Treatment options & Self Help for OCPD: How effective is CBT?

A Quick Guide

Obsessive Compulsive Personality Disorder OCPD is characterized by perfectionism, rigidity and stubbornness, and miserliness. There are different treatment options for OCPD that range from therapies like CBT to medications. In this article, we will discuss the treatment in great detail along with the effectiveness of CBT for OCPD.

Understanding OCPD

According to DSM-IV-TR, it is diagnosed as such. Starting by early adulthood and present in a range of circumstances, people exhibit a persistent pattern of obsession with orderliness, perfectionism, and cognitive and interpersonal control, at the cost of flexibility, openness, and efficiency, as demonstrated by four (or more) of the following:

• Demonstrates rigidity and obstinacy.
• Excessive perfectionism gets in the way of finishing tasks, such as when one is unable to finish a project because one’s own excessively high standards are not satisfied.
• Is hesitant to assign responsibilities to others or to collaborate with them unless they completely conform to their way of doing things.
• Is so focused on specifics, guidelines, checklists, order, structure, or timetables that the main purpose of the activity is overlooked.
• Is too focused on efficiency and work, to the exclusion of social life and friendships that are not justified by a clear economic need.
• Is very conscientious, meticulous, and rigid in regard to moral, ethical, or value considerations that are unrelated to one’s culture or religion.
• Refuses to throw away shabby or useless items, even if they have little sentimental value.
• Takes a conservative spending attitude towards both oneself and others; money is seen as something that should be saved for emergencies in the future.

Treatment options for OCPD

There is still a lack of strong evidence about the most effective therapies for OCPD, but counseling and medication may work together to lessen symptoms. Obsessive-compulsive personality disorder (OCPD) is generally challenging to treat, just like the other nine personality disorders. A medical expert does not treat a transient mental state or a passing collection of behaviors when treating personality disorders. Instead, they are addressing deep patterns that have persisted throughout a lifetime.

Don’t give up despite the difficulty of the situation. There are OCPD treatments available to control the symptoms. One can effectively manage OCPD by being aware of the condition and possible treatments.

Therapy for OCPD

There are a number of things to take into account while selecting a therapeutic approach for OCPD:

• Is it evidence-based, which means that it is backed up by scientific findings?
• Is it accessible where I reside?
• Does it fit into my budget and schedule and suit my way of life?

It is significant to highlight that little study has been done on the most effective therapies for OCPD. When a variety of therapy modalities are accessible, it might be more advantageous to prioritize the most crucial treatment targets (symptom reduction, improved relationships, and increased insight) to guide treatment choice:

• If there are problems with attachment and insight, psychodynamic therapy may be the best option.
• The most effective treatments for maladaptive behavioral and cognitive disorders may be cognitive therapies (CT) or cognitive behavioral therapy (CBT).
• If OCPD is hurting parent-child interactions or other interpersonal issues within the family, family-based therapy may be a useful alternative.
• If the main factor driving you to therapy is how OCPD is affecting your relationship, couples therapy can be more helpful.

Although the effectiveness and supporting data for each of these may differ, the effectiveness of the treatment and the patient’s motivation is frequently more crucial than the treatment method itself.

How effective is Cognitive Behavioral Therapy (CBT) for OCPD?

Although there isn’t a therapy designed expressly to treat OCPD, cognitive behavioral therapy CBT is the most extensively used and researched treatment for the condition. It is employed by therapists to address a variety of disorders related to substance abuse and mental health, such as addiction, depression, and anxiety.

To educate and assist clients in understanding the relationships between ideas, feelings, and behaviors, CBT practitioners take on the roles of both a teacher and a teammate. The therapist will assist the patient in identifying core beliefs and how they impact relationships and happiness during this process. CBT encourages self-awareness and autonomy while focusing on maladaptive thoughts, feelings, and actions so common in OCPD. It might accomplish this through sessions and assigned readings that emphasize coping skill development, emotion control, and cognitive reframing (alternative ways of thinking).

A person with OCPD could think that perfectionism is a virtue and that they need to control their surroundings and the people in them in order to succeed. A therapist can make an effort to highlight the shortcomings of this line of reasoning and offer alternatives.

The client may find it difficult to adopt the behaviors that were recommended by the therapist during a counseling session because they think their solutions are the only ones that will work. When the client is involved in the planning process and the plan has a clear, sequential structure, they are more likely to cooperate with it. The client is provided with the framework they are familiar with when the plan is organized and certain phases are prioritized over others.

How long does it typically take?

The length of treatment will be decided by the therapist based on the clinical severity and the patient’s desire to participate in treatment planning; however, most patients can anticipate a minimum of 10 one-hour sessions. Because of the persistent aspect of disordered personality versus the largely behavioral features of OCD, treatment for OCPD often lasts longer than treatment for Obsessive Compulsive Disorder (OCD). While some studies indicate that CBT is helpful for OCPD, other studies reveal no benefits from the mode of treatment.

Additional forms of treatment for OCPD

Psychodynamic Therapy 

Psychodynamic therapy is based on psychoanalysis and transference-focused treatment principles. By analyzing unconscious thoughts, psychodynamic therapy aims to assist patients in appreciating the relationship between recent experiences and their feelings and behavior.

This strategy is appropriate in terms of OCPD. According to experts, the urge for control and perfectionism stems from a desire for acceptance or attention from absent or harsh parents. This connection could be used to bring about the required modification.

People need an understanding of their conditions, according to psychodynamic therapy, for growth to happen. The issue is that people with OCPD frequently lack insight and frequently place blame on others rather than accepting accountability for their actions. This obstacle might make treatment difficult. Although studies have not demonstrated psychodynamic therapy’s efficacy for OCPD, therapists continue to frequently suggest it.

Radically Open DBT, also known as dialectical behavioral therapy (DBT)

By emphasizing both acceptance and change, dialectical behavioral therapy (DBT) was devised to outperform cognitive behavioral therapy (CBT) for OCPD. It has been discovered that a particular form of DBT termed Radically Open DBT (RO DBT) is useful for treating OCPD. While RO DBT is better suited for treating over-controlled behaviors and disorders like anorexia and OCPD. Traditional DBT focuses on under-controlled symptoms such as excessive dysregulated emotions and behaviors (like substance use issues or overeating).

The characteristics of RO DBT include encouraging openness, flexibility (in ideas and actions), and enhancing interpersonal relationships as well as social signaling, such as expressing genuine feelings to foster better relationships.

Even though there has only been a small amount of research done, one study revealed that RO DBT was successful in treating OCPD symptoms. Hence, giving it a promising alternative for future investigation and clinical intervention. 30 weeks of weekly individual and group sessions make up most RO DBT therapies.

Other Therapy Options

When getting help for OCPD, you can also try the following therapies:

• For many personality disorders, schema therapy has been demonstrated to be an effective treatment.
• Interpersonal Therapy (ITS) is a systematic, time-limited technique with the goal of resolving interpersonal conflict.
• Relationship dynamics may be improved by family therapy and/or couples psychotherapy.
• Instead of trying to alter a person’s internal makeup, nidotherapy aims to alter their environment.

It is possible to practice relaxation and mindfulness techniques independently or as part of an established treatment.

Medications for OCPD

Although doctors and researchers have tried a variety of drugs, such as benzodiazepines, stimulants, and antipsychotics, to reduce the symptoms of OCPD, no one kind of medication has demonstrated particularly high success.

Antidepressants and anticonvulsants may currently be most helpful, according to doctors. These drugs may be used either temporarily to treat depression and high-stress symptoms or permanently to maintain long-lasting improvements.

Finding a physician with experience treating OCPD is necessary because there are no particular drugs created to treat the disorder. The course of treatment may include a lot of trial and error.

Selective Serotonin Reuptake Inhibitors SSRIs

In order to boost the amount of this “feel good” neurotransmitter in the brain, SSRIs, a subclass of antidepressants, work to decrease the uptake of serotonin. This might benefit people with OCPD who also struggle with rigidity and over-attention to detail as well as their co-occurring anxiety and depression.

According to some research, SSRIs are the most efficient drug therapy and, when combined with CBT, can be the most efficient treatment plan for OCPD. The findings in support of particular treatments are mainly based on uncontrolled trials, literature reviews, and case studies where causality cannot be clearly established. However, it is crucial to keep in mind that research on OCPD is scarce. Fluoxetine (Prozac) and paroxetine (Paxil) are two examples of SSRIs that are frequently used for OCPD.

Benzodiazepines

A class of medications known as benzodiazepines is typically used to treat anxiety disorders. But they can also be used to treat other illnesses like insomnia and seizures. By affecting brain neurotransmitters, benzodiazepines attempt to lower nervous system activity. Although the drug’s exact process is not fully understood, one neurotransmitter that it boosts is GABA, which reduces activity in the nervous system.

Due to their addictive qualities and withdrawal symptoms, benzodiazepines have recently lost support from healthcare professionals. However, they are successful in lowering anxiety symptoms in 70 to 80 percent of people. This medicine is useful in reducing symptoms for those with OCPD who also feel anxiety. And it may also lessen agitation and the need to exert excessive control by promoting relaxation.

Anticonvulsants

Anticonvulsants are frequently administered to people with OCPD, especially those who tend to be irritable, hostile, or angry. It is common knowledge that several anti-convulsants have the ability to stabilize mood. When someone cannot maintain control over a situation or their environment or when others do not live up to their high expectations, they may experience this negative mood state.

According to the limited evidence we have thus far, anticonvulsants and antidepressants are the most effective drugs for treating OCPD. Sodium valproate and divalproex sodium are additional anticonvulsants besides carbamazepine that have been shown to be effective in treating OCPD. Ask your doctor about the advantages and disadvantages of anti-convulsant treatment. That way you can determine if it would be the appropriate medication for your OCPD symptoms.

Other Medications

The following other, less frequently prescribed drugs can be used to treat OCPD:

• When an antidepressant has had little to no effect, antipsychotic drugs like risperidone, haloperidol, or olanzapine may be taken in combination with SSRIs.
• When previous drugs have failed to control an individual’s mood, lithium may be administered to treat both OCPD and bipolar disorder.
• In some studies, stimulant medicines have been proven to lessen the symptoms of OCPD and can treat comorbid ADHD symptoms.

Alternative Treatments for OCPD

People are looking towards novel treatments for OCPD due to the lack of effectiveness that has been seen with conventional kinds of therapy. Nidotherapy and relaxation therapy are two complementary therapies that are actively being researched.

Relaxation

Many different relaxation methods can be beneficial for controlling the stress and tension brought on by OCPD. Some helpful techniques for relaxation include:

• Autogenic training
• Deep breathing
• Meditation
• Progressive muscle relaxation
• Yoga

For a few weeks, put these strategies into action. These methods can reduce stress and make challenging circumstances more tolerable with consistency and patience.

Nidotherapy

Nidotherapy, a more recent type of therapy, is not therapy in the conventional sense. It alters the environment to fit the person rather than attempting to alter the person to fit the environment.

Nidotherapy won’t make an effort to lessen a person’s need for control or perfectionism. It aims to place the person in a position where their personality traits are advantages rather than disadvantages. Nidotherapy is a relatively new form of therapy that has not undergone adequate testing or research, as was previously indicated. However, for some people, particularly those with personality problems, this type of therapy may have positive outcomes.

Self-Help

Given the ambiguity around professional OCPD treatment, a person may be tempted to look into self-help approaches. Self-help makes use of a person’s motivation and drives for change to produce results. Reading OCPD-related books, putting an emphasis on personal development, or joining live or virtual support groups for OCPD are all examples of self-help.

Self-help is an excellent choice. In the process, a person can still depend on a reliable support system. This behavior might strengthen bonds and enhance one’s emotional well-being.

Changing one’s way of life can frequently have a significant impact on one’s mental functioning and health. An individual will feel better and have more fun in life if they make changes to their exercise and food as well as their resilience and flexible coping abilities. Additionally, a crucial first step in receiving treatment for OCPD is being self-motivated and realizing that you need support.

There are methods for managing your condition at home. You can apply them on a regular basis to reduce symptoms and distress. These can be used alone or in combination with an already-established treatment plan. Before putting self-help techniques into practice on your own, it is usually advisable to discuss them with your provider.

Lifestyle Modifications

The following are some lifestyle modifications and self-help practices that may help reduce the symptoms of OCPD and improve general wellness:

• Choosing treatment values and objectives.
• Consuming a balanced diet.
• Establishing a network of support.
• Getting adequate sleep.
• Getting regular exercise.
• Pursuing medical and psychological therapy.
• Using mindfulness and relaxation practices.

We hope you found this article useful in learning more about treatment options for OCPD along with Cognitive Behavioral Therapy CBT.