Welcome to the subReddit for people with suspected and diagnosed OCPD and mental health providers. Please take a minute to review our community guidelines. If you can't see them in the sidebar, you can see the reply to this post. Feel free to ask questions through Mod Mail.
If the Auto Mod blocks your post or comment by mistake, we apologize for the inconvenience and we will restore your content asap.
DIAGNOSIS AND TREATMENT
Dr. Allan Mallinger, an OCPD specialist, created this Screening Survey. The diagnostic criteria for OCPD, and the general criteria for PDs is in the reply to this post.
On the surface, OCPD symptoms can look similar to OCD and Autism. Misdiagnosis is an issue.
This post has common treatment approaches for OCPD, and results from studies about the effectiveness of therapy in reducing perfectionism and OCPD symptoms: Finding Mental Health Providers.
The resources in this sub do not refer to children or teenagers with OCPD diagnoses. Most clinicians only diagnose adults with PDs. The human brain is fully developed at age 26. The DSM notes that individuals with PDs have an “enduring pattern” of symptoms (generally interpreted by clinicians as 5 years or more) “across a broad range of personal and social situations" that causes “clinically significant distress or functional impairment.”
SELF-DIAGNOSIS
If you suspect that you have a PD, keep in mind that the DSM has 265 disorders. Ideally, clinicians diagnose PDs after a thorough process that ‘rules out’ other disorders. Different disorders can cause the same symptom. Mental health providers are trained in differential diagnosis.
The DSM is a quick reference tool for providers. Its value for the general public is limited. A therapist explains that the DSM is “designed for researchers first and foremost...a lot of clinically relevant content is left out of the criteria…The overarching goal is to standardized diagnostic language as to allow researchers to communicate their research more efficiently and accurately to each other.”
All personality disorder symptoms are part of the human experience. Many people have some PD traits, without meeting criteria for diagnosis. According to The National Institute of Mental Health, approximately one in ten American adults has a personality disorder. However, about 70% of the general population has some maladaptive personality traits.
I highly recommend Heidi Priebe's YouTube channel about attachment styles. The avoidant attachment style is most common for people with OCPD.
BOOKS
There are two short books about OCPD for the general public: Too Perfect (1996) by Dr. Allan Mallinger, who has worked with clients with OCPD for 50 years, and The Healthy Compulsive (2022) by Gary Trosclair, who has worked as a therapist for more than 35 years.
If you want to learn more—or if you don’t relate to these books because your perfectionism isn’t as severe—I highly recommend The Perfectionist’s Handbook (2011) by Dr. Jeff Szymanski, the former Director of the OCD Foundation. He has provided group therapy to perfectionists. Other books on perfectionism, personality, and overwork: Resources For Learning How to Manage Obsessive Compulsive Personality Traits
ARTICLES
Perfectionist Tendencies has a list of perfectionistic habits. When these habits lead to significant distress and/or impairment, they may be symptoms of OCPD.
Cognitive Distortions has information about common thinking habits in people with clinical perfectionism (and also people with untreated trauma).
COPING STRATEGIES
After focusing on perfectionism in therapy, I made enough progress to no longer meet criteria for OCPD. These are the coping strategies that I developed first:
- Having a 'one day at a time' approach, and focusing on the present moment as much as possible, rather than ruminating on the past and future.
- Taking opportunities to get out of my head and into my body. I spend as much time outside as possible and move as much as I can. I made small changes as consistently as I could (e.g. short walk every day) and slowly built on my success.
- Recognizing that every instance of naming my feelings is important. Eventually, I learned to “feel my feelings” instead of overthinking and using numbing behaviors, like overuse of technology, work, and food.
- Approaching the task of learning about OCPD with openness and curiosity, viewing it as a project, rather than a source of shame. I viewed the label as an arrow pointing me towards helpful people, places, and coping strategies. I tried to focus on pursuing joy, not just reducing distress.
- Practicing mindfulness by adopting ‘be here now’ as a mantra, and focusing more on my five senses, breathing, and other body sensations, and less on my thoughts. I try to breathe deeply and slowly at the first sign of frustration, and pay attention to how my feelings and body sensations influence my behavior. Eventually, this helped prevent difficult situations.
- Thinking of a time when my OCPD symptoms were the lowest, and finding ways to reconnect with the people, places, things, and activities from that time.
Maintaining self-awareness was half the battle. Better self-awareness (without shame) is the foundation of developing healthier habits.
I would recommend making sure you get routine medical care if you have diagnosed or suspected OCPD traits. OCPD tends to take a toll on physical health. Medical issues can cause or exacerbate mental health issues. Some issues have a quick fix; for example, I started taking iron supplements after finding out that I had severe anemia (which causes fatigue). I found that improving my physical health had a positive impact on my mental health.
DESCRIPTIONS OF OCPD FROM CLINICIANS
Megan Neff (psychologist with ASD, ADHD, has an OCP):
The core feature of OCPD is “an ever-looming sense of impending failure, where individuals constantly anticipate things going wrong, a flaw being exposed, or a profound loss of control. [It causes frequent] self-doubt, doubt of others, and doubt of the world at large...an obsessive adherence to rules, order, and perfectionism becomes a protective shield.
“Autonomy and control are central to OCPD, yet they create a painful paradox. Individuals with OCPD [are often] intent to keep every option open — an effort to maintain control over every possible outcome — [which] ironically leads to a state where no real choices remain…This hyper-vigilance toward autonomy ironically [creates] a self-imposed prison…
“OCPD can be perceived as a sophisticated defense structure...that develops over time to safeguard against feelings of vulnerability. The pursuit of perfection and the need to maintain control...protect oneself from shame and the anxiety of potential chaos. Living with OCPD often feels like being overshadowed by an impending sense of doom and a persistent state of doubt, even while maintaining an outward appearance of efficiency and success.”
Allan Mallinger (psychiatrist with OCPD specialty):
“The obsessive personality style is a system of many normal traits, all aiming toward a common goal: safety and security via alertness, reason, and mastery. In rational and flexible doses, obsessive traits usually labor not only survival, but success and admiration as well. The downside is that you can have too much of a good thing. You are bound for serious difficulties if your obsessive qualities serve not the simple goals of wise, competent, and enjoyable living, but an unrelenting need for fail-safe protection against the vulnerability inherent in being human. In this case, virtues become liabilities…”
Gary Trosclair (therapist with OCPD specialty, has an OCP):
“The problem for unhealthy compulsives is not that they respond to an irresistible urge, rather they’ve lost sight of the original meaning and purpose of that urge. The energy from the urge, whether it be to express, connect, create, organize, or perfect, may be used to distract themselves, to avoid disturbing feelings, or to please an external authority…Many compulsives have a strong sense of how the world should be. Their rules arise out of their concerns for the well-being of themselves and others. Yet that same humanistic urge often turns against others when the compulsive person becomes judgmental and punishing, losing track of the original motivation: the desire for everyone to be safe and happy."
“There is a reason that some of us are compulsive. Nature ‘wants’ to grow and expand so that it can adapt and thrive, and it needs different sorts of people to do that…People who are driven have an important place in this world. We tend to make things happen—for better or worse. We are catalysts.…Nature has given us this drive; how will we use it?...Finding and living our unique, individual role, no matter how small or insignificant it seems, is the most healing action we can take.”
“With an understanding of how you became compulsive…you can shift how you handle your fears. You can begin to respond to your passions in more satisfying ways that lead to healthier and sustainable outcomes…one good thing about being driven is that you have the inner resources and determination necessary for change.”
RELATED SUBS
r/Perfectionism is for perfectionists, loved ones, and mental health providers.
Posts in LovedByOCPD contain inaccurate information about OCPD; global, negative statements about people with OCPD; and stigmatizing language. People with positive attitudes towards their spouses are not inclined to participate, for example the woman who wrote My Husband is OCPD and Understanding Your OCPD Partner. (Another positive post: Behavioral scientist married to a diagnosed OCPD individual) Almost all of the partners described have no awareness that they have OCPD, and refrain from seeking therapy or use therapy sessions just to vent about others.
I appreciate this comment from a woman who posted Introducing your OCPD loved one to stories in this subreddit: "actually told my husband to never look [at r/LovedByOCPD]. He's not abusive, I joined hoping to find some info on coping strategies and just life tips. And then reading everyone's posts i realized how lucky we are. Im glad people have a place to vent and find support, but my husband is in therapy and making fantastic progress. I think it would be demoralizing for him to read some of these stories."
DISCLAIMER
Resources and advice in this sub do not substitute for working with mental health providers.
In my continued hope that loved ones will stop telling the Mods to f*** ourselves, I'm giving folks a heads up--loved ones who post or comment in this group will be banned. When we just removed comments sometimes people continued to participate.
I'm confused why some people are surprised that their content is removed. The description, first guideline, two flairs, and a pinned post state that this group is for people with OCPD. Another clue is that all of the posts are from people with OCPD.
The loved ones' group is r/LovedByOCPD. r/FamilyWithOCPDAdvice has resource posts--all of the information relevant to loved ones that I've found in three years of research.
The post announcing the change in guidelines to make this an affinity group had an upvote rate of 98%. Loved ones were included in this sub for many years; it led to a lot of conflict:
“I've been drafting this post in my head for about a month now, just now got the courage to post because I thought I would get shit on for saying this.”
“This took me over an hour to make because I feel like I’m going to get attacked…I feel as if I’m on thin ice.” The OP stated that he had been awake since 4am. Six loved ones replied with many details about their partner and other negative comments. The OP (whom I think was recently diagnosed) deleted their account.
A member wrote “I don't know if I have OCPD, I've been a little reluctant to reach out for help.” Someone replied with a rant about people with OCPD referencing their loved one.
Someone wrote about the myth that all people with OCPD are abusers: “Many of us have been abused in the past and seeing our disorder constantly related to abuse does not help any of us. It really hurts.”
A member commented that he left the sub because of loved ones' posts and then “made a mistake of coming back to search for advice” and read another hateful post.
Someone recalled writing a post that “got more responses from people who dated people with OCPD than people who actually have it.“
A member described her reaction to browsing a loved ones' forum: “When I was first diagnosed, I went online to find a support group/discussion forum so that I would feel less alone and scared. The first thing I came across was an entire forum absolutely packed with people saying that people with OCPD are narcissistic abusers who aren't capable of love, and who don't deserve to be loved. I had just come out of a five year relationship, and this absolutely destroyed me and my self-esteem for a very long time.”
A member wrote, "the wide internet can be a terrifying and vilifying space (personally, the very first day I was diagnosed, I was told repeatedly in so-called support communities that I was unloveable because of it and I should die alone so that I don't inflict my disorder on anyone else)."
Another reason that the guidelines were changed is the fact that 30-40% of people with OCPD experience suicidality in their lifetime. Loved ones' content with derogatory language can be triggering.
Mod mail messages with disrespectful language will receive no reply. Here are our replies to comments from loved ones:
Go f*** yourself. Thank you for validating our decision to make this sub a safe space for people with OCPD.
You're controlling. You're censoring. Reddit moderators and other social media moderators make guidelines and remove content. We're not obligated to keep content that doesn't follow our community guidelines. Our guidelines were thoughtfully created, and we believe they are in the best interest of our online community.
Anyone can start another OCPD subReddit with whatever guidelines they like; we're available to help, and there are subs for Mods to ask questions.
You're being selfish. One could argue that you're being selfish for intruding on this group. There seems to be a notion that people with PDs have a duty to give advice to loved ones. That's not a thing; receiving a diagnosis does not obligate someone to give advice to strangers.
People with PDs who have hurt others are accountable for figuring out their mental health needs and making amends. They are not accountable for the behavior of other people with PD diagnoses, and have no obligation to atone for their behavior by giving advice to strangers.
We are not guilty by association for your loved ones' choices. We are not responsible for the choices of the millions of people who have OCPD (about 6.8% of the population).
Can you make an exception for me and leave my content? No. What a strange request. This sub is for people with OCPD and mental health providers.
There's no resources for loved ones. An r/OCPD mod created r/FamilyWithOCPDAdvice. It has more than 40 resource posts for loved ones.
You should just give me a f***ing reminder instead of banning me. When we just removed content, some people continued to participate. If you're planning on respecting the rules for the sub and refraining from posting, why do you care that your account is banned?
You're unhinged. How strange that you disclosed private details about your life and asked advice from unhinged people.
If your child had OCPD, would you view them as unhinged?
I need help. My partner is driving me crazy. When loved ones were allowed to participate in this sub, very few people with OCPD responded to loved ones' posts. When people did respond, they offered sympathy, and rarely offered advice.
Thirty to forty percent of people with OCPD experience suicidality during their lifetime. Many people in this sub are just trying to get through the day; they're not interested or able to provide advice about strangers. We can't figure out what's going on with your partner just because we have the same diagnosis. People with the same diagnosis are not carbon copies of each other. People with OCPD are the most diverse PD population. My father and sister may have OCPD; I can't explain their behavior.
It’s unlikely that strangers will offer you useful insights on your life. Mental health providers, and your friends, and family are the best people to offer you advice and support. A few people with OCPD participate in r/LovedByOCPD to give advice. (The moderators allow them to participate). r/FamilyWithOCPDAdvice has a lot of information from therapists who specialize in perfectionism and OCPD.
Why can't you allow respectful loved ones' posts? People with and without OCPD have different opinions about what constitutes a respectful post. People with OCPD tend to view 900+ word posts from loved ones as rants. The loved ones just think they're giving details to fully explain the situation.
Loved ones use language like "an OCPD" to refer to their partner; from the point of view with someone with OCPD, that's dehumanizing language.
The mods are not up for debating what constitutes respect with loved ones. This is an affinity sub for people with OCPD, and input from professionals is allowed.
My psychiatrist recently “diagnosed” me with OCD and put me on fluvoxamine. Honestly, I really don’t resonate at all with OCD and I strongly feel like it is OCPD. I am diagnosed with ADHD. The reason I say she “diagnosed” me with OCD, is because after like 5 minutes of talking she said it “seems” like OCD. I mentioned that I’ve heard of OCPD and I thought that it could be that and she paid it no mind and I know OCPD is extremely understudied. I feel like I shouldn’t even say anything because I know there’s no meds for OCPD so maybe this is the only way I can really get help for it. The only reason I even want help is because I spend several hours a day trying to “optimize” things before starting the actual task. I’ll spend hours highlighting, using a nicer font, fixing headings, text sizing, etc. I’ll organize my room and declutter. It’s gotten to the point I have gotten rid of over 85% of my clothes and things because I see it as clutter. I have spent multiple 12 hour night shifts (where I have lots of free time to work on homework and studying) on making to-do lists, schedules, checklists, or just “organizing” my life. I’ve spent several 12 hr shifts planning the next 10 years of my education (as I’m going for my CRNA and there are many years to go until I finish) and I’ve planned out individual steps and phases for each of the years until I finish all of my schooling. These tasks literally consume my life and I can’t stop because as much as they distract me I know that they’re things that kind of need to be done or that do sometimes end up benefiting me. I just don’t know what to do really because I am wondering if these OCD meds will make me lazier and not do my little tasks or be okay with being lazy and skipping them and then they just don’t get done. If anyone has some words of wisdom for me please do let me know.
I just finished reading Thomas Lynch's workbook about Radically Open Dialectical Behavior Therapy (RO-DBT). There is a lot of interesting information about nonverbal communication.
Studies indicate that nonverbal communication (e.g. tone of voice, facial expression) has a much larger impact on social interactions than the content of what we say. I became much more mindful of my nonverbal communication when I learned to manage OCPD, and have found it very helpful.
In How To Be Enough (2024), Ellen Hendriksen states, “Research shows that hanging out with someone whose expression doesn’t vary—whether they’re all smiles or all business—makes us anxious and uncomfortable. It literally increases our blood pressure. And because it’s stressful to interact with someone we can’t read, we’re more likely to avoid them in the future.” (245)
A large body of research shows that body language (e.g. tone of voice, facial expression) has a much larger impact on social interactions than what we say.
Our brains are hardwired by evolution to view ambiguous stimuli—such as a blank facial expression or an unfamiliar sound—as potential threats. Studies have found that people become anxious when interacting with a non-expressive person, and they prefer not to spend time with them. (“Emotional Regulation: Affective, Cognitive, and Social Consequences,” Gross, 2002; “The Social Consequences of Expressive Suppression,” Butler et al., 2003)
People with disorders characterized by overcontrol, such as OCPD, have heightened threat sensitivity. They tend to interpret neutral and ambiguous situations as threatening. They are highly aware of small details, which results in being more likely to notice small changes in someone’s facial expression that are interpreted as rejection. Studies have shown that experiencing physical pain and perceived social rejection results in similar brain activity. (“Why Rejection Hurts: A Common Neural Alarm System For Physical and Social Pain,” Eisenberger and Lieberman, 2004)
Over the past month or so, I have educated myself more on OCPD, and I'm seeing a lot of symptoms/behaviours in myself that line up. I have diagnosed ADHD, and major impostor syndrome, so I'm really unsure and hesitant to even move forward. I'm currently not seeing a psych (can't afford one, and I'm above the age for bulk-billed access in Australia), I don't know if I should try and save up to see someone.
I guess I'm just wondering if anyone else had had similar experiences - doubting themselves, pinning symptoms on other diagnoses like ADHD or other psychological factors. Did an OCPD assessment/diagnosis help you? Do you find any specific therapeutic approaches help you once there is an understanding of a personality disorder?
How does one even approach a professional? I have so much anxiety even bringing up the possibility to my partner and my closest friends... let alone my GP. Has anyone had experiences where they truly suspected OCPD, but were shut down by a practitioner?
Some context: I'm F(26) living in Australia. I have ADHD and have suspected ASD (though no formal diagnosis as yet). In short - I have long attributed my perfectionism, hyper-fixations, need for control, order, and difficulty with change etc. to suspected autism, accompanied with my difficulties with deadlines, task completion, and self-regulation with ADHD. Now, I have no idea what to think, and the uncertainty has begun to bother me more and more. Much of my identity surrounds my mental health and how I manage it, as I have a long history of mental health experience. Not being sure, or feeling like an imposter, makes me so anxious.
So, if anyone has any words or advice, reassurance, or stories/experiences to help me draw from down the road, I would appreciate you so so much!
If you've read this, thank you :) I hope you have a wonderful day, stranger <3
I have been recently officially diagnosed with OCPD and ADHD. A long time ago, I realized that I was very harsh on myself, putting unrealistic standards in every aspect of my life that I had to meet and getting devastated if I couldn't meet them. If I did meet them, I would feel an extremely short-lived sense of relief, and then the target would move. The cycle would start over.
Having ADHD and living in a place where I have no access to psychotherapy and barely have access to a psychiatrist definitely hasn't helped, although I have been taking medication (an SSRI antidepressant) and trying to cope.
What I have recently realized through self-reflection is that I see the whole world through the same lens I use to look at myself: perfectionism. I go nuts when things don't go the way I assume they are supposed to, whether it's family behavior, my country's status, school, dating, etc.
My current biggest concern is dating. I have noticed a pattern, and I am wondering if I am alone in experiencing this. I wish someone could help me.
Six months ago, my first real romantic relationship ended. It was a long-distance relationship. At the time, my ex and I had been talking for a while. I sent her a photo of myself, and she sent me an image of herself. I found her cute, although I didn't get the chance to look at the image properly at first because she deleted it quickly, as she was very insecure about her appearance. Eventually, she let me keep the image, and all of a sudden, I started having doubts: Is this what my life partner is supposed to look like? I had always assumed she would be gorgeous.
I brushed the thought off, tried to continue the relationship, and decided to give it a chance. However, the idea kept coming back relentlessly. I used to spend entire days looking at her image and wondering whether she was attractive enough. I kept looking at the faces of every girl I came across in the streets, on the internet, or anywhere else, comparing them and wondering whether I would be happier if my girlfriend looked like one of them.
I kept showing her image to people in my inner circle, waiting for some kind of validation. No matter what they said, whether positive, negative, or neutral, it would calm me temporarily, but then I would become even more obsessed.
I even kept thinking about what people would think when they saw us together. Would they say I was lucky? Would they envy me? Would they not care? Or would they think less of me because I didn't have a conventionally attractive partner? It's worth noting that I hate looking at myself in the mirror or taking pictures of myself.
It was a shit show. I was torn apart by guilt. I kept ruminating about how superficial and disloyal I was, and I kept blaming myself and putting myself in her shoes until I felt tightness in my chest and could barely breathe at one point.
I just couldn't help feeling bad for her. I wished I weren't like that, and I felt pity for her. The idea of breaking up with her haunted me daily. Eventually, I figured that maybe I should end the relationship, but I thought to myself that people look different in real life than they do in pictures. Maybe I should meet her face-to-face before deciding. So, I travelled to meet her.
I was terrified, constantly thinking about what I would do if I didn't find her appealing in real life. When we finally met, I felt very comfortable looking at her. My eyes liked what they saw, and I thought to myself that she was good-looking enough that I would feel comfortable being intimate with her.
It was a very sweet time. I was relieved that I wouldn't have to break things off and break her heart. I finally felt content in the relationship. However, after I went home and we had our first argument following our date, the obsessions and chest tightness came back even stronger.
What made it even more confusing was that I felt lust when talking to her. I fantasized about being intimate with her, and I even masturbated to thoughts of her. We kept having arguments and fighting until the relationship eventually fell apart and we drifted apart.
I learned what I thought was a lesson from the experience: I must be superficial. I should never make a move or get involved with anyone again until I find the most attractive girl I can possibly get.
I noticed a pattern. I can easily find a girl attractive, but when I start thinking of her as my one and only partner for life, I feel suffocated and start thinking, Meh, she's not the perfect partner.
I even started having disturbing thoughts about how I could keep my future partner young and beautiful by providing her with hormone replacement therapy, or how I might choose an adult who is noticeably younger than me so that she would remain more attractive in comparison to me. For example, having a 20-year-old partner when I'm 30.
I even went so far as to consider being in a polygamous relationship because it's allowed where I live. That way, I wouldn't have to worry about whether my choice was attractive enough, whether I was missing out on someone better, or whether I had made the wrong decision.
Time passed, and I eventually forgot about the whole thing. I was no longer anxious about it. Then I met another girl. We are neighbors, and we had been bumping into each other by chance. We got to know each other better and became friends.
From the beginning, it was clear that she wasn't my type in terms of appearance. She's average-looking, but as time passed, we grew closer, and I started enjoying seeing and meeting her. I feel that she has started to like me too, although she is waiting for me to make the first move.
However, the horror of my first experience is still haunting me. I doubt on a daily basis whether she is the right partner. I feel that I would be doing her a disservice by pursuing anything romantic with her.
I keep thinking: What if I enter the relationship and end up repeating the same experience? Why not leave her for someone who is 100% certain that she is the most attractive woman in the world?
Does anyone relate to this? Can someone tell me what the solution might be? Is what I'm feeling normal? Is this OCPD, or am I just being vile? Can therapy help me overcome this if I ever travel abroad and gain access to it?
I have the gift of hyper-focus.
I'm in flow in a blink.
It shines when the path is clear.
It creates chaos in waves.
It needs an object to fixate on.
It needs something to obsess.
It follows an image in my head
and not really what I am.
The gift has won me trophies and medals.
The gift made me survive things
I'd not wish upon my worst enemy,
like an animal about to die of thirst,
like a stunted tree that shines bright
only to impress the gardener
so it won't be dewatered.
It has also cost me
things beyond repair.
I only lived in the past or the future.
I only lived in guilt or relief.
I don't feel days because I don't live them.
I don't enjoy the trophies
because they only brought relief.
The gift turned inward
and consumed me.
The praises became
the laughs in my head.
The gift gave me years
in bonus
only to take them away.
Being in it is
being possessed.
For it to obsess,
it kills you
in the promise
of what you are not.
Is it a soul
or a demon
someone should exorcise?
I was once an explorer.
The gift exists only in pages.
All goals have been achieved.
All years have been lost.
Love is lost.
I'm diagnosed with OCPD and have undiagnosed ADHD. I love hoarding data, reading articles but then I'll have lots and lots of doubts while reading one and I open a lot of tabs of articles, reddit threads, yt videos etc to understand the topic. Since I'm a farmer and freelancer I dont have enough time to read them and I need to be in a silent environment, literally 0 person around me to disturb, literally 0 upcoming events/errands only then I can read them. So I try watching the videos while eating but either I can't retain any information or I eat for hours without knowing, so it's a loss-loss
My medications (SSRI) for Dysthymia is over and I'm yet to visit my therapist for ADHD and OCPD. But in the meantime I have 2k+ tabs, 10k+ media to consume (if I dont then it's literally useless), and since I'm also a communist (newbie) I can't avoid reading and understanding current affairs, This issue is literally affecting my work, personal life and mind. If you know something that would help me in this please give me suggestions. TIA
Of course if someone comes along (rare) that fits my every box and doesn’t disappoint me and disgust me (yes I’m being dramatic) then sure I’ll think about it but I really can’t see it happening
Having untreated OCPD and trauma was like having an unhealed wound, and rushing around trying to get a million tasks done while the wound became infected.
TRAUMA AND PERSONALITY DISORDERS
“Personality disorders are not character flaws…They are emotional survival systems.” Akindotun Merino
A study by Battle, Shea, Johnson, et al. (2004) of 600 individuals with PD diagnoses found that 73% of participants reported childhood physical/sexual abuse, and 82% reported neglect. ("Childhood Maltreatment Associated With Adult Personality Disorders")
A therapist explained why she and her colleagues are hesitant to label people with personality disorders: "Oftentimes, personality disorders are misunderstood by patients and can instill hopelessness and be self-defeating. Over the years, as our understanding of mental illness has improved, these diagnoses do not have to be a life sentence and are treatable but if a client believes they aren't able to be treated, it complicates therapy."
She reports that many therapists are "moving away from diagnosing personality disorders the more we understand the impact of trauma. Many trauma reactions can manifest as what appears to be a personality disorder and oftentimes it's more effective to treat the underlying trauma than to label it as a personality disorder.”
TRAUMA AND PERFECTIONISM
In The Perfection Trap (2023), Thomas Curran states that hundreds of studies show that “perfectionism is a well-documented coping mechanism against mistreatment.” (248-49)
In The Perfectionist’s Guide to Losing Control (2023), Katherine Morgan Schafler explains that “Perfectionism as a response to abuse and neglect is not only about wanting to be loved but about surviving. Your caregivers aren’t just there to be your cheerleaders and give you hugs; they also give you food, shelter, and clothing—you’re totally dependent on them. When that primal attachment isn’t secure, being anything less than whatever their perfect version of you is can feel imminently dangerous. Walking-into-traffic dangerous." (106)
Schafler recalls, "I started my career in social work; doing home visits to check on kids who may be living in abusive environments was part of my job. I’ll never forget the chilling advice my boss gave me before I went into the field for the first time. She said, ‘Look for the kids who are behaving perfectly, those are the ones who are terrified.’ “ (106)
In "The Myth of Perfection," Dr. Allan Mallinger theorizes that children who later develop OCPD construct a myth of absolute personal control in reaction to feeling helpless in a home environment that is "untrustworthy, hostile and unpredictable." They have a relentless drive to minimize the disorder of the world "through ever rigorous control of the internal and external environment."
OCPD AND THE NEED FOR CERTAINTY
The human brain interprets familiar situations as safer than novel situations because they are more predictable. In a study, Dr. Emily Gray and her colleagues concluded that "intolerance of uncertainty" is a factor that may explain the association between child abuse and neglect and Obsessive Compulsive Personality Traits. ("Child Abuse and Neglect and Obsessive-Compulsive Personality Traits: Effect of Attachment, Intolerance of Uncertainty, and Metacognition")
A child who is being abused might conclude that uncertainty = danger and certainty = safety. This belief can help them stay on guard in an unsafe environment. In adulthood, this unconscious belief causes many problems.
CASE STUDY: PERFECTIONISM AND TRAUMA
This case study illustrates how perfectionism can be a risk factor for PTSD. “Kate describes herself before the sexual assault as being a perfectionist...and she had always excelled in her studies and work. After the trauma she reported significant rumination over the event, focusing on why it should have happened to her, what she should have done differently, and feeling like a failure for not having done something different to avoid the attack.
"Kate also reported feeling that she had failed to meet her standards of being in control of her life and her emotional states, saying she viewed the PTSD symptoms she was experiencing as a sign of her failure to be strong and in control, and that she should cope better. She said she was also feeling like a failure at work, performing below her standards as she was spending a lot of time ruminating over the trauma and feeling anxious.” (“The Relationship Between Perfectionism And Rumination In Posttraumatic Stress Disorder,” Behavioural and Cognitive Psychotherapy, pg. 6)
"If you're raised in a burning house, you think the whole world is on fire." Anonymous
I just finished Jeffrey Lieberman's book about the history of psychiatry. He's a former Head of the American Psychiatric Association, the organization that publishes The Diagnostic and Statistical Manual of Mental Disorders (DSM V)--the reference book for mental health providers in the U.S.
Dr. Lieberman wrote about the seven year process of revising the DSM for the 5th edition, published in 2013. Patient advocacy groups used the internet to lobby for the process to be more transparent to the general public. See the reply for the current diagnostic criteria.
The name of OCPD needs to be changed to distinguish it from OCD. Misdiagnosis is a major issue, and clinical obsessions are not a symptom of OCPD.
HOARDING
Hoarding is not a common trait of people with OCPD. Because people tend to question their OCPD diagnosis when they don't have all eight symptoms, I think hoarding should be removed.
People with OCPD could have a co-morbid diagnosis of hoarding disorder.
DIMENSIONAL VIEW
Changing from the categorical view of personality disorders to the dimensional view would be an excellent update but it's probably a long shot. I think this issue was debated and voted down for the DSM V. Debate About Personality Disorders Among Professionals
EXCESSIVE DOUBT AND CAUTION
Outside the U.S., mental health providers often use the International Classification of Diseases (ICD-10). The ICD lists "excessive doubt and caution" as a symptom of OCPD (called Anankastic Personality Disorder).
Excessive doubt and caution is a common characteristic of people with OCPD. Dr. Megan Neff believes that the core feature of OCPD is “an ever-looming sense of impending failure, where individuals constantly anticipate things going wrong, a flaw being exposed, or a profound loss of control. [It causes frequent] self-doubt, doubt of others, and doubt of the world at large..."
DEMAND-SENSITIVITY AND DEMAND-RESISTANCE
Demand-sensitivity and demand-resistance could be listed as a new symptom. In Too Perfect (1992), Dr. Allan Mallinger observes that OCPD causes a “special sensitivity to perceived demands or expectations…[Many of my clients are] sensitive to demands, either real or imagined…[and have a] tendency to ‘hear’ demands or expectations in an exaggerated way...[They are often very] attuned to unstated obligations hearing them as if they were shouted through a bullhorn...
"Demand-resistance is a chronic and automatic negative inner response to the perception of pressure, expectations, or demands (from within or without).”
Dr. Mallinger has provided therapy to people with OCPD for 50 years; he created the terms demand-sensitivity and demand-resistance after observing these issues in many clients with OCPD.
What changes to the OCPD criteria would you like to see in the sixth edition of the DSM?
i brought up ocpd and ocpd recently with my therapist (who specializes in adult autism (why im seeing them) and ocpd (which i learned at the end of this appointment) while there is a lot of overlap with ocpd and autism in the outward presentation, my therapist does think it's likely i have ocpd. but something they brought up when discussing the symptoms was that a lot of the symptoms i have are overshadowed by my people pleasing tendencies (that im working on)
i was wondering if anyone else has experienced this, or or have any insight to how people pleasing affects how ocpd presents?
or navigating trying to stop people pleasing while treating ocpd?
i often think about what the ideal life and the ideal character for a human is and try to manifest it as best i can in my own imperfect real life. it helps guide my actions in a constructive way. does anyone else do this?
Government agencies, companies, banks, and even McDonald's. Everywhere you look, there's stupidity, inefficiency, and pure waste. Lazy, stupid people who don't give a fuck about their profession.
Here are just a few examples:
Bank: "No, we can't reach out to you when we have a better offer. That would take too much time."
McDonald's: We mark your order as completed and remove it from the screen a second later, while a huge group of people is still standing around waiting for their orders. Is the system broken? No, you just want to make your stupid KPIs look better.
Domain broker with 10 million domains: "No, we can't issue a receipt with a date that matches when you purchased the service. Instead, we issue all receipts with today's date. It doesn't matter what the IRS says. It's technically impossible."
Police: "No, we can't display caller ID when we call you. That's technically impossible." Meanwhile, an impostor can spoof caller ID to display any number they want.
The level of stupidity, inefficiency, and complete lack of care for even the most basic things in 2026 is terrifying.
A woman stopped her car out front of my house, got out, and threw a bag of trash into my trash can (it was trash day so it was out on the curb). I IMMEDIATELY opened my window and yelled ‘girl use your own trash can!’ And as soon as I closed that window, I said out loud to myself ‘WHY DID YOU DO THAT BITCH’. I’m always moaning about how people litter and here’s my ass telling someone to not use mine!!! Like who the hell cares!! UGH my OCPD was just like ‘tHaT’S nOT hEr tRAsH CaN’ and I couldn’t help myself but tell her. Truly one of my most shameful moments of my life!!
It sucks when you think that your OCPD is only hurting yourself (I know that’s not great but I’d hate it to affect other people) and then something like this happens. UGHHHH I feel guilt so deeply and I really don’t want her to feel like everyone is an asshole and strangers are dicks.
Anyone with both diagnoses, any suggestions of tools/strategies that have helped or anything that has made things worse? I got on ADHD meds almost 2 years ago, and though my ADHD has improved in many ways since then (mainly academic functioning), my OCPD symptoms have become a lot worse.
Also, I know we are not allowed to give medication advice (I will consult my doc first!!), but anecdotally, are there any adhd medications that folks have found better at not worsening OCPD? (if this is not allowed, mods lmk and I'll remove it from the post).
hey everyone. could really use some honest perspective from people who deal with rigid perfectionism and the exhausting need to control their physical environment.
every time an object in my room gets even slightly damaged—an accidental water mark on the white drywall, a tiny scratch on my wooden desk finish, a small scuff—my brain treats it like an intolerable violation of order.
it’s not just that it looks bad. it feels like a heavy, suffocating internal rage and distress. my mind goes into this rigid overdrive: "this shouldn't have happened, this space is ruined now, i have to restore it to factory-clean perfection immediately or i can't rest."
i waste hours taking photos under different lights to inspect the damage, pacing around the room, obsessively researching repair techniques, and getting furious at myself for letting reality leave a mark. it completely paralyzes my day. i have critical civil service exams in a few days and i'm literally burning study sessions because my brain refuses to accept that a wall can just be stained and life goes on.
rationally i understand that demanding eternal, pristine condition from physical matter is pure madness. things decay, surfaces get scratched, everyday life leaves scars. but my nervous system reacts as if tolerating the flaw makes me sloppy, weak, or out of control.
for those of you who managed to soften this kind of OCPD rigidity: how do you force yourself to leave the mark alone? how do you stop the endless inspections and accept that an imperfect, damaged room is still a completely functional space to live in?
really need some grounded advice on breaking this cycle.
Hey guys after being on sertraline for 4 months, last full month at 200mg, I had to change my brand. I was somewhere out and couldn't get the same brand.
After taking the medicine i started to feel dizzy, brainzaps all day long and I lost my sleep. Can't sleep more than 4 hrs a day and my sleep has become light. I feel like my mind is dragging me and my body on the floor towards anything but try to sleep. I have also started to wake up in the middle of night terrified for no apparent reason.
The brainzaps have declined quite a lot now which is a relief.
I have an appointment in 3 days and I am getting worse. It has been 10 days and it is going downhill.
One good thing is I am a bit calm and have space to process things. Yes even after being sleep deprived. If someone has any insight or experience please consider helping. 🙏🏻
Currently finishing university. I enjoy my subject area but my brain ruins things, especially big research projects and makes them hellish.
I kinda yearn to "give up" and switch to some simple non-"academic" job where its hands on and doesn't require a lot of thinking so my obsessiveness can't ruin it. I'm gonna try and get some help but sometimes I dream of getting a job like that after I graduate, even if just temporarily.
I’ll start off by saying I know this comes from growing up in an abusive household & how that shaped my thinking patterns into OCPD. I learned very early on that I would experience consequences for doing things wrong. Dropping the ball, lying, having an attitude, etc. Anything I could do wrong very well could and would likely have a negative punishment of some kind, whether that be emotional, physical, etc.
As I’ve grown into an adult who can choose who I spend my time around, I’ve realized there’s obviously much less that most normal non-abusive people can actually do whenever someone does something wrong. Unless an actual crime is committed, there’s not really any recourse except for telling someone “I didn’t like that”, which sometimes can lead to changed behavior, but can also lead to someone shrugging it off and never doing anything differently.
That all being said, I am dumbfounded and pretty enraged that I hold myself to an insanely high standard (out of fear of The Consequences) and others might not and there’s just… nothing that happens, because The Consequences aren’t usually real in day to day life. People get away with some annoying, cruel, inadequate, and so many other things with little to no recourse other than someone maybe telling them “I don’t like that” and them having the free will to shrug it off.
Does anyone else struggle with this? How do I redirect this anger?
I suppressed my feelings for decades before receiving treatment for OCPD and trauma. I had no idea that I had a problem because my abusers and sister suppressed their feelings too. The unspoken rule in my childhood home was to repress feelings and focus on achievement. I joke that I'm a recovering thinkaholic. I started to work on increasing awareness of my feelings by paying attention to my body sensations (e.g. breathing, tension). Keeping anaudio journalhas helped with maintaining my progress.
From Running On Empty: Overcome Your Childhood Emotional Neglect (2019), Jonice Webb, Chritine Musello:
Understanding The Purpose and Value of Your Emotions (pgs. 120-22)
“Neuroscientists have studied extensively the evolutionary development of the human brain. For humans, the ability to feel emotion evolved millions of years before the ability to think. Human emotions originate in the limbic system, which is buried deep below the cerebral cortex, the section of the brain where thought originates. In this way, our feelings are a more basic part of who we are than our thoughts…Our emotions cannot be erased, and will not be denied, any more than we can erase or deny our hunger or thirst.”
“For every emotion, there is a purpose. Emotions are incredibly useful tools to help us adapt, survive, and thrive. People who were emotionally neglected were trained to try to erase, deny, push underground…this invaluable built-in feedback system. Because they are not listening to their emotions, they are operating at a disadvantage from the rest of us. Pushing away this vital source of information makes you vulnerable...” (122)
“Sometimes, especially to emotionally neglected people, emotions feel like a burden…[but] emotion is necessary for survival. Emotions tell us when we are in danger, when to run, when to fight and what is worth fighting for. Emotions are our body’s way of communicating with us and driving us to do things.”
Emotion
Function
disgust
tells us to avoid something
fear
tells us to escape/self-preservation
anger
pushes us to fight back/self-protection
love
drives us to care for spouse, children, others
passion
drives us to procreate, create and invent
hurt
pushes us to correct a situation
sadness
tells us we are losing something important
compassion
pushes us to help others
DON'T BLAME THE MESSENGER
In the video "The Myth of Perfect Regulation," Heidi Priebe suggests that viewers ask themselves, “Do I know how to listen to my emotions as messengers even when they are telling me something I don't want to hear?”
My feelings provide valuable information about my needs and circumstances. I no longer view uncomfortable feelings as a ‘problem.’ Instead, I view them as possibly indicating issues that need to be addressed. If I fully experience them (instead of overthinking), I’m more likely to make healthy decisions.
Two things can be true. I don’t want this feeling. It’s telling me something important. Experiencing uncomfortable feelings isn’t a problem; the situations provoking those feelings may be problematic.
BENEFITS OF LABELING FEELINGS
Studies indicate that habitually labeling feelings has a positive impact on mental health. Dr. Dan Siegel created the phrase "name it to tame it" to refer to how labeling feelings promotes emotional regulation. Neuroimaging studies show that labeling emotions reduces activity in the amygdala, resulting in a calming effect.
From Atlas of the Heart (2021), Brene Brown:
“Language is our portal to meaning-making, connection, healing, learning, and self-awareness. Gaining access to the right words can open up entire universes. When we don’t have the language to talk about what we’re experiencing, our ability to make sense of what’s happening and share it with others is severely limited. Without accurate language, we struggle to get the help we need, we don’t always regulate or manage our emotions and experiences in a way that allows us to move through them productively, and our self-awareness is diminished.” (xxi)
BEING PRESENT WITH FEELINGS
From Gary Trosclair's The Healthy Compulsive (2020):
“Avoiding feelings…cuts you off from a source of direction and wisdom. Each of these feelings can serve as a warning sign that something is out of balance.” (65)
“To move toward the healthier end of the compulsive spectrum, you will need to stop avoiding emotions with busy-ness and instead allow them to flow into consciousness. Once you’re aware of what you’re feeling, you can decide how to respond to it. If you don’t, you’ll be driven by forces you aren’t aware of. Emotions are a necessary element in change...
"While it is true for everyone that avoiding feelings can make the feelings more disturbing, people who suffer from OCPD are particularly prone to a cycle of negative emotions…if they don’t slow down to deal with them…People who are driven have energy and a capacity for intense work that give them a way to avoid their feelings that’s socially sanctioned and rewarded. Avoiding emotions may seem beneficial at first, but over time it can lead to a rut of anger, disappointment, and cynicism.
"But what does it mean to listen to feelings? It means to allow the feeling to rise into consciousness long enough to really experience it, to understand what’s bothering you, to develop the capacity to tolerate the feeling, and to see if there is anything to learn from it…For most compulsives, this will need to be deliberate; you’re likely to rush into doing rather than feeling, and consequently you miss both disturbing and positive feelings.” (59-60)
WORRY VS. ANXIETY
People sometimes worry to reduce their anxiety. They distract themselves from distressing mental images, and physical sensations caused by anxiety. In How To Be Enough (2024), Dr. Ellen Hendriksen explains that “worry and rumination are cognitive methods of engaging with emotion that keep us in an abstract, intellectual, verbal headspace in an attempt to control and avoid the physiological activation of anxiety. Worry and rumination might feel bad…[but] anxiety feels worse.” (226)
Dr. Dan Siegel created the phrase "name it to tame it" to refer to how labeling feelings promotes emotional regulation. Neuroimaging studies show that labeling emotions reduces activity in the amygdala, resulting in a calming effect.
“What you resist not only persists, but will grow in size.” “The only way out is through.” Carl Jung
HEALTHY PERSPECTIVES ON EMOTIONS
From The DBT Skills Handbook (2025), Marsha Linehan, pg. 40
-Emotions are neither good or bad, right or wrong. Feelings just ARE. They exist. It is not helpful to judge your emotions.
-There is a difference between having an emotion and doing something or acting on the emotion.
-Emotions don’t last forever. No matter what you’re feeling, eventually, it will lift and another emotion will take it’s place.
-When a strong emotion comes, you do not have to act on your feeling. All you need to do is recognize the emotion and feel it.
-Emotions are not facts. When emotions are very powerful they feel just like “the truth”.
-You cannot get rid of emotions because they serve important survival functions. Be willing to radically accept your emotions as they arise.
CONSEQUENCES OF HABITUALLY SUPPRESSING EMOTIONS
From Running On Empty: Overcome Your Childhood Emotional Neglect (2019), Jonice Webb, Christine Musello, pg. 123:
“Emotions can do a variety of interesting things when they are pushed underground or ignored. They can:
-turn into depression, causing problems with eating, sleep, memory, concentration, or social isolation
-sap your energy
-cause you to explode at random times, or blow up ‘over nothing’
-aggravate anxiety and/or panic attacks
-keep your relationships and friendships superficial and lacking in depth
-make you feel empty and unfulfilled
-cause you to question the purpose and value of your own life
OCPD AND BEHAVIORS THAT SUPPRESS EMOTIONS
People with OCPD have a higher than average rate of substance use and other numbing behaviors.
In The Healthy Compulsive (2020), Gary Trosclair noted that people with OCPD “are particularly vulnerable to becoming addicted to the use of computers, tablets, mobile phones, and the internet. Because you’re capable of shutting everything else out and focusing intently, and because you feel the need to be thorough, without realizing it you may become more attached to devices than to people or other sources of gratification.
"You may think that you’re doing something for your own sake, but instead you’ve entered a trance and gotten sucked into something you hadn’t intended to. Your never-ending quest for completion and solutions may lead you to check out every web page on the internet that …Because you may intensely seek answers or solutions, the internet can grab your attention and never let it go.” (109-10)
SUPPRESSION OF POSITIVE FEELINGS
“That’s the thing about pain, it demands to be felt." John Green
“The longest journey you’ll ever make is the journey from the head to the heart.” Lissa Rankin
Brene Brown explains, "We cannot selectively numb emotions. When we numb the painful emotions, we also numb the positive emotions. Studies show that suppressing emotions doesn't actually get rid of them. It just stores them in the body. When we refuse to process sadness, it often resurfaces as anxiety, stress, even physical pain…I'd rather face my emotions on my own terms than let them ambush me down the road…When we refuse to let ourselves hurt, we refuse to let ourselves heal.”
In The Pursuit of Perfect (2009), Dr. Tal Ben-Shahar explains that “when we do not allow ourselves to experience painful emotions, we limit our capacity for happiness. All our feelings flow along the same emotional pipeline, so when we block painful emotions, we are also indirectly blocking pleasurable ones. And these painful emotions only expand and intensify when they aren’t released. When they finally break through—and they eventually do break through in one way or another—they overwhelm us” (xvii)
METAPHORS
Some people conceptualize their thoughts and feelings as weather to remind themselves they are temporary and can be observed without judgment. People who meditate sometimes visualize themselves as a mountain and view their thoughts as clouds passing by.
In Cognitive-Behavioral Treatment of Borderline Personality Disorder (1993), Marsha Linehan states that “borderline patients are so fearful of emotions, especially negative ones, that they try to avoid them by blocking their experience of the emotions. That is, they avoid emotional cues and inhibit the experience of emotions; thus, they have no opportunity to learn that when unfettered, emotions come and go…like waves of water coming in from the sea onto the beach.
"Left alone, the water comes in and goes out. The emotion-phonic patient tries to keep the waves from coming in by building a wall, but instead of keeping the water out, the wall actually traps the water inside the walls [intensifying the feelings]. Taking down the wall is the solution.” (345)
I took very small, consistent steps to "lower the wall" that suppressed my feelings. I think of suppressing feelings like putting a lid on a pot of boiling water; it only make the water hotter.
