Treatments for obsessive-compulsive personality disorder (OCPD) include various types of talk therapy. For some people, medications may also help lower symptoms.

Research on OCPD medications has been inconsistent. There is also a general lack of research into OCPD and effective treatments despite it being one of the most common personality disorders.

This article explores various treatments for OCPD, shedding light on their effectiveness and the potential for improvement.

Two people holding hands in a family therapy session for OCPD.Share on Pinterest
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It is human to have a desire for order, perfectionism, and control at times. However, with OCPD, these desires can intensify and occur more frequently than in individuals without the condition.

On the other hand, when it comes to obsessive-compulsive disorder (OCD), occasional anxious thoughts are something almost everyone goes through. However, for someone with OCD, these thoughts might be more persistent. They may also experience compulsions or checking behaviors in a way that might be particularly intense.

It is important to understand that even though both conditions involve certain habits, OCPD and OCD are different from each other.

The main treatment for OCPD is talk therapy, or psychotherapy. Research has not identified any single type of talk therapy that works significantly better than others, so there are options to choose from.

Examples of talk therapies that may help with OCPD include:

Medications, such as selective serotonin reuptake inhibitors (SSRIs), are also a possibility. However, there is limited research on whether these work.

Currently, the Food and Drug Administration (FDA) has not approved any drug specifically for OCPD treatment.

Psychodynamic therapy explores aspects of the mind that a person is not consciously aware of, such as unconscious beliefs or past experiences that still affect them in the present day.

For OCPD, psychodynamic therapy aims to help people understand the insecurities that prompt their desire for control and perfection. A therapist may help them identify where those insecurities come from and learn how to reduce them.

By increasing feelings of security, people with OCPD may begin to see that such rigidity is not necessary and learn a more balanced way of thinking.

According to a 2022 research review, OCPD as a condition is understudied. As a result, there is not much research on how effective any treatment is.

A small 2008 study involving 27 people with OCPD found that intensive short-term psychodynamic therapy significantly improved symptoms compared with people who were on a waiting list.

After following up, the researchers noted that all the people had maintained these improvements after treatment ended. However, this was a small study, so more research is necessary.

CBT is a talk therapy that focuses on the link between a person’s thoughts, feelings, and behavior. It aims to help people manage unhelpful thoughts or beliefs that negatively affect them.

A 2013 study involving 116 people with OCPD found that 10 sessions of CBT significantly lowered distress levels in comparison with what they were before the treatment began.

However, there was no control group in this study, meaning the researchers could not compare the effects of CBT versus the effects of not receiving any treatment.

In comparison with psychodynamic therapy, CBT focuses less on the underlying root causes of mental health conditions and more on how these affect a person now. There is not much data on which approach works best for OCPD.

Other types of talking therapy that may help people with OCPD who also have coexisting depression include interpersonal psychotherapy (IPT)​ and schema therapy.

Schema therapy focuses on the frameworks, or schemas, that people use to understand themselves and the world. For example, a belief in the importance of high standards is an example of a schema a person with OCPD might have.

Similarly to other talk therapies, schema therapy aims to help a person identify, alter, or replace unhelpful schemas that negatively affect them.

IPT focuses on personal relationships, addressing the current problems a person is experiencing in them. A therapist might help someone improve communication, resolve conflict, and sustain relationships over time.

Medication is not typically the first-line treatment for OCPD. There is a lack of research in this area, and the studies that do exist only involve a small number of people.

However, some individuals with OCPD who also have anxiety or depression may benefit from medications such as SSRIs. These drugs can help ease the symptoms of these conditions.

Early evidence suggests that fluoxetine may help reduce perfectionism and hoarding in OCPD. More studies are necessary to confirm this.

OCPD is a chronic condition, meaning that it persists over time. However, with the right treatment, people can learn to manage the effects of OCPD on their lives.

Some previous studies have found that therapy can reduce symptoms in some people to the point that they no longer meet the criteria for an OCPD diagnosis.

The goal of treatment is not necessarily to get rid of perfectionistic traits entirely but to help people reach a balance that is healthy for them, allowing for greater flexibility and reduced distress. This may help improve quality of life.

However, as with all personality disorders, it can be difficult for people with OCPD to recognize that they have a mental health condition. How effective treatment is will depend on the person, their willingness to engage in talk therapy, and other factors.

Ongoing therapy may be necessary for some people to help maintain their progress. Anyone who is concerned they may have OCPD symptoms may contact a doctor or therapist to determine the right type of treatment for them.

OCPD treatment usually involves talk therapy. This could be psychodynamic therapy, CBT, or other forms of therapy, such as schema or IPT.

There is not much research on these treatments for OCPD specifically, and few studies have compared them with each other. As a result, it is unclear which is most effective. People may need to try different options to find one that works for them.

In some cases, medications may help lower symptoms of depression or anxiety, and there is limited evidence that certain drugs may reduce perfectionism. People can discuss the benefits and drawbacks of each treatment option with a doctor or psychologist.