Obsessive-compulsive personality disorder (OCPD) is not a rare condition (estimates are that it affects at least 8% of the population), yet when you go to review the research on the disorder and treatment... crickets. The term “personality disorder” in itself can be daunting, and a name so similar to OCD is confusing.
First, let’s break down a personality disorder. At the simplest, having a personality disorder means that someone’s mental health symptoms are pervasive to all areas of their life: work, romantic relationships, friendships, caregiving, etc. Their symptoms are more stable and not dependent on moods or emotions. In fact, it might be better to refer to them as “traits” that lead to symptoms that cause distress in themselves or others.
There is a lot of stigma and misunderstanding surrounding personality disorders. Having a personality disorder does not mean that someone has a “bad” personality. And, although it means that all areas of life are likely impacted, someone with a personality disorder might not be functioning worse than someone with a more situation-dependent disorder such as depression or panic disorder.
OCPD at its core is excessive perfectionism that negatively impacts the person’s life. Someone with OCPD might get so caught up in living up to an ideal that they never actually get to enjoy the present moment. For example, they might be a “workaholic” but never feel a sense of accomplishment when they have a major work-related achievement. People with OCPD also tend to be more rigid in their thinking and inflexible in their behavior. For example, they might think their method of loading the dishwasher is flawless and anyone who does it differently is wrong. You can see how this leads to the inherent interpersonal difficulties of the disorder... Control and order are essential, and other symptoms might include hoarding, being extremely conservative with spending money, and taking a hard line on morality (American Psychiatric Association, 2013).
People with OCPD often do not seek treatment for themselves because their symptoms are what we would call “ego syntonic.” This is a fancy way of saying that they only feel distress when their rules of living are broken by others, and so they would not assume that their way of thinking and behaving is the core issue. Usually, people with OCPD only start to realize they might have issues to work on in therapy when they experience a major stressor such as a breakup or job loss.
Because of the productivity, high conscientiousness, and high achievement of many with OCPD, it might not sound all bad or even like a disorder at all. In fact, these are traits on a spectrum and can be positive, when applied correctly. The problem with OCPD is that these traits are so rigid, and the perfectionism is so pervasive that it ends up corroding the person’s life. In addition to the problems interacting with other people OCPD can cause, it is also highly associated with other mental health conditions that would warrant treatment as well.
Back to the original question: Would treatment be trying to change the personality of someone with OCPD? Of course not!
In treatment, people with OCPD learn things like how to evaluate their own standards and whether they are helpful or hurtful to their life (and emotions), how to get along with other people when those people are not meeting their standards, and how to decrease unhelpful perfectionism while still achieving and getting work done. For example, someone with OCPD who was extremely careful with money might learn that they actually really enjoy sailing, and it’s so worth it to them to have the joy of sailing in their life that they are willing to spend money on it and de-prioritize having the “perfect” amount of money in their savings account. But they might still be more careful with their money with other people after treatment, and that’s totally fine! They don’t need to become a shopaholic or go into debt.
While there is not an established evidence-based treatment, cognitive-behavioral therapy and interventions that fall under that umbrella seem to be highly effective (Grant, Chamberlain, & Pinto, 2020). It can be challenging to find a provider who is familiar with OCPD and its treatment. OCPD.org has a directory of therapists who work with OCPD. If there is no one in your area, the IOCDF is another resource. I enjoy working with OCPD and can see people in Georgia and PSYPACT-approved states.
Get more information on OCPD here: https://www.ocpd.org
Listen to this podcast by the US expert on OCPD, Dr. Anthony Pinto: https://theocdstories.com/episode/pinto-397/?fbclid=IwZXh0bgNhZW0CMTAAAR1kVdWG5XGCFZAbjoWK1iLnJuBgAAuHvG7yrk2oncdX8mbLxAB1aK_x9Ns_aem_AXVVwUcealjz0Qj9z-RbcMJHF5_zWrFPnpd8tn34fy_HkB2d9aI6ulYp-tXgXFMVjTPIMfwQKGCp7SPlrLRDlSTS
References
American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders (5th ed.). https://doi.org/10.1176/appi.books.9780890425596
Grant, J. E., Pinto, A., & Chamberlain, S. (Eds.). (2020). Obsessive-compulsive personality disorder. American Psychiatric Association Publishing.
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