseling is as effective as in-person therapy in treating symptoms of personality disorders. In one study, researchers found that client satisfaction with online personality disorder treatment was moderate to high and that they found the platforms over mobile apps more accessible than face-to-face therapy. In addition, an absence of adverse effects from symptoms was observed. 

If you're interested in trying therapy but have a busy schedule due to your career, online therapy might be valuable to you. You can choose a session time outside of standard business hours and work with your therapist to find a plan that fits your needs at a cost-effective price.

Read below for reviews of BetterHelp counselors, from those who have experienced similar concerns. 

“Melanie is such a thoughtful and caring counsellor. She has really helped me dealing with my OCD and have provided me with a lot of support through the conversations we have had as well as proving me with helpful coping mechanisms. Melanie is very non-judgmental is really willing to help you deal with any anxieties you are having while ensuring that you stay in the right track.” 

"Dr. Seavy was a great helpline me in recognizing my eyes for OCD and helping me to understand that it’s okay to feel that way. He also gave me some great tips for dealing with those feelings and the anxiety I get from them. I highly recommend Dr. Seavy."