TREATMENTS
The goal of our Foundation is to not only provide you with a clear explanation of what obsessive compulsive personality disorder is but to also assist in the process of finding the best treatment option for you. We would love nothing more than to be able to tell you exactly what your next steps should be, but the process of finding the right treatment is a personal one. What the Foundation can provide you with is a starting point. The following article is not intended to serve as a “paint-by-numbers” guidebook. Rather, this is a list of therapies you may encounter in your search for answers and a brief introduction to each. In this way, you may explore the therapeutic techniques that speak to you the most.
Some of the treatment methods we are about to present have shown promise in addressing the issues you face as someone with OCPD. As of now, though, there is not a one-size-fits-all solution. Our Foundation will continue to research OCPD treatments and present the best options available to you. Nothing is more important to us than finding a solution that will improve the quality of your life. In the interim, please use this resource as a jumping-off point.
Cognitive Behavioral Therapy (CBT)
CBT counters what many people think of when they think of talk therapy. Instead of placing the focus on issues from your past, this form of therapy aims to work on reframing your current problems. It does this by breaking down your problems into smaller parts and helping you to change the way you think and behave. The foundation for this method is based on the idea that your emotions, thinking & actions are all interconnected. The work done using cognitive behavioral therapy will extend outside of the therapist's office in that it employs assigning “homework” exercises that will, in effect, help you become your own therapist.
Initially, your therapist will assist you in identifying what areas of your life are causing you difficulty, and they will help you set goals that will challenge your current mode of thinking. Once you have identified the trouble areas, you will be encouraged to share your thoughts on them. This process will include describing emotional, behavioral & physical responses to their line of questions. The work that follows will involve challenging your negative and inaccurate thinking. This process can be involved, as it may include facing long-standing and deeply held beliefs about yourself. CBT has been proven to be effective against an increasingly long list of mental health issues, including mood disorders, anxiety disorders, substance abuse problems & some severe mental health disorders. CBT aims to improve daily functioning and quality of life through experiential learning (learning through trying new behaviors, challenging old/rigid ways of thinking, all while coping with the distress that inevitably accompanies change).
Dialectical Behavior Therapy (DBT)
DBT is a specific type of CBT that focuses on learning and applying skills for managing high emotionality (i.e., skills for emotion regulation). Principally, this form of therapy is directed at people who experience emotions intensely (sometimes to the point of self-harm or suicidal behaviors), and it can help in negotiating social relationships. DBT focuses on accepting feelings, thoughts & the realities of the your life.
DBT is a structured program of psychotherapy that will usually consist of weekly, individual therapy sessions taking place over the course of six months to a year. The “dialectical” part of DBT refers to the combining of opposite and complex ideas. Balancing the opposing forces of validation, your own unique challenges & the benefits of change are the primary focus of DBT.
In order to accept the complexity of life, therapists will generally employ four different types of sessions. In general, these sessions may include a pre-assessment, individual therapy, group skill training & telephone crisis coaching, with the goal of improving your emotional regulation.
Schema Therapy
Simply put, schemas are maladaptive patterns of thinking (and associated behaviors) that develop during childhood, often for self-protection, but they become automatically activated by related cues in present day, leading to immediate shifts in mood and distress. These patterns of thinking may lead to someone engaging in unhealthy behaviors. And in turn, this can negatively impact relationships and emotional well-being. The primary goal of schema therapy is to make you aware of these schemas and their impact on present day behavior and to work on reshaping these world views. Elements from CBT, psychoanalysis & Gestalt therapy are integrated into schema therapy, and early studies are showing promise in treating personality disorders.
Schema therapy is aimed at addressing unmet needs and then helping to break unhealthy patterns by developing healthier alternatives. The therapist will help to identify the underlying causes of your behaviors and, through empathic confrontation, encourage you to see the need for change. The techniques used to provide you with the tools to affect change can include psychoeducation, imagery rescripting & limited reparenting.
Another key component of schema therapy is the building of a strong therapeutic relationship. You will need to be comfortable with your therapist and will need to feel emotionally safe during sessions. This will help further the goal of addressing emotional needs that went unmet in childhood.
If you are interested in taking a pre-test to determine the likelihood of OCPD traits, you can do that by clicking the “TAKE TEST” button.
Acceptance and Commitment Therapy (ACT)
ACT is a type of mindfulness-based psychotherapy that aims to help you focus on the present and accept your own thoughts and feelings without self-judgement. Acceptance and commitment therapy utilizes a mix of metaphor, paradox, mindfulness, behavioral interventions & experiential exercises to guide you through difficult emotions. The therapist will help you build coping mechanisms to free you from negatively toned thinking and experiential exercises to guide you through difficult emotions and thought content. The therapist will help you build coping mechanisms to free you from negatively toned thinking.
Through ACT, you will learn to be present and engaged by taking effective, mindful action. ACT will teach you acceptance, cognitive defusion, being present, self-as-context, choosing personal values & committed action. Although this form of treatment stems from traditional behavior therapy and cognitive behavioral therapy, its scope extends beyond traditional Western techniques. In order to make a transformative shift in your mind, ACT encourages you to experience life as a whole and to accept negative emotions as part of the human experience.
Exposure Therapy
Although the avoidance of fears and the reliance of certain behaviors to create a sense of safety or certainty may reduce distress in the short term, the long-term effects can be a deepening of that fear, a decrease in one’s perceived ability to cope with anxiety, and a negative impact on functioning. Exposure therapy is a psychological treatment that focuses on addressing one's fears by safely and cautiously exposing you to triggers of your anxiety within a secure setting and encouraging you to remain in the situation without avoiding or depending on safety behaviors. This type of exposure can help to break the pattern of escape from distress through avoidance or rituals. Most often, this form of treatment is used in the cases of phobias, social anxiety, obsessive compulsive disorder, panic disorder, and post-traumatic stress disorder.
Variations of exposure therapy may include in vivo (in real life) exposure, virtual reality exposure, interoceptive exposure & imaginal exposure. In addition to these variations, exposure therapy employs different forms of pacing depending on the needs of the patient. Exposure therapy falls under the CBT umbrella and, as such, utilizes some of the same techniques. The combination of exposure and CBT will teach you that you are fully capable of facing your fears.
During treatment, you will be encouraged to actively confront your fears, and you will maintain proximity to or engage with those fears until you build tolerance for feelings of distress. Over time, you will acquire the ability to associate more rational beliefs with the objects or situations that you fear. Throughout the exposure, a therapist will provide strategies to effectively manage your levels of anxiety and fear.
Analytical Psychology
Analytical psychology is the brainchild of Swiss psychiatrist Carl Jung. An overarching element of Jung’s method is founded in the importance of understanding a patient’s immediate conflicts and how they relate to the human psyche. This development in psychotherapy deviates from Sigmund Freud in that it places less importance on the uncovering of childhood conflicts and the role of sexuality in the neuroses. What we now recognize as analytical psychology is an amalgamation of the evolved teachings of Jung and a century of psychotherapists building on his thoughts and analysis.
Jungian/analytical psychology is rooted in the concept of archetypes. According to Jung, we begin by categorizing people as introverted or extraverted, and from there, we can further distinguish people by the functions of the mind. These functions of the mind include thinking, feeling, intuition & sensation. The archetypes Jung built upon are universal symbols that reside within our unconscious, and the intention of analytical psychotherapy is to bridge the conscious and unconscious parts of our psyche.
Jung theorized that our psyche includes the 'shadow'. This is the part of ourselves that we spurn and dismiss. By integrating our shadow, we move closer to self-understanding and growth. Jung believed it was the position of the therapist to respect an individual’s unique psychological reality. By respecting a patient’s reality, the therapist can embark on a shared journey of exploration in which patterns and meanings can be uncovered.
Metacognitive Therapy (MCT)
Metacognitive therapy is focused on modifying unhelpful beliefs about your thoughts that perpetuate worry, rumination, and overthinking. By empowering metacognitive competence, you will better comprehend the fallibility of human cognition and be prompted to reflect on your behaviors and your approach to problem solving. The next step in the MCT process involves learning to replace dysfunctional coping strategies with helpful and actionable ones. This can be accomplished by teaching you how to detect exaggerated thoughts and how best to defuse them.
Alternative Therapies
Presently, there exists an almost endless list of alternative therapies. In attempting to treat personality disorders, the research accomplished up to now has focused primarily on Western psychotherapy and modern medicine. In order to achieve the highest chance of success and to treat your disorder expeditiously, we would encourage you to begin your journey of self-healing with these tried and true methodologies. Many of the treatment options explored in this article are backed by extensive studies and research. However, each person must decide which path they would like to journey down.
For personality disorders, very little research has been done examining the positive effects of alternative therapies. If there exists evidence, most of it is circumstantial and anecdotal. That said, with OCPD in particular, it is not uncommon for there to be comorbid conditions and additional mood disorders. For these particular struggles, there has been considerable research testing the effects of alternative treatments and their effect on mood. For these purposes, many people choose to also incorporate additional therapies into their treatment plans. Available alternative therapies that you may wish to further explore might include medical interventions, psychedelic therapies, breathwork, relaxation techniques, physical activities, hormones & Eastern philosophy.
Medically Reviewed by Anthony Pinto, Ph.D. on March 01, 2024 | Written by Darryl Rossignol