Treatment of Compulsive Personality Disorder – Switching Perfectionism from Bad to Good

Introduction, Perfectionism is a Personality Trait

Perfectionism is not a personality disorder of its own but a personality trait. Yet, in its extreme form, traits of perfectionism account for one of the criteria of Obsessive-Compulsives Disorder or Obsessive-Compulsive Personality Disorder (OCPD). OCPD is about over focusing on details, preoccupation with orderliness and being perfect. Obsessive-compulsive personality disorder is similar to OCD (Obsessive-Compulsive Disorder). However, OCD is a disorder featuring obsessions (intrusive thoughts), leading to anxiety and causing the individual to perform compulsive actions for relief.

Negative consequences of perfectionism

Some experts would argue that being a perfectionist (striving unrelentingly for high standards of performance and combining that with extremely critical self-evaluation) is highly associated with emotional distress.  Furthermore, there is an association with psychological disorders, such as depression, borderline personality disorder, anxiety disorders, suicidal tendencies, eating disorders and profound interpersonal relationship difficulties. In addition, perfectionism interferes with functional leadership. A manager possessing perfectionist traits might be excessively controlling. Moreover, they might be unable to realize that their awkward behaviour is due to deficiencies in self-awareness and interpersonal compassion. Research demonstrates that bosses-perfectionists do not become good leaders. However, it is possible to make perfectionism work for—not against—you.

Helpful and Unhelpful Kinds of Perfectionism

Researchers and clinicians differentiate between helpful and unhelpful perfectionism according to the extent of rigidity that affects individual standards. The presence of adequate flexibility to allow for human imperfections while striving for the highest standards would make perfectionist traits adaptive. Dysfunctional perfectionism, on the contrary, features uncompromising, overly high standards, unforgiving of flaws.

How to exploit positively perfectionism

If you strive for perfection based on fundamental beliefs about the self as proficient and worthy, there is a good chance that your perfectionism will lead to constructive outcomes. Conversely, unhelpful perfectionism is about a preoccupation with the avoidance of shortcomings. And it is due to perceptions of the self as incompetent or worthless.

Therefore, transforming our beliefs may be helpful to make perfectionism work for us and prevent it from becoming a barrier to goal achievement and well-being. Consequently, it is about transforming beliefs from being rigid and founded on a sense of personal insufficiency, to flexible views, based on self-worth. Research suggests it is worth a try.

Treatment of Obsessive-Compulsive Personality Disorder (OCPD)

OCPD is often treated by long-term psychological therapy. No typical pharmacological treatment for OCPD or other personality disorders exists. Yet, psychiatrists may prescribe medications which may help alleviate some co-existing conditions (e.g. depression, poor impulse control, anxiety).

However, similarly to narcissistic personality disorder, many individuals with obsessive-compulsive personality disorder and perfectionism typically do not see any problem in their personalities, even though their marriage or professional life suffers. They may start to seek help after hitting “rock bottom” in their career or personal life.

Cognitive-Behavioural Treatment

Fear of failure and uncompromising pursuit of success lie at the core of a cognitive-behavioural conceptualization of perfectionism (Shafran et al., 2002). That relentless chase for success results in an intricate relationship between an individual’s sense of self‐worth and achievement. That, in turn, creates a set of inflexible standards, causing rigid rule‐governed behaviours.

These highly uncompromising standards generate different forms of cognitive biases. The perfectionist biases often include dichotomous thinking, overgeneralization and selective attention (disregarding the positive). In addition, perfectionists often manifest maladaptive performance‐related behaviours, including reassurance seeking, repeated checking and comparing themselves to others.

Subsequently, these processes maintain the ongoing problem.

One of the goals of cognitive-behavioural treatment is to gain insight into factors preserving the fear of failure and relentless striving for success.