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OBSESSIVE-COMPULSIVE PERSONALITY DISORDER

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[Music]

Hi everyone, Dr. Peter Serno here. I am

a retired licensed psychotherapist,

personality disorder specialist, trauma

specialist, and I'm featured in a docue

series on Hulu and Disney Plus called

Ted Bundy: Dialogue with the Devil. I

get a lot of questions um saying, "Why

are you retired? Why did you retire? So,

I want to clarify what retirement means.

Retirement doesn't mean that I no longer

work. Retiring a license means that

you're changing the status from actively

practicing psychotherapy to no longer

practicing in a clinical setting. I'm no

longer operating from the position of

running a private practice. I still

write. I still teach. I still instruct

and train therapists. I offer

consultation in a non-clinical format

for people who want to gain an

understanding of the relationships that

they're dealing with. So, it's not to

say that I'm not working. It's just the

retirement status is how they officially

refer to the license no longer being active.

active.

And I just wanted to clarify that cuz I

get a lot of comments and emails and

questions about when did you retire? Why

did you retire so young? It's not that I

retired from working. It's just that

I've chosen to no longer be active in my

therapy practice. And down the road, if

I choose to unretire my license, I'm

able to do that. So, at this point in my

career, I'm just focusing more on

research and writing and education. So,

before we dive in, I like to give this

disclaimer and I like to ask this

respectfully. Please keep the comments

respectful. In the past, when I did not

say this in the beginning of a video, I

was pretty much assaulted with harsh

criticism, devaluing

harsh critical comments that were

somehow justified by the commenters

saying that they were offended by the

material or or that I was using

stigmatizing or pjorative language. And

the reality is if you specialize in the

treatment of personality disorders and

you attend required trainings, this is

how people talk in these clinical

settings. This is how they talk in the

trainings. They don't have to offer

disclaimers because they understand that

the people who are attending the

trainings know, look, we know that

you're professionals. You're coming here

because you want to learn about this.

And we use clinical language because it

helps with the descriptive and

explanatory pathology. So, nobody has

this idea that people's feelings are

going to get hurt. I understand this is

a different forum because this is a

social media platform. And I did oftent

times in my first videos make the

assumption that people were going to

understand that when you share science,

you don't necessarily need to offer

disclaimers, but I learned the hard way

that you do. So comments that are

disrespectful to me or disrespectful to

other commenters who have suffered

immeasurable harm and abuse, they're

just not tolerated. So they're going to

either be deleted or if they are

threatening or harassing, they're going

to be reported. So I just want to

clarify. If you want to stick out like a

sore thumb and be the person who for no

reason other than you want to is going

to insult the other commenters on this

post or you're going to insult me

because you're misinterpreting what I'm

saying. It's going to be dealt with in a

way where it won't be tolerated. These

videos are opportunities for

understanding, not grounds for cyber

abuse or assault. So today we are going

to discuss obsessivecompulsive

personality disorder. Much different

than OCD. They are not related except by

name. I'm going to start with the

distinction between obsessivecompulsive

disorder and obsessivecompulsive

personality disorder. Just to get that

out of the way because a lot of people

say things like, "I'm so OCD or that

person is so OCD." And often what they

mean is they're referring to this type A

characteristic personality, not the

intrusive thoughts and compulsive

behaviors that alleviate the anxiety in

somebody who is afflicted with

obsessivecompulsive disorder. So

obsessivecompulsive disorder, the one

that is not related to personality, is a

condition where there are intrusive

thoughts and compulsive behaviors that

are meant to alleviate the anxiety that

results from those intrusive thoughts.

This is when you see things like ritual

handwashing and other things where

people have to do something repetitively

because they're trying to alleviate the

anxiety that they're feeling. And this

is an egoistonic

condition. What that means is the person

who is going through this understands

that something is fundamentally wrong

inside and that they're not okay with it

and they don't justify it. It's

afflicting them. Whereas people with a

personality disorder, they have an

egoinonic experience, which means they

don't think that there's something

wrong. They justify their distorted or

disordered lens. And if you watched my

video on avoidant PD, I confessed in

that video that I've suffered from

avoidant personality disorder my entire

life. Somebody with an anxiety related

avoidance knows that the way that

they're thinking is wrong, that there's

there's something wrong about it, that

it's irrational. They don't justify it

and say, "No, this is the truth." They

say, "I understand this is problematic

and I want to do something about it. I

just don't know how to turn it off."

Avoidant personality disorder, like

other personality disorders, the person

who has the disorder, they don't think

to themselves, there's something wrong

with the way I'm thinking. They think,

"See, I was right. I'm justified in

perceiving reality this way. The world

really is that scary and therefore I

have to avoid it. I really will be

humiliated and therefore I have to

isolate and avoid." So, I'm willing to

admit that about myself because I think

it helps and informs people understand

the difference between somebody who's

afflicted with something that they

really don't like and they understand

that there's something wrong with it and

somebody who justifies their perspective

even though the perspective is based on

a distortion. It's not based in truth

but for that person it is their truth.

And to use another example, when we talk

about narcissism, narcissists truly feel

entitled to mistreat people because

their disordered lens is grandiose. It's

I do have a special superior place in

the world. People just need to accept

that and then everyone will get along.

They don't think to themselves, I should

probably fix this within myself. It

doesn't occur to them that being

grandiose is problematic. What occurs to

them is when other people confront them,

that's the problem. It's happening out

there. It's not happening in here for

the narcissist. And although the

operating system is different for

somebody with obsessivempulsive

personality disorder or avoidant

personality disorder, that mechanism of

inflexibility is the same.

So the first recourse is not to look

inward and say, "I need to probably

self-correct this because it's not

working." The reason why it's considered

a personality

disorder rather than a mood disorder or

a trauma disorder is because with mood

and trauma disorders, the person is

aware that the symptoms that are

afflicting them are interfering with

their life and need to change. On the

contrary, when it comes to a personality

disorder, the personality

tells that person due to the perceptual

gaps and distortions, there's nothing

wrong with me. It really is happening

out there.

One of the reasons I think why cluster

B's are the ones who get the most

attention is because those are the ones

that cause the most significant

impairment in interpersonal

relationships because

of the traits that make up those

disorders. They're different than the

traits that make up the cluster C

disorders. So, cluster C disorders, I

will admit, can cause a lot of harm in

relationships. Especially

when we're talking about avoidant

personality. Because as I mentioned in

my other video, if you are in a

relationship with someone who's avoidant

or you're trying to be friends with

someone who's avoidant, their avoidance

eventually becomes so pervasive that

it's almost like you stop asking them to

participate in the relationship because

you're going to get let down by them

because they have convinced themselves

that they're going to receive harsh

ridicule and shame before anything even

happens. that they stop altogether even

trying to socialize with you. And so

that can be really painful for the

person on the receiving end of dealing

with someone with avoidant personality.

Um I mentioned in that video too that

the way that you treat avoidant

personality is you don't go down memory

lane as to all of the horrible things

that happened in their life because

that's actually not going to stop them

from being avoidant. What's going to

stop them from being avoidant is

installing the traits that are really

deficient or lacking in them and

strengthening them. Traits like

resilience, traits like courage, you

know, the ability to just do the thing

anyway, even though it terrifies them,

they typically stop at I've convinced

myself this is going to be so horrible

and humiliating that it's not even worth

trying. I can't do it. And what you need

to do is install that capacity of I can

do it in spite of the fear. And you have

them practice that over and over and

over again that eventually they have

enough evidence to realize they were

wrong that that the humiliation and the

criticism actually are survivable. When

they get to that point, they can start

functioning in social situations more

adaptively. It's not easy. And as I as I

mentioned in that video, these are

traits that I am always going to be

afflicted with. It's never going to be

something that I completely conquer. I'm

not sure if there are others out there

with avoidant traits at the severe end

of the continuum who have conquered

them. If there are and you're watching

this, please leave a comment so that

people can understand your journey and

see how you've overcome it. I think it's

something that's going to be a lifelong

struggle, but I think it can be much

more manageable if the right

interventions are implemented. Going

back to obsessivempulsive personality

disorder, OCPD is a rigid pervasive way

of being. It's the entire operating

system. It's not a symptomatic

condition. It's not hypervigilance

related to trauma or depression related

to a mood disorder. It is the entire

operating system which is why we call

them personality disorders because they

actually cause the entire person to

operate out of order hence disorder.

It's not an insult. Regarding prevalence

estimates, OCPD is considered to be the

most common or most prevalent of the 10

recognized personality disorders in the

DSM. So this is the most prevalent

disorder OCPD. The main feature, the

defining feature of obsessivecompulsive

personality disorder is rigidity. It's

that inflexibility. The trait that they

need that they are lacking that would

balance the rigidity is more

flexibility. So this causes people with OCPD

OCPD

to see themselves as the righteous one.

They are doing the best. They are doing

striving for perfection. They are doing

the most. Sadly, what that means for

people in their life is they see others

as lacks and not doing a good enough

job. They might even refer to others as

careless because they perceive them as

not trying hard enough when in reality

the person with OCPD is in fact trying

way too hard in ways that are just

unrealistic. They see the world as

contaminated or disordered. And the way

they cope with this is they feel that

they have no choice but to control

everything in their life. Regarding the

diagnostic themes, they are preoccupied

with details and lists to the point

where they actually lose sight of the

activity or the task. Their

perfectionism interferes with their

ability to complete tasks. They have an

excessive devotion to work and

productivity. So this is that

workcoholism that people often see in in

individuals with this disorder. They

have a rigid inflexibility about morals

and values. But the morals and values

that they are rigid and inflexible about

are their own. So they really don't have

the capacity for understanding other

people's values and morals. It really

comes down to theirs are right. So

everyone else's must be wrong. Some do

show hoarding behaviors, but hoarding

disorder doesn't have to be comorbid or

accompany OCPD. There's a reluctance to

delegate tasks because they have to be

in charge because they're the only ones

who know how to do things right. They

tend to be stingy with money or

resources which goes way beyond frugal.

And they have an overall general

rigidity and stubbornness in their

perspective. Something that's

interesting about OCPD is while they do

tend to externalize blame because they

think others aren't doing a good enough

job, they also are very very critical of

themselves because they believe that

they have to strive for perfection. So

if something goes wrong, they actually

often believe it's their fault. So

everything must be perfect. And that's

what differentiates OCPD from the

cluster B disorders. Because if you take

a cluster B disorder like narcissism,

they are not going to think anything is

their fault. The way that the

narcissistic world works is I'm right,

everyone else is wrong. End of story, no

questions, and they feel very confident

in that reality that everyone else is

wrong and they are right. With OCPD,

that rigidity can be really hard to deal

with in relationships and they feel very

closed off in a way. So, people can

often mistake it for narcissism. But

what it really is, they're holding

themselves to such a high standard. So

they are very controlling, doineering,

oftentimes critical, but that criticism

is also on themselves. It's their fault

if something's not perfect.

And so that's why we see the fear.

That's why this is in the cluster C

because it's more associated with fear

and anxiety than exploitation.

The person with OCPD must be in control

at all times. One of their recurring

themes in their mind is life is very

demanding and there is no room for

errors whatsoever. Their identity is

typically tied to work and productivity.

Things that they can see measurable

progress with that they are in charge

of. Emotions tend to be restricted,

controlled and rarely expressed in a

vulnerable way. So with these

individuals, goal direction and

self-direction sort of becomes a trap.

They are so moralistic and conscientious

to a fault that they can't complete many

of the tasks they start because

nothing's ever good enough. And empathy

can be a challenge. It's not the same

deficit you see in narcissism, which is

a lack of concern for others and an

indifference to the feelings and needs

of others. It's more about rigidity,

being so focused on a task that they

can't step away to attend to someone

else's needs. Doesn't feel good to be on

the receiving end of it, but I just want

to clarify the motivation is different.

And sadly when it comes to relationships

they come second to work. Productivity

is the priority and so personal

connections inevitably suffer. So the

traits that we see there that are

inherent in a obsessivempulsive

personality rigid perfectionism and

insistence that everything must be

flawless restricted emotional expression

and intimacy avoidance because tasks and

productivity and work have to come

first. Behaviors can look like speech

that goes off on tangents and

overexlains, procrastination because

it's never good enough to finish,

endless list making and scheduling,

workcoholism and micromanagement. And

here is where I differ from many of the

modern trends in psychology. OCPD is not

the result of childhood trauma. These

are human traits. Rigidity,

conscientiousness, morality taken to

extremes. Some of these tendencies can

be learned and adopted because of

environmental influence, but not

everybody who adopts and learns these

traits experience them or take them to

the extreme that somebody with a

personality disorder does. These traits

have been around as long as humans have.

And historically, people were described

by their character, their virtue, and

their flaws. Writers and philosophers

debated for thousands of years how to

balance out these traits for the good of

the community. It's only a recent

occurrence that trauma stories are

embedded in the thinking structure of

everyone to explain every single

behavior. And even if trauma has

occurred, which often times it does

occur. People with OCPD, many of them

have been abused, many also have not.

But those who do have trauma, the

present traits that are impairing life

still need to be balanced out. And you

don't balance rigidity with endless

trips down memory lane in therapy. It

will not make somebody with OCPD any

less rigid. If you go down memory lane

with them and have them gain insight

into their history, it really will not

make them any less rigid. Behavior

change in the here and now and

practicing a new way of being is what is

going to work. So other people react to

individuals with OCPD seeing them as

rigid, stingy, cold, demanding,

sarcastic. Some people feel compelled to

try and please them and meet their

standards. Other people feel provoked or

triggered by them, and other people feel

controlled by them. Treatment is about

balancing out these excessive and

deficient traits. So turning

perfectionism into flexible reasonable

standards. Replacing my way or the

highway with perspective taking.

Shifting workcoholism to incorporating

leisure and rest and fun. Moving from

indecisiveness to healthy

decision-making. Expanding restricted

affect into genuine affection.

Transforming stinginess into frugality

or even generosity. And learning to let

things go. So to sum it up, OCPD, rigid,

controlling, emotionally constricted,

rarely satisfied with their own level of

order or with anyone else's. Cluster C

disorders don't get as much public

attention as cluster B disorders, but

they really can cause deep suffering in

others. I am a perfect example of that

because, as I mentioned, I have lived

with these avoidant personality traits.

I can guarantee you these traits were

not embedded in me or instilled in me

through trauma or adversity. I know

there's going to be some analysts out

there who say, "Well, you just repressed

it so much that you don't even remember

and you're in denial." Okay, that's a

perfect theory because you can't test

it. Point is from personal experience,

these are not quirky personality styles.

I also get comments, "Why are you

pathizing everybody's personality? These

are just differences." Okay. Well, I'm

the first to admit somebody who has

cluster C pathology, differences to this

extreme cause immense suffering in the

individual and in the people in their

lives. And so, it is the person's

responsibility to do something about

balancing out those traits and reliving

your history in therapy for 10 years and

blaming your mom and dad and your

teachers and your upbringing and all of

that. even if they didn't do a great

job, still will not make you flexible.

So, the interventions still need to be

geared around changing the behavior, not

processing the trauma. Trauma

interventions can deal with the trauma.

But even if you heal all of your trauma

with evidence-based trauma

interventions, you will still have the

fullblown personality disorder because

the personality disorder doesn't go away

once the trauma symptoms go away. And

they've done replicated studies to prove

this and longitudinal studies to measure

this. These are pervasive ways that are

rigid and inflexible and shape someone's

entire life and affect all important

areas of life. It's not a reaction to

adversity. Trust me, if you recognize

these patterns in yourself or someone

else, remember it is never about blame.

Whether we're talking about the

heritability, the genetic influence, the

biological underpinnings, or the

environment that exacerbated or

amplified it, it's never about blame.

That doesn't get you anywhere. It's

about understanding, compassion, and

when possible, effective treatment.

Thank you for watching. I'm Dr. Peter

Serno. If you found this helpful, please

feel free to view my other videos.

Subscribe to this channel for more

videos to come. I also encourage you to

read my book, The Nature and Nurture of

Narcissism and Traumatic Cognitive

Dissonance. There's a lot of commenters

out there that that refer to me as a

reductionist and a biological

determinist. I know for a fact they

haven't read my book because if they had

read it and they did their due

diligence, they would know that that is

categorically untrue. I don't believe in

environmental determinism and I don't

believe in biological determinism.

Again, please leave comments and please

make sure that they are respectful to me

and to everyone else. I want this to be

a community where people feel safe to

disagree or to be curious, but it

doesn't necessarily have to involve

antagonism or insults or belittling or

devaluing in any way, shape, or form.

Until next time, take care and I will

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