My opinion for talking to a partner with OCPD traits about their mental health:

- Consult with a therapist about how best to speak with your spouse about therapy.

- Plan what you want to say in advance. Take notes. Do role plays with a therapist or friend.

- Have short, ongoing conversations. Pick your battles--one or two issues to discuss. Attempting to discuss many issues will likely lead your partner to be more defensive.

- Express curiosity (e.g. I'm wondering...., It seems like..., I've noticed...) and concern (e.g. about their stress level) about your partner's mental health, rather than making assumptions or accusations.

- Approach the conversation as the two of you working to manage a problem, rather than opposing each other.

- Use "I" statements whenever possible, rather than "you" statements.

- If they are open to receiving a resource about childhood trauma, Dr. Jonice Webb's Running on Empty--a book about emotional neglect--might be helpful. It's an excellent book, and not a "heavy" read, compared to other books on trauma.

- Mention to your partner that therapy is not a lifetime sentence. Short-term therapy can be helpful. For example, most people lose their PTSD diagnosis after three months of therapy.

- Recognize that many perfectionists have anxiety and fear about confiding in mental health providers. This post may be helpful in illustrating the anxiety that someone with OCPD may feel about seeing a therapist for the first time: need help understanding the experience of getting diagnosed

I would suggest refraining from:

- Surprising your partner This will likely make them more defensive. Give them advance notice that you want to have a difficult conversation.

- Making direct and indirect negative remarks about their character. I agree with Kirk Honda that OCPD is a "shame based disorder." Try to describe their difficult behavior in objective terms.

- Using the words "always" and "never" when describing their difficult behavior.

My general advice would be to refrain from telling partners that you think they have a personality disorder. The stigma is extremely high. There is no standard treatment protocol for OCPD. Therapy for perfectionism and therapy for OCPD are essentially the same. Showing your partner r/Perfectionism may be helpful in helping them understand their perfectionism is a problem. The description of the group refers to OCD, OCPD, anxiety, and depression being associated with perfectionism.

An r/OCPD member recalls, “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.”

It's very unlikely that someone would respond positively to their partner telling them they may have a PD. Because of the stigma, the comment would likely be viewed as synonymous with, 'You are a bad person' and 'You are fundamentally flawed.'

What resources might be helpful to give to my partner with suspected OCPD or diagnosed OCPD?

Advice from The American Psychiatric Association: "Individuals with personality disorders are usually aware that their life is not going well. Approaching a friend about their painful feelings or the frustrations and disappointments in their life, and offering to listen, might be a way to help them consider treatment. If you have had a successful experience in therapy, share that with your friend...Most people with personality disorders enter treatment with another problem, such as depression, anxiety, substance use, a job loss, a romantic break-up, etc. The challenge is to get your friend [or loved one] “in the door,” so to speak, not to commit to long-term treatment at the beginning."

Dr. Anthony Pinto, the leading OCPD specialist, just did a fifth interview about OCPD on the "OCD Family" podcast. He suggested loved ones play a podcast episode about OCPD when they're in their car with their loved ones, and asking them if they relate to the content.

In The Healthy Compulsive (2020), Gary Trosclair states, “If your partner is reactive, defensive, or oversensitive, it’s best not to try to have a discussion when he or she is upset…Generally, if there is something you need to discuss, ‘strike while the iron is cold.’ Find a time when he or she is less upset to engage…If you can ask what he or she needs from you, and tell what you need from him or her when you’re both calm, you’ll probably get a more useful response.” (169)

Dr. Steven Hendlin, the author of When Good Enough Is Never Enough (1992) states, “One helpful fill-in-the-blank formula for expressing to the perfectionist how you feel is the following: “When you _______, I feel __. What I would like is for you to __.” (209)

Are You in Love With a Controlling Perfectionist? | Psychology Today has good descriptions of difficult relationships with partners with OCPD.

The article includes advice from psychologists Neil Lavender and Ian Cavaiola, author of the short book Impossible to Please (2012):

First of all, you need to recognize that you are not this defect laden person who they see you as. He is not some personality expert in human behaviors who is qualified to proclaim which of your personality traits and behaviors are acceptable and which isn’t. Sure, it's difficult to keep your self-esteem when the person you love is hammering away at you night and day. But this is no place for the faint hearted, so stand your ground and lose the idea that they are in any position to deem you worthy or not. Take a hard look at yourself and ask yourself the question "am I relying too much on this individual for my self-esteem? Am I an approval seeking people pleaser?" If you answer that question yes you will need to address your own issues before you go on to interact effectively with your controlling perfectionist.

Secondly keep in mind that their controlling and perfectionistic nature is not your responsibility. You didn't cause it. Moreover, you can't change them. And don't even think about curing them; you won't. Forget about trying to give them a "personality overhaul". Although these individuals can do very well in psychotherapy, therapeutic improvements usually take time and should best be handled by professionals well-trained in the treatment of personality disorders.

Also, bear in mind that the controlling perfectionist thinks they're normal and any attempt at telling them that they are critical will usually go nowhere. You'll find they usually respond by making such remarks as "listen, things are either right or they're wrong. Do you have something against doing things right? Isn't the world screwed up enough without one more person screwing it up even more?"

I cannot speak from experience about romantic relationships. Due to having an undiagnosed trauma disorder (dissociative amnesia) and CPTSD symptoms, I've never had a romantic relationship.

I agree with this advice from a member of r/LovedByOCPD:

-You need to get a therapist for yourself as soon as you can. Everything changed for me when I knew I had someone in my corner who understood and validated me. [I would add, find a therapist for your children].

-Journal these incidents in detail before you act. I found this immensely helpful for me to look at things objectively and see that it was not all my fault. Also good to have a record of things to avoid gaslighting if that’s happening. Make sure your records are honest and include the bits where you messed up as well, you grow that way.

-Make a deal with yourself that you will STOP apologising for things that are not your fault to keep the peace. This is hard, because it means you can’t make the conflict go away quickly, but things will NOT improve ever if you keep doing this.

-Learn to be okay with your partner’s being disregulated. That is their issue not yours. Have a plan for what you can do to self-soothe or protect yourself. Can you leave the room/house, go for a walk with the dog, get a coffee etc. If it goes on for a long time you will need a longer strategy.

-Have scripted responses in your pocket to respond to attacks and attempts to draw you in or elicit an apology. This is why journaling is good because you already have an objective understanding of why you don’t need to apologise. Eg ‘I am not going to be yelled at about X, if you keep yelling I will Y’. ‘I don’t see it that way, I’m happy to have a conversation about it when you are calmer.’ ‘I understand that you think (reflect what they said), but I don’t agree that that’s how it was.’

-Know that you can’t fix this person, be prepared to leave, you are not obligated in any way to put up with abuse. Don’t go to couples counselling IMO, unless they are in a place where they admit they are controlling and are doing their own work. YOU CAN LEAVE THEM. But you will need to address your own boundary issues regardless, otherwise you could end up back in the same position with another controller.

Gary Trosclair has worked as a therapist for more than 35 years. The Healthy Compulsive (2020) includes a chapter for partners of people with OCPD traits. Most of the chapter is a case study.

“People at the unhealthy end of the compulsive spectrum can be demanding, cold, punishing, angry, and critical…It’s very hard to live or work with someone who isn't aware of their condition and who’s convinced they’re right all the time…But with understanding, support, and their own work on their issues, compulsives can also make great partners: reliable, loyal, consistent, hardworking, and committed…Because you can’t coerce them into change, it often seems impossible to make any progress in improving the relationship.” (164-65)

“Unrealistic demands and criticism are the way he or she tries to cope with a disturbing inner world, not his or her essence. Think of that as an external layer of protection, a suit of armor covering someone who wants to do the right thing but is taken over by anxiety and insecurity…Even when he or she seems to have it all together, underneath he or she probably feels very vulnerable.” (167)

“Compulsives aren’t known for their communication skills. They don’t realize how they come across, and, because they’re often preoccupied with getting things done, they aren’t always aware of the impact they have on others…Their behavior communicates something that they don’t intend. That doesn’t mean they don’t care; in fact it could even mean that they’re consumed with doing something originally intended to help, but they’ve lost track of why they’re doing it and now they’re obsessed with completing the project. This certainly doesn’t justify their behavior, but if you interpret it as meaning that they don’t care, it will make matters worse.” (168)

“If your partner is reactive, defensive, or oversensitive, it’s best not to try to have a discussion when he or she is upset…Generally, if there is something you need to discuss, ‘strike while the iron is cold.’ Find a time when he or she is less upset to engage…If you can ask what he or she needs from you, and tell what you need from him or her when you’re both calm, you’ll probably get a more useful response.” (169)

Rationals “are the most self-directed and independent-minded of all the temperaments, and they resist (and resent) any and all forces that would coerce them into acting against their will…If Rationals detect in their mates’ messages…[a] suggestion of social or moral obligation—they will balk and refuse to cooperate, not only on significant matters such as tending the children, or saying ‘I love you,’ but also on seemingly trivial things such as cleaning up the kitchen, dressing for a party, or helping bring in the groceries. Their refusal might take some form of silent, passive resistance…On occasion, they might…go along in order to avoid a quarrel, but they allow their autonomy to be abridged only under duress, and with growing annoyance.” (244)

“Rationals are not at all comfortable with [emotions] and seek to take control of them…after all [freely expressing emotions] might lead to mistakes and inefficiency. [They often respond to emotions by] evaluating them and analyzing them, which effectively kills them…Analysis…is paralysis. The Rationals’ tight rein on their impulses…takes its toll on their marriages…” (244-45)

“Rationals show little sympathy with mates who look to the Rational to give them happiness orwholeness…Such people are sorely lacking in self-sufficiency, says the NT, and need to become whole in themselves, self-determined and self-possessed…Rationals are [loyal and supportive to their family and friends] only if there is no sign of dependency or game-playing in the needy person. If those close to them…try to make a crutch of the NT, or hope to extort sympathy with some overdone complaint, the NT will…refuse even to meet them half way [because of their strong belief that] no one can make you happy but yourself.” (245)

“Rationals tend not to own the behaviors of their mates as might those of other temperaments, and so do not feel they have the right to interfere with them…in the case of a quarrelsome mate, Rationals will usually not let themselves be hooked into the interpersonal battle, but will quietly step back and observe their mate’s curious, overwrought behavior, waiting for their anger to burn itself out. Unfortunately, such benign detachment often only feeds the fire, and Rationals, instead of being valued for their patience and self-control, are…accused of their mates of being aloof
and uncaring.” (245-46)

In 2014--long before I read about OCPD--I was shocked to read David Keirsey's Please Understand Me II (1998). His profile of the Rational Mastermind (INTJ) was the story of my life. The profile referred to many common characteristic sof people with OCPD.

Please Understand Me II has been translated into 20 languages. It has 1.4K reviews on Amazon.

Dr. Keirsey explains how temperament and personality type:

-contribute to beliefs, values, and core psychological needs

-impact relationships, school, work, and leisure, and

-impact one’s behavior as a friend, romantic partner, employee, employer, leader, student, teacher, child and parent.

Dr. Keirsey's description of how people with Rational temperaments tend to relate to their partners helped me understand my parents' marriage.

“Rationals spend much of their time absorbed in the abstract world of ideas, principles, theories, technologies, hypotheses…and the like. When they aren’t puzzling over a problem from work, they are studying other subjects…and this makes them often seem…oblivious to [their] homelife…[as if they’re] a million miles away even when sitting with their spouse in the living room. This is one of the major complaints of their mates: the NTs seem to direct exclusive attention to the world of theory…at the expense of giving sufficient attention to them.” (243)

“And yet, while Rationals might seem unaware of their mates and the domestic life around them, they are not indifferent…usually showing genuine interest when these people and events are brought to their attention...NTs don’t notice everyday reality…very well on their own…The problem is not that Rationals are cold and inhuman, but that they are by nature both abstract and highly focused, and have to be reminded to get their nose out of their books, their technical journals, their computer files—to get out of their heads—and join the family circle.” (243)

“But there’s the rub, because many husbands and wives feel humiliated having to ask their Rational mates to pay attention to them, or to give time to the family. They want their Rational mates to think of them and care about them of their own volition…They will wait with growing anger for the NT to offer interest or affection, and when this fails, they will accuse them of…indifference.” (243)

Bryan Robinson, a therapist who has specialized in work addiction for more than 30 years, wrote Chained to the Desk (2023, 4^th ed.). He is a recovering workaholic. The book has a short chapter for the partners of workaholics, and a chapter about the children of workaholics. Studies indicate that the children of workaholics have a similar rate of psychological difficulties as the children of alcoholics.

“If you’re a spouse or partner of a workaholic, chances are you…

-Feel ignored, neglected, shut out, unloved, and unappreciated because of your spouse’s physical and emotional remoteness

-Believe you’re carrying the emotional burden of the marriage and parenting, which makes you feel…alone in your relationship

-Think of yourself as second to work, because family time is a low priority, dictated by work schedules and demands

-Perceive yourself as an extension of your workaholic mate, whose addiction demands to be center stage

-View yourself as controlled, manipulated…by your partner, who calls the shots…

-View your relationship as serious and intense, with a minimum of carefree time or fun

-Harbor guilt for wanting more out of the relationship, while your partner is applauded by colleagues and society for accomplishments

-Have low self-esteem and feel defective, in some way unable to measure up to your spouse, who is often put on a pedestal…” (125)

Dr. Robinson encourages partners to set boundaries.

“Many partners and spouses build their lives around the workaholic because they want to feel connected and supportive…But as with any addiction, molding your life around a workaholic spouse only leads to disappointment and enabling. The key to avoid enabling, when you’re desperate to spend time with your workaholic partner, is to stop postponing your life. If you plan a trip to the zoo with the kids and the workaholic cancels (for the umpteenth time) because of last-minute demands at the office, go without her. When your workaholic promises to be home in time for dinner and never shows, consider eating on time without him and...let him fix his own meal.

You can refrain from such activities as…making alibis for her absenteeism or lateness at social functions or family gatherings, and let the workaholic take responsibility to explain. You can stop assuming your workaholic’s household duties…

Although it’s important for you to include your workaholic in your plans and let him know he was missed…you don’t have to continue putting your family’s lives on hold.” (130)

Dr. Allan Mallinger included a short chapter for loved ones in Too Perfect (1992). He has provided therapy to people with OCPD for 50 years. You can listen to Too Perfect with a free trial of Amazon Audible. Audiobook preview. The Spanish edition is La Obsesión Del Perfeccionismo (2010). The German edition is Keiner ist Perfekt (2003).

I highly recommend Dr. Mallinger's Substack; the articles have a lot of helpful information for loved ones.

“Obsessive behavior usually stems from deep-seated fears, and not from any malice toward you. Yet it’s easy to lose sight of this. If hardly a day passes without your spouse criticizing something you do, you may feel as if he or she regards you in a fairly dim light. Worse, you may start seeing yourself that way.

"Try to remember that your mate’s finely tuned sensors would find fault with even the saintliest, most infallible person...Remember that the obsessive's personality was formed long before he met you, and he would demonstrate this behavior with anyone…” (186)

“Most obsessives prize candor and honesty more than other people do.” (190)

“It’s tempting to feign agreement with some obsessive just to get them to stop badgering you. But this can backfire! Obsessives need to be able to feel they can trust you, either to say openly that you’re not going to comply [with their request]…or actually follow through on your word. Even in the smallest things, most obsessives respond dramatically to any evidence that they can’t trust you. They immediately wonder what other things you’ve been dishonest about. Can they believe you when you say you love them? Can they ever believe or trust that you’ll do what you agree to do? (191)

Dr. Mallinger encourages loved ones to refrain from being pressured by partners to disavow their own feelings and preferences. “Even if you can’t win a debate demonstrating the superiority of your position, you are still entitled to your own view. You should feel free to assert that right.

Unless you’re equally obsessive, you’re probably no match for an obsessive in a logical argument….But just because a course of action seems to be more efficient, practical, or logical to him or her, you still don’t have to choose it. Don’t be shamed or bullied into doing so. Practicality is only one criterion of worthiness. Other criteria are just as important, such as likes, dislikes, pleasure, and personal values. You have every right to your own preferences and your own way of doing things…when someone else is interfering with your enjoyment of life, you have the right to object, even if you can’t prove, logically, that their behavior is ‘wrong.’ “ (191)

 The Healthy Compulsive (2020) also has a short chapter for loved ones.

In Cognitive Therapy of the Personality Disorders (2004, 2^nd ed), Aaron Beck, et al. explain that therapy clients with PDs “may perceive alterations in ideas, beliefs, or behaviors as a direct threat to their personal identity. Although this may seem paradoxical, in that their thinking makes them anxious, depressed, suicidal, or generally dysfunctional, these patients fear becoming unkonwn to themselves. They often choose the familiarity of their discomfort, no matter how destructive, to the discomfort and uncertainty of a new mode of thought or behavior.” (99)

“One of the most important considerations in working with personality-disordered patents is to anticipate the anxiety that will be provoked by a therapeutic process that challenges their identity and sense of self. Although their schematic structure may be unrewarding and lonely, change means that such patients are in new territory, where the land is alien. They are being asked not just to change a single chain of behaviors…but rather to give up who they are and how they have defined themselves for many years, and across many contexts.” (7)

People with OCPD tend to be fiercely independent and guarded, feeling a responsibility to resolve their problems on their own and taking pride in doing so.

From “The Myth of Perfection: Perfectionism in the Obsessive Personality” (2009), Allan Mallinger, American Journal of Psychotherapy:

“Obsessive patients may experience their very presence in a therapist's office as evidence of a shameful failure of their own self-control, self-discipline, or strength of character. And they may dread and avoid any loss of composure, such as crying, anger, or visible anxiety, making it difficult for the therapist to elicit and explore emotions, an exploration essential for the development of empathic understanding basic to the therapeutic alliance.” (126)

“In other words, the therapeutic relationship is the antithesis of a comfortable environment for many perfectionists. Thus, it requires extraordinary courage and motivation for perfectionists to enter therapy and then to persist and move forward in spite of their anxiety. This progression also requires of the therapist an unwavering position of forbearance, empathic understanding, interest and patience, to facilitate an atmosphere of safety in which trust can develop, however slowly. While this therapist position is essential with every patient, it is especially so in working with perfectionists, many of whom struggle mightily with allowing themselves both the vulnerability and the fulfillment of intimacy.” (130)

My Opinion:

Studies indicate that the vast majority of people with PDs are trauma survivors. The therapist who led my trauma group explained that working on PDs is essential for making progress with trauma symptoms. I think it's unlikely someone with OCPD and a trauma history would make significant progress on their OCPD without working on their trauma.

Making the decision to work through trauma can feel like 'opening Pandora's Box.' It can take a very long time for people to feel ready to confront their trauma, and some people never reach this point.

VIDEOS

When Perfect Becomes Problematic (perfectionistic teenagers)

How to Help and Support Your Perfectionist Child

Perfectionism (psychological factors that influence achievement)

Perfectionism in Teenagers and the Mental Health Consequences

The Perfectionism Trap (psychologists talk about rise in perfectionism among children and teenagers)

Parenting Styles Contribute to Perfectionistic Kids

Why a Sense of Control is Key to Mental Health: How to Foster It in Kids

Helping Your Perfectionistic Child

Managing Anxiety & Perfectionism (gifted children)

The Self-Driven Child: The Science and Sense of Giving Your Kids More Control Over Their Lives

When Your Autistic Child Melts Down Over One Tiny Mistake   

Are We Pushing Kids To Be Perfectionists?

Parenting Teens For Connection Not Perfection

The Mental Health Implications of Perfectionism in American College Students

Managing the Invisible Load (perfectionism in parents)

ARTICLE

Tips for helping young children with perfectionism

ONLINE CLASSES

Dr. Alan Kazdin is the Director of the Yale Parenting Center. He has published 750 articles and 50 books. He served as the 2008 President of the American Psychological Association, and earned the APA’s Lifetime Contribution Award. His free online class: Everyday Parenting: The ABCs of Child Rearing.

Workshops with Julie King, author How To Talk So Kids Will Listen series: Events

FAMILY THERAPY

Charlie Health offers virtual intensive therapy, 9-12 weeks, based on CBT, DBT and other evidence-based treatments for children age 8 and older, teenagers, and adults. Clients participate in individual, group, and family therapy. Most forms of insurance are accepted. Financial aid and sliding scale fees. Available in 39 states.

RESOURCE FOR MENTAL HEALTH PROVIDERS

Perfectionism in Childhood and Adolescence, Gordon Flett and Paul Hewitt (see reply for description)

ADVICE

I recovered from OCPD (no longer meet criteria), and have researched perfectionism, OCPD, and related topics for two and a half years. I'm not a mental health provider.

If your child has an OCPD diagnosis, I would suggest asking a provider to screen them for trauma, depression, and suicidality. ADHD is a common co-morbid condition. OCPD can co-occur with (and be misdiagnosed as) OCD and Autism.

Studies indicate that the factors that largely determine the effectiveness of therapy are the rapport between the therapist and the client, and the client’s belief in their ability to change. Finding a therapist who creates a safe space where your child feels understood, connected, and respected is more important than the type of therapy.

If your child struggles with anger, consider what feelings, beliefs, and habits may be contributing. Be aware that teenagers with depression are often irritable.

If you're a perfectionist or have a perfectionistic partner, these resources are helpful: 19 Tips for Compulsive Parents and episodes 44 and 91 of "The Healthy Compulsive Project" Podcast.

Don't compare your child to other people, directly or indirectly.

When having conversations with your child to see how they're doing, listen more than you talk. Express curiosity, rather than assumptions about their behavior and experiences.

If you want your child to work with a therapist, refrain from acting as if they are a "problem" in the family. Admit to your mistakes and limitations. You could communicate, 'I'm not sure how to help you with __________. (The therapist) has helped many children/teens.'

Be a role model for your child in showing flexibility, acknowledging mistakes, and prioritizing mental health.

Parent Seeking Advice for a Teen with OCPD

RISE IN PERFECTIONISM AND SCHOOL STRESS

Gordon Flett and Paul Hewitt, the leading experts on perfectionism in children, have stated that their review of the research indicates that about one-third of children and teenagers experience concerning levels of perfectionism.

Thomas Curran and Andrew Hill analyze studies that involved more than 40,000 college students participants who completed The Multidimensional Perfectionism Scale. Socially prescribed perfectionism—the type of perfectionism that has the strongest correlation with mental health difficulties—is rising among young adults at an alarming rate.

Studies have indicated that the rate of psychological problems in children from affluent homes is higher than that of children living poverty. A survey of students by the Robert Wood Johnson Foundation found that excessive pressure to excel was the fourth leading cause of unwellness in adolescence after poverty, trauma, and discrimination.

Dr. Stuart Slavin surveyed students at three suburban high schools in Ohio. Results indicated a very high rate of anxiety and depression, and “rampant perfectionism.” When asked to identify what caused them stress, the top ten most common responses were related to school. The most common response was feeling pressured to get into a good college.

DIAGNOSIS

Psychiatrists and therapists with PhDs and PsyDs (psychologists) diagnose personality disorders most often. Individuals with PD diagnoses have an “enduring pattern” of symptoms (generally defined as 5 years or more) “across a broad range" of situations. Most clinicians only diagnose adults with personality disorders. The human brain is fully developed at age 26. Finding Mental Health Providers has information about sixteen studies showing the effectiveness of therapy for OCPD.

Many people have obsessive compulsive personality characteristics. Mental health providers evaluate whether they cause “clinically significant distress or functional impairment."

Diagnostic Criteria and Descriptions of OCPD From Therapists

Children and teens can be assessed for clinically significant levels of perfectionism using The Childhood Multidimensional Perfectionism Scale, The Adaptive/Maladaptive Perfectionism Scale (available online), and The Child-Adolescent Perfectionism Scale (available online). Clinical perfectionism is associated with OCD, OCPD, depression, anxiety disorders, eating disorders, and trauma.

ARTICLES AND BOOK EXCERPTS

Children and Mental Health: Is This Just a Stage? - National Institute of Mental Health

Therapy for perfectionism focuses on these issues: Perfectionist Tendencies, Cycle of Maladaptive Perfectionism, Identifying and Responding to Feelings, and Cognitive Distortions.

BOOKS FOR PARENTS

\ See reply to this post for descriptions*

How to Talk So Kids Will Listen & Listen So Kids Will Talk series, Joanna Faber (recommended by Gary Trosclair, an OCPD specialist)

Never Let Go: How to Parent Your Child Through Mental Illness, Suzanne Alderson *

Please Understand Me, David Keirsey *

Letting Go of Perfect: Empower Children to Overcome Perfectionism, Jill Adelson, Hope Wilson *

The Self-Driven Child, William Stixrud

The Whole Brain Child, Daniel Siegel, Tina Payne Bryson

Nurture by Nature: Understand Your Child's Personality Type, Paul Tieger (most helpful for parents of children up to age 12)

Perfectionism and Gifted Children, Rosemary Callard-Szulgit 

Anxious Kids, Anxious Parents, Reid Wilson

Straight Talk About Psychological Testing for Kids, Ellen Braaten, Gretchen Felopulos

BOOKS FOR CHILDREN AND TEENAGERS

Penelope Perfect, Shannon Anderson (ages 4-7)

The Girl Who Never Made a Mistake, Gary Rubinstein (4-8)

Too Perfect, Trudy Ludwig (6-10)

What to Do When Mistakes Make You Quake, Claire Freeland (6-10)

Be a Perfect Person In Just Three Days!, Stephen Manes (7-11)

Jaclyn Hyde, Annabeth Bondor-Stone, Connor White (8-11)

Captain Perfection & The Secret of Self-Compassion, Julian Reeve (7-11)

What to Do When Good Enough Isn't Good Enough, Thomas Greenspoon, MD (8-13)

Nobody’s Perfect: A Story for Children About Perfectionism, Ellen Burns (8-11)

The Perfectionism Workbook for Teens, Ann Marie Dobosz (13-18)

A Perfectionist’s Guide to Not Being Perfect, Bonnie Zucker (13-18)

BOOKS FOR OLDER TEENAGERS

The Perfectionist’s Handbook, Jeff Szymanski

The CBT Workbook for Perfectionism, Sharon Martin

The Self-Compassionate Teen, Karen Bluth

Conquer Negative Thinking For Teens, Mary Karapetian Alvord (workbook)

Perfectionism Workbook for Teen Girls, Sienna Weston

CBT Workbook For Perfectionist Teens, Jane Williams

BOOKS FOR ADULTS

Resources For Learning How to Manage Obsessive Compulsive Personality Traits

Dan Neuharth, PhD, a family therapist, offers insights and advice to adults who had parents that exhibitted controlling behavior in If You Had Controlling Parents: How to Make Peace with Your Past and Take Your Place in the World (1999).

3 Tactics of Controlling Parents ... and Ways to Handle and Heal (13 min. video)

There is an episode of "The Healthy Compulsive Project" podcast about aging. It might be a helpful resource for people with elderly parents with OCPD traits.

r/EmotionalNeglect is a large, active sub. I've participated for a few months, and find many posts helpful.

Guardedness and people pleasing can impede progress in therapy.

Paul Hewitt stated that almost of his perfectionistic clients are “extraordinarily adept at hiding their pain behind a mask of high functioning, maximization, and competency.” (The Perfection Trap, Thomas Curran, pg. 201).

In I'm Working On It In Therapy (2015), Gary Trosclair writes about the importance of being open during therapy sessions:

"We all need to use masks in certain areas of our lives…to get along with others and to feel safe…Working hard in therapy includes taking off the mask and bringing in as many different parts of your personality as possible…Acknowledging these hidden parts….may feel like a wound to our idealized sense of whom we want to be, but it’s also how we move toward growth and wholeness…” (2-3)

“Trying too hard to be a good client, or trying too hard to please the therapist, could be a repetition of what you’ve been doing for years, and it may hide the parts of you that you need to bring into the process. When you notice what you want to hold back from your therapist (your angry, childish, vulnerable, or strong parts, for instance), you get clues as to what you have excluded from your personality.” (4)

"Bring your mask in, show what it looks like, but then take it off and study it to see how it works and what it’s covering up. This part that we want to cover up, deny, or get rid of, is known as the shadow…[it] causes problems only to the degree that it’s hidden or unconscious; once we begin to integrate it more consciously, it actually enriches our personality.” (4-5)

"It's helpful to say whatever comes into your mind during your sessions “even if you think it unimportant or irrelevant or nonsensical or embarrassing…When your therapist asks you a question, don’t censor or think about it too much…This approach opens the possibility for the many different aspects of your personality to come to the surface.” (4)

Trosclair also discusses how people with OCPD may struggle to 'feel their feelings' during therapy sessions.

“Some clients feel more comfortable being abstract and intellectual in therapy, focusing on why they are the way they are, leaving out the actual experience of feelings…staying in intellectual mode is often a defense against feeling.” (21)

People with OCPD may be anxious about addressing childhood trauma in therapy.

Some people view their OCPD as synonymous with their intelligence and achievement, and mistakenly believe that working on their perfectionism with a therapist will make them "lazy." In reality, therapy for perfectionism will prevent burnout, and aid people in reaching their potential at work.

Masking my true OCPD self

Trying to get an A in therapy

This post may be helpful for people who question the point of seeing a therapist, and for people making slow progress in therapy.

These are excerpts from Gary Trosclair's I'm Working On It In Therapy (2015). This is the book that helped me the most in reducing OCPD symptoms. It's available with a free trial of Amazon Audible. Trosclair has worked as a therapist and for 35 years, and specializes in OCPD.

Therapy sessions can serve "as a microcosm of your life that fosters insight: the way that you relate [to your therapist may] mirror what happens in your larger world. [A therapy session] allows you to see more clearly what you do and don’t do that works for you or against you," (63)

"Therapy creates a unique and safe environment that allows us to slow down and pay close attention to ourselves…so that we can live more consciously in our everyday life. It’s a bit like playing a video in slow motion so that we can observe our thinking, feeling, and behavior more clearly. We can see and learn from what is usually pass over in everyday life…When you speak about disturbing emotional issues in the presence of someone you feel you can trust…[the] experience is coded differently in the brain and becomes less disturbing.” (63)

“Work outside of session includes observing the patterns in your life and thinking about what meaning they have…Deep change also requires moving beyond thinking to action—applying the insights you’ve had in session by doing things you haven't done before." (135)

Corrective Emotional Experiences

Many of the benefits of therapy relate to corrective emotional experiences, defined by Deborah Fried as the “reexposure of the patient, under more favorable circumstances, to the emotional situations which he could not handle in the past.” 

From I'm Working On It In Therapy (2015): “When you speak about disturbing emotional issues in the presence of someone you feel you can trust…[the] experience is coded differently in the brain and becomes less disturbing.” (63)

The Most Difficult Thing About Healing

Island of Time

From Allan Mallinger's Too Perfect (1992):

A therapy session is an "island of time for honest communication, reflection, clarification, and encouragement, a starting point. In the end, each person must use his or her…insights, creativity, courage, and motivation as a springboard for his or her own trial solutions.” (xv)

Relationships Between Therapists and Clients

Marsha Linehan, the therapist who developed Dialectical Behavior Therapy (DBT), stated, “The relationship is the vehicle through which the therapist can effect the therapy; it is also the therapy.” [Cognitive-Behavioral Treatment of Borderline Personality Disorder (1993)]

It's important for someone with OCPD to find an experienced therapist that they trust. At the same time, it's also helpful to be aware that compulsive perfectionism can lead to having unrealistically high standards for therapists. One of the biggest 'lies' (cognitive distortions) of OCPD is 'I need the perfect therapist to help me with perfectionism.'

A clinical psychologist wrote an excellent article on how therapy clients can advocate for themselves if they are upset with their therapist: What to Do in Therapy If You Want It to Work.

Therapy clients' feelings towards their therapists can give them insights about their relationships people from their past. Why Being Frustrated With Your Therapist is a Goldmine.

Short-Term Therapy

Therapy is not a lifetime sentence. Short-term therapy can be helpful too. Emma McAdams, the therapist who created the Therapy in a Nutshell YouTube channel, mentioned in a video that most people with PTSD no longer meet criteria after three months.

This stages of change model was originally for substance addiction. It's a useful framework for mental health recovery.

People with mental illness often struggle with recognizing that progress is not linear. This may lead to giving up when setbacks inevitably occur.

In The Perfectionist’s Handbook (2011), Dr. Jeff Szymanski refers to two common myths about the process of changing habits. “The insight theory of change refers to the belief that your behavior automatically changes once you commit to changing….In the linear model of change…you recognize that change happens over time but believe that the process is smooth—one that ‘gets a little better’ each day.”

Dr. Szymanski explains that progress with behavior change is not linear; “the actual change process….consists of many starts and steps…you will have good days and bad days…Real and enduring change in behavior is uneven and takes time an effort. You can see real trends only when you look over longer periods of time.”

I did not have any goals when I was managing OCPD. Instead, I took a 'one day a time' approach. Reviewing resources from OCPD specialists (e.g. The Healthy Compulsive) allowed me to have confidence that I could develop and maintain healthier coping strategies.

The 5 Stages of Change in Recovery

In Revisiting Prochaska and DiClemente's Stages of Change Theory, Freeman and Dolan (2001) describe an “anti-contemplation” stage. This refers to people with the attitude, ’I’m fine the way I am. I do not need to change.” 

Many members of r/LovedByOCPD have stated that they use the grey rock method with their partners.

From "What Is The Grey Rock Method and Is It Effective?," a Psych Central article:

"The grey rock method is where you deliberately act unresponsive or unengaged so that an abusive person will lose interest in you. Abusive people thrive on emotions and drama. When you act indifferent and don’t show your emotions, they may lose interest and stop bothering you."

"Using the grey rock method might look like avoiding eye contact, giving short answers, and focusing on other things when talking with someone who’s using abuse tactics."

"This method theorizes that, when dealing with an emotionally abusive, toxic, or narcissistic person, withholding your reactions can put a stop to their behaviors. If you show no emotion they won’t get the thrill or enjoyment out of their harmful behavior."

"It’s important to note that the person may get very upset when you withhold your reactions. However, right after the anger or escalation, you may get the behavior you want if you continue to 'grey rock' the person. It may not always be safe to attempt grey rocking on your own. If you are concerned for your safety, consider talking with a mental health professional who can help advise you on how to use this method while providing emotional support."

What Happens When You Go "Gray Rock"?

When The Gray Rock Method Is Reasonable With A Narcissist

When does the Gray Rock Method Fail? | Narcissism & Detachment Strategy

In The Healthy Compulsive (2020), Gary Trosclair states, “Unless there are other serious mental health issues involved, no compulsive wants to hurt others.” (170-71),

This is a short video from Dr. Todd Grande: Empathy with All 10 Personality Disorders. He begins by explaining the difference between cognitive empathy and affective empathy.

Five minutes in, he shares the results of a study that assessed empathy in people with all ten personality disorders. There were no statistically significant differences in cognitive empathy between any of the PD populations and people without PDs.

Five populations showed statistically significant lower affective empathy than people without PDs: people with Antisocial, Narcissistic, Schizoid, Avoidant, and Paranoid Personality Disorders.

This is the study: Fluid intelligence and empathy in association with personality disorder trait-scores: Exploring the link. There were 196 participants (with and without PDs) in Switzerland.

Reflections on Empathy

Covert Narcissist Traits & How to Respond

I used to be friends with someone whom I later realized has some covert narcissistic traits. When I finally spoke to him about his hurtful behavior, I was "discarded." I spent 18 months offering him lots of encouragement and had made a huge donation to one of his projects. He had nothing to say about my work as a Reddit mod (resource posts have more than 1/2 a million views total).

He didn't fit the stereotype of someone with NPD traits; I kept holding out hope he would show reciprocity in our relationship.

I was completely baffled by his behavior until I read the chapter on NPD in Aaron Beck's Cognitive Therapy for Personality Disorders (2004). The chapter explained his entitled behavior, extreme need for admiration, and all of the behaviors I had been trying to figure out.

Beck and colleagues wrote, “Narcissistic individuals tend to create a market of personal opportunity by exaggerating the needs and weaknesses of others, and embellishing their own virtues and merits. ‘They need me,’ and ‘I’m doing them a service,’ may rationalize actions that are primarily self gratifying or exploitive. Seeing oneself as a generous, noble benefactor or mentor allows minimization or denial of possible risks or harm to others…” (253)

DSM CRITERIA FOR NARCISSISTIC PERSONALITY DISORDER

For a diagnosis of narcissistic personality disorder, patients must have

- A pervasive pattern of: Grandiosity (in fantasy or behavior)

- Need for admiration.

- Lack of empathy.

These are observed beginning by early adulthood and present in a variety of contexts

Five (or more) of the following symptoms are present:

- A grandiose sense of self-importance (e.g., exaggerates achievements and talents, expects to be recognized as superior without commensurate achievements).

- Preoccupation with fantasies of unlimited success, power, brilliance, beauty, or ideal love.

- Believes that he or she is “special” and unique and can only be understood by, or should associate with, other special or high-status people (or institutions).

- Requires excessive admiration.

- Has a sense of entitlement (i.e., unreasonable expectations of especially favorable treatment or automatic compliance with his or her expectations).

- Is interpersonally exploitative (i.e., takes advantage of others to achieve his or her own ends).

- Lacks empathy or is unwilling to recognize or identify with the feelings and needs of others.

- Is often envious of others or believes that others are envious of him or her.

- Shows arrogant, haughty behaviors or attitudes

What is Narcissistic Personality Disorder (NPD)? What is covert narcissism?

Studies indicate that about 16% of people with OCPD also have NPD.

Darren Magee explains that people with OCPD “tend to hold themselves to the same, if not higher standards than others. Many of their behaviors are driven by a need for perfection, routine, and structure, whereas narcissistic people are often driven by a diluted sense of superiority and entitlement.”

In people with OCPD "the need for control tends to be rooted in anxiety around imperfection or chaos. Whereas with narcissism, it's just about power, dominance, or maybe trying to seek admiration."

He notes that "a partner with OCPD may create tension by enforcing rigid rules, criticizing imperfections, or prioritizing tasks over emotional connection and intimacy. So, the partner might feel controlled and undervalued. But the rigidity in the thinking and the behaviors again stems from anxiety around chaos and imperfection rather than from a desire to dominate. A narcissistic partner, however, will undermine the partner's self-esteem through manipulation and belittling them just so that they can feel superior.” 

Video from NPD specialist: OCPD and Narcissistic Relationship

Article from OCPD specialist: Differences Between Narcissistic Personality and OCPD

Common characteristics of people with PDs who are abusive and manipulative: Top 100 Traits & Behaviors

People with OCPD often have other mental health disorders and neurodivergent conditions.

People who are overwhelmed by untreated disorders that make them feel 'out of control' (e.g. ADHD) may develop OCPD symptoms.

OCPD can contribute to the development of other disorders (e.g. depression).

OCPD is often misdiagnosed as OCD and Autism Spectrum Disorder.

DSM criteria for all ten PDs: Psychiatric Disorders - Merck Manual Professional Edition

Research findings

Source: Good Psychiatric Management for Obsessive–Compulsive Personality Disorder

Some of this data refers to participants’ current diagnoses. Some data includes past diagnoses.

Rates of OCPD in Individuals with Impulse-Control Disorders

[Includes rates from two studies on trichotillomania and excoriation]

Source: Obsessive-Compulsive Personality Disorder (2020), edited by Jon Grant, Anthony Pinto, Samuel Chamberlain, pg. 90

Trauma

Individuals with personality disorders have a very high rate of trauma. The therapist who led my trauma therapy group stated that it’s necessary to work on PDs to make significant progress with trauma symptoms, and visa versa.

Resource

Dr. Meghan Neff, a psychologist with autism, ADHD, and OCPD tendencies, created very popular Venn diagrams to show the similarities and differences between mental health disorders and neurodivergent conditions: Neurodivergent Insights.

Clinicians conceptualize the cluster C personality disorders as being driven by anxiety and fear.

People with untreated OCPD often have a very strong habit of overthinking and worrying about most or all aspects of their lives. This symptom can make it very difficult for people to realize the extent of their anxiety and fear.

Clinicians have theorized that 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.”

Many people with OCPD meet criteria for one or more anxiety disorders.

I reduced my overthinking by increasing my awareness of my body sensations (e.g. breathing, muscle tension) as consistently as I could, and having a daily walking routine. I call this strategy 'get out of your head and into your body.'

Over time, this made a big difference in staying connected to my feelings. I let go of the habit of suppressing my difficult emotions by overthinking. I accepted that experiencing the short-term discomfort of being fully aware of difficult emotions was better for me in the long run.

I think people with OCPD tend to take pride in being strong. That could be another factor making it difficult for people to realizing the extent to which their behavior is driven by their responses to frequent or constant anxiety and fear.

I exchange emails with Gary Trosclair, the therapist who wrote The Healthy Compulsive (2020). He has a weekly podcast. The Healthy Compulsive Project  

He sometimes uses topics suggested by listeners.

These are the episodes that are most useful for family members of people with OCPD:

Episodes 4, 9, 46, 47, 74, 81, and 106 focus on how people with OCPD relate to their partners.

14 and 42 are about demand sensitivity and demand resistance.

Episode 81 is about love languages. 88 is about passive aggression.

If there are any topics that you'd like to learn about, let me know. I can add them to my next list of suggested topics that I send to Gary.

I've asked him to consider an episode on having a parent with OCPD traits.