OCPD treatment
OCPD (obsessive compulsive personality disorder) is usually treated with individual psychotherapy or counseling that focuses on helping people accept themselves, change inflexible thinking, and get more in touch with their feelings. Medications are typically not utilized in the treatment of OCPD.
Behavioral therapy with medications seems to offer the best long-term improvement for the treatment of OCPD. Even though the
person may probably realize that his anxiety and behaviors are excessive and irrational, changing them is not a simple
matter. Most people with OCPD require assistance from a qualified therapist.
Medication
For many years, medications for OCPD and other personality disorders were thought to be ineffective since they did not affect the underlying causes of the disorder. More recent studies, however, indicate that treatment with specific drugs may be a useful adjunct (help) to psychotherapy. In particular, the medications known as selective serotonin reuptake inhibitors (SSRIs) appear to help the OCPD patient with his or her rigidity and compulsiveness, even when the patient did not show signs of pre-existing depression.
Medication can also help the patient to think more clearly and make decisions better and faster without being so distracted by minor details. While symptom control may not "cure" the underlying personality disorder, medication does enable some OCPD patients to function with less distress.
Psychotherapy
Psychotherapeutic approaches to the treatment of OCPD have found insight-oriented psychodynamic techniques and cognitive behavioral therapy to be helpful for many patients. Learning to find satisfaction in life through close relationships and recreational outlets, instead of only through work-related activities, can greatly enrich the OCPD patient's quality of life. Specific training in relaxation techniques may help patients diagnosed with OCPD who have the so-called 'Type A' characteristics of competitiveness and time urgency as well as preoccupation with work.
It is difficult, however, for a psychotherapist to develop a therapeutic alliance with a person with OCPD. The patient comes into therapy with a powerful need to control the situation and the therapist; a reluctance to trust others; and a tendency to doubt or question almost everything about the therapy situation. The therapist must be alert to the patient's defenses against genuine change and work to gain a level of commitment to the therapeutic process. Without this commitment, the therapist may be fooled into thinking that therapy has been successful when, in fact, the patient is simply being superficially compliant.
Prognosis
Individuals with OCPD often experience a moderate level of professional success, but relationships with a spouse or
children may be strained due to their combination of emotional detachment and controlling behaviors. In addition, people
with OCPD often do not attain the level of professional achievement that might be predicted for their talents and abilities
because their rigidity and stubbornness make them poor 'team players' or supervisors.
Although there are few large-scale outcome studies of treatments for OCPD, existing reports suggest that these patients do benefit from psychotherapy to help them understand the emotional issues underlying their controlling behaviors and to teach them how to relax. Since OCPD sufferers, unlike people with OCD, usually view their compulsive behaviors as voluntary, they are better able to consider change, especially as they come to fully recognize the personal and interpersonal costs of their disorder.
Prevention
Most theories attribute the development of OCPD to early life experiences, including a lack of parental warmth; parental over-control and rigidity, and few rewards for spontaneous emotional expression. Little work has been done, however, in identifying preventive strategies.
