Obsessive-compulsive personality disorder

Written by Katherine Nicholls
Katherine Nicholls
Counselling Directory Content Team

Last updated 15th February 2024 | Next update due 14th February 2027

Obsessive-compulsive personality disorder (OCPD) is a condition where people get very caught up in rituals and routines. Their preoccupation with orderliness and control can overtake their lives, compromising their flexibility and openness.

Here we'll explore how obsessive-compulsive personality disorder affects people and what can help.

We recognise that the system of personality disorder diagnosis can be considered controversial. It is completely your choice which term, if any, you want to use, knowing that your doctor or care team may use another.

The terms used on Counselling Directory are those that are generally used in the UK, currently. We refer to these terms throughout, with the hope of reaching and supporting as many people as possible.

What is obsessive-compulsive personality disorder?

Many of us will have perfectionist traits and the need for things to be clean and orderly, but for some people, this perfectionism becomes a preoccupation. They can become so focused on orderliness and adhering to certain rules, rituals and systems that they struggle to lead happy and fulfilling lives. Their relationships, health and well-being may suffer as a result.

People with these traits may be diagnosed with a type of personality disorder known as obsessive-compulsive personality disorder (OCPD). Those with the condition may not be aware that their thought processes are problematic. People with OCPD can believe that their way of thinking and doing things is the right way and that everyone else is wrong. 

The impact of OCPD

The need to be meticulous and do everything perfectly often means those with OCPD are constantly on edge - worried that something may go wrong. They may be more prone to becoming upset or angry if they feel unable to maintain control of their surroundings.  

Another characteristic of OCPD is a strong devotion to work and productivity and a preoccupation with logic and intellect. Those with the condition are often highly conscientious and ambitious, but the quest for perfection can be counterproductive.

Decision-making can be particularly hard for those affected. They may find it hard to prioritise tasks and work out the best way of doing them, stopping them from getting started. People with OCPD may also struggle to adapt to new situations and can find themselves feeling resistant to change. 

In terms of social interaction, people with OCPD may lean towards more serious and formal relationships. During conversation, they may hold back and speak only when they are sure of what they want to say. Generally, they will be guarded emotionally and may only express affection in a controlled manner. People with OCPD can also find it difficult to delegate, trust others and share responsibilities, holding them back from fulfilment. 

Therapists who can help with OCPD

What is the difference between OCPD and OCD?

Although they share similarities, obsessive-compulsive disorder (OCD) and obsessive-compulsive personality disorder (OCPD) have notable differences. For example, OCPD is a consistent and enduring preoccupation with perfectionism. In contrast to this, OCD is fear/anxiety-driven illness where symptoms can change in severity. Other key differences between the two include: 

  • The obsessions and compulsions that characterise OCD are not associated with OCPD. Although both conditions can result in repetitive behaviours, the underlying motives are different. For example, while OCD sufferers may clean and tidy excessively to keep a perceived catastrophe from taking place, people with OCPD will be more likely to do these activities to increase their productivity.
  • People with OCD often recognise they have a problem and are likely to seek help. However, OCPD sufferers are often unaware that their behaviour is unhelpful and can be resistant to seeking support.
  • In contrast to those with OCD, OCPD sufferers tend to have rigid views of right and wrong, and this rigidity may extend to other habits such as spending.

Signs and symptoms of OCPD

Usually, it is family members and friends of individuals with OCPD who recognise there may be a problem behind their perfectionism. Below is a list of common OCPD behaviours that may cause concern:

  • excessive devotion to work that interferes with social and family activities
  • preoccupation with details, lists and schedules
  • stubbornness
  • difficulty expressing emotion
  • inflexibility
  • hoarding
  • rigid following of moral and ethical codes
  • an overwhelming need to be punctual
  • a sense of righteousness about how things 'should' be done
  • perfectionism that interferes with the completion of tasks
  • a reluctancy to work in teams or delegate

Other symptoms people with OCPD may have include: 

  • a sense of entitlement
  • passive-aggressive behaviour
  • objectification of others
  • tunnel vision

Someone with OCPD does not have to have all of these symptoms to have a personality disorder. There is a specific diagnostic criterion that health professionals will use to diagnose obsessive-compulsive disorder symptoms and this can be found in the American Psychiatric Association's Diagnostic and Statistics Manual (DSM). OCPD is defined as a cluster C (anxious or fearful) personality disorder and the patient must have at least four or more of the above OCPD symptoms in order to be diagnosed.

Getting help for OCPD

In the majority of cases, obsessive-compulsive personality disorder is unlikely to be the reason why people with the condition seek help. Often it tends to be the result of other problems in their life, such as stress, work, and relationship problems which on top of their disorder is making their lives incredibly difficult. Up until this point, many people with OCPD are unaware of the discomfort that their behaviour is causing themselves and those around them. 

Making an appointment with the doctor is the first important step to seeking help for obsessive-compulsive personality disorder. Here, assessments will be carried out to identify symptoms and distinguish between OCD. A doctor also needs to rule out any medical conditions or other personality disorders which may mimic OCPD.

Ultimately, the health professional will be looking for signs that a person's behaviours and thought patterns are severe enough to be causing significant impairment to interpersonal and occupational functioning.

OCPD treatment

As with most personality disorders, counselling and psychotherapy are typically the most effective treatment for OCPD. Medication may also be offered to help individuals with their rigidity and compulsiveness, but this tends to be more effective when used in combination with psychotherapy.

Aims of psychotherapy

Counsellors supporting those with OCPD can experience difficulty when trying to earn their client's trust. They will ensure that any new and changing information is carefully incorporated into therapy so clients can adjust gradually.

Furthermore, therapists need to ensure their client feels comfortable enough to open up and share their thoughts and feelings. OCPD sufferers can struggle to express emotions, so techniques will be used to help them examine and identify their feelings at their own pace.

Cognitive behavioural therapy (CBT)

The most common approach used in OCPD treatment is cognitive behavioural therapy (CBT). This is used to help alter a person's way of thinking by challenging automatic and unhealthy interpretations of the world and themselves. These interpretations tend to be driven by core beliefs established during childhood, and therapists will aim to replace them with healthier and more accurate ones.

In the majority of OCPD cases, clients find CBT valuable for understanding the emotional issues that underly their controlling behaviours and unhealthy thought patterns.

Psychodynamic therapy 

Psychodynamic therapy can be used to help people with OCPD identify feelings towards a situation and then stop and think about why they fear not having a sense of control. Therapists will help the client to accept their humanity - focusing on the idea that they are just as prone to error as anyone else and that making mistakes is natural.

A fundamental aspect of psychodynamic therapy is to modify a harsh and critical sense of self to soften a client's need to outperform and control every situation. This can be a crucial part of managing OCPD.

Further help

Search for a counsellor
Trusted Information Creator - Patient Information Forum

Trust our content

We are a PIF TICK 'trusted information creator'. This means you can be assured that what you are reading is evidence-based, understandable, jargon-free, up-to-date and produced to the best possible standard.

All content was accurate when published.

Would you like to provide feedback on our content?
Tell us what you think

Please note we are unable to provide any personal advice via this feedback form. If you do require further information or advice, please search for a professional to contact them directly.

You appear to have an ad blocker enabled. This can cause issues with our spam prevention tool. If you experience problems, please try disabling the ad blocker until you have submitted the form.

This site is protected by reCAPTCHA, the Google Privacy Policy and Terms of Service apply.

Find a therapist dealing with OCPD

All therapists are verified professionals

All therapists are verified professionals