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Effective treatment for clinical perfectionism & obsessive compulsive personality disorder (OCPD)?

DesperateForChange
Community Member

Hi all,

Has anyone here been treated for Obsessive Compulsive Personality Disorder and/or clinical perfectionism? And can you please share what modalities/interventions were effective for you?

I appear to need a great amount of order and do not tolerate uncertainty well. This is most pronounced when it comes to making decisions, large or small. I engage in copious amounts of research (hours or days on end), deliberate for ages and eventually avoid choosing. If possible, I try to get someone else to choose for me. I appear to be very fearful of making the wrong choice/not "getting it right". Unfortunately, this is having a massive impact on my day-to-day living, but more generally, it is inhibiting me from living a more adventurous and experience-rich life.

If there's anyone out there who has suffered from the same problem, can you please share:

1. What modalities worked for you? I have tried Cognitive Therapy with limited results. Whilst i can come up with cognitive challenges, they don't seem sufficient enough to overcome the dread/fear that I feel when faced with a decision.

2. Do you know of a psychologist who specializes in OCPD and perfectionism? I am in the process of looking for a psychologist but have found the process to be extremely difficult.

Thanks in advance (constructive answers appreciated).

3 Replies 3

JessF
Valued Contributor
Valued Contributor
Hello Desperate For Change, I have found that acceptance and commitment therapy (ACT) has been of most benefit to me. Sometimes cognitive challenging can be a bit like a cat chasing its own tail I have found. At some point you can get so caught up in the challenging that you aren't actually doing anything, which it sounds like might be a problem for you... hours and hours weighing up the pros and cons, and then not coming to a decision.

Another one that I have found helpful is something called behavioural activation, although I understand this is more for depression rather than anxiety based problems. It could potnetially still be something that works to short circuit your procrastination, though. For example, you might try using it to give yourself deadlines for decisions on specific things. When the deadline comes, if you haven't decided on a choice, then you make a choice at random. The important thing is to make the decision. Then afterwards, you can evaluate how it went.

Another thought on the cognitive challenges, it may be that if you can't get them to stick that you aren't asking yourself the right questions. For example, one that comes to mind from your post is around this idea of being fearful of not getting a decision right. Have you tried brainstorming the worst case scenario of a wrong choice as part of yoru cognitive challenges? Sometimes when writing these out you can find that your fears are not as great as they seemed in your head.

Hi Jess,

Thanks for your suggestions. Behavioural activation sounds like a good idea. I also think exposure therapy (which I hear is used for phobias) could also help. I think I just need to practice making 'uninformed' choices so that I can learn, through experience, that the world does not end and that even if the outcome is not ideal, I can still make it work. I do need to find a psychologist/counsellor/social worker to help me set up and engage in these experiential learning exercises though, as I am sure that I lack the strength to sit with the anxiety and follow through.

Re: cognitive challenges, I believe I've been asking myself the right questions ("what's the worst that could happen" question is very salient for me) but it's interesting, because whilst I can come up with the right answer, or the answer I know a therapist would want to hear, I don't actually believe it at an intrinsic level. That is, I don't believe I could cope if the worst case scenario were to eventuate (a confidence issue perhaps). Something I'll only truly believe once I experience it to be true (bringing me back to experiential learning).

I read that we can create and strengthen new neural pathways but only through repetition and practice. I wish it wasn't so much hard work and comitment, though 😕 How I wish there was a switch I could flick instead. Factory settings restored!

Anyways, thanks again for your post, Jess and take care 🙂

LookingForHelp778
Community Member
Hi DesperateForChange I was wondering if you managed to find any help and what worked for you?

I was diagnosed with GAD over 10 years ago, but have recently come to realise I'm probably suffering from OCPD. Your experience sounds very familiar! Next week I'm going back to see the same psych I worked with a couple of years ago. She uses a psychodynamic approach which helped me with the GAD and I've read it's helpful with OCPD also.