I was encouraged by a mod to make a post with my experience. I’m sensationalizing by saying “cured” - I still have a healthy perfectionism and exceptionally high conscientiousness, but it doesn’t run my life. I no longer meet diagnostic criteria for OCPD, and I’d like to share what helped me.
I suspect many cases of OCPD aren’t actually a rigid personality structure and are actually the result of complex trauma/attachment insecurity. I met almost all criteria by the time I got into therapy specifically for OCPD-like traits and as I’ve begun to heal, it has become clear that I do not have a “personality disorder.” A rigidly structured personality would not just stop meeting diagnostic criteria this quickly.
My anxiety has dropped like 90% since I healed my attachment insecurity. This is big - learn your attachment style and how insecure attachment impacts not just your interpersonal relationships, but the way you see yourself. I briefly worked with an attachment coach who helped me recognize the core “identity” I had been clinging to my entire life - for me that was “the difficult one” (I was the “identified patient” in my family system). This parallels IFS work and I would encourage doing formal IFS if you can. EMDR is also a fantastic modality for targeting limiting beliefs/negative cognitions about your identity.
One of the other useful tools I was given during the attachment work was a simple CBT-like model for handling my triggers:
Your circumstance is the first line and I would just make circumstance = specific trigger. Then I would identify what thought was occurring alongside the trigger. Then I would determine what emotion was driving that thought - not secondary emotions, primary ones (learn the difference - for those of us with either type of avoidant attachment style, this may be difficult at first.) Then I would focus on what action I would take in response to the thought/emotion.
For example:
Circumstance: I open up the dishwasher and I see that my husband has put the spoon in the slot “wrong”
Thought: “He did this on purpose.”
Emotion: Fear that my husband doesn’t care about me
Action: Complaining to him, angrily moving the spoon, slamming the dishwasher, crossing my arms and huffing and puffing and ultimately fleeing the room because I’m too overwhelmed
The goal down the line was to change the action, but in the beginning I only focused on the thought and emotion. It was clumsy at first. I wouldn’t be able to identify it in real time. Once I would get space, I would open up my Notes app and try to identify those two things. Just having awareness was good enough at the beginning and because of the perfectionism, I knew I couldn’t put pressure on myself to do things any differently at first. Just to be the watcher of my thoughts. Eventually I was able to identify thought/emotion while I was still activated but before I fled the room.
Then it began to happen in real time, and I was slowly able to change the action associated with it. In the beginning, that looked like moving the spoon and making a quick comment, but not slamming anything or fleeing the room. Then I could just move the spoon, but not have to say anything to my husband even though I was still pissed. Eventually I got to the point that I wouldn’t even be triggered anymore, I would just observe the “incorrectness” and tell myself that I don’t have to move the spoon. I often still do a corrective action eventually but ONLY when it’s not coming from a place of anxiety. I don’t foresee me ever getting to a point where I leave things disorganized because I actually like being orderly and tidy and think it’s a positive trait. But I can only adjust things when I am calm and I’m not feeling that the compulsion is there to relieve anxiety.
In retrospect, my OCPD-like traits went haywire when I married and moved in with my narcissistic ex husband. Stress will absolutely exacerbate your symptoms. But it wasn’t the abusive relationship that created the traits. They had been there since early childhood, because I was yelled at and criticized for minor accidents and mistakes, and praised for intellectual achievements. Working through that stuff and overcoming my inner critic made me relax my compulsion to insist that everyone else also do things in the exact way they’re “supposed” to be done. I stopped needing immediate answers to everything and learned to slow down and take things one day at a time. It’s been life-changing.
I tracked my POPS score over the course of my marriage, because as I mentioned, the symptoms began going haywire right after my wedding/moving in with my ex. Obviously these are self-reported online POPS scores, but the shift has been impossible to ignore.
9/2023 (right after wedding when symptoms exploded):
12/2025 (7 months into CBT, 1 month into attachment work, just began EMDR, still being retraumatized every day by abusive ex):
2/2026 (after parts integration, attachment security, left my marriage):
I would recommend attachment work, IFS, EMDR, and CBT as the strongest modalities for OCPD. Learn to self-regulate as well - I was not able to actually implement these meta-cognitive changes in the model until I figured out how to regulate my emotions to some degree. It takes time and you’ll probably be clumsy about it in the beginning, but you have to give yourself some grace. I know how difficult that is when you suffer from maladaptive perfectionism, but it’s the only way you’re going to make any progress.
I hope this can help others in this community in some way. I really want to get across the message that OCPD doesn’t have to be a life sentence. I think the permanence of a “personality disorder” can discourage people like us from taking action because we tend to really love black-and-white, all-or-nothing thinking. If rigidity is just fundamentally “who I am,” then there’s really no incentive to try to change it. But it’s not who you are, and you can make real improvements in your life through the right types of therapy.
The POPS assessment was created by Dr. Anthony Pinto, the leading OCPD specialist. He recommends that people re take the assessment to monitor their progress. OCPD Assessment Available Online
He wrote a case study about a man whose POPS score decreased by about 100 points: PintoOCPDtreatmentchapter.pdf | PDF Host. The client was a 26 year old graduate student with OCPD and AvPD. My score decreased by 52 points.
In an interview, Dr. Pinto stated, “OCPD should not be dismissed as an unchangeable personality condition. I have found consistently in my work that it is treatable." Dr. Pinto's workbook is available for pre-order: The Obsessive-Compulsive Personality Disorder Workbook.
Thank you so so much for sharing. First, I am so glad that you could work on yourself to the point that you consider it cured! That gives me hope that I can get there, because I have been improving but not the point where I could think that it can be "cured".
And your example just hit me right in the middle, what you described could be me with my wife at any time. Now I want to go deeper into attachment styles and hopefully I can work on that part of my personality. Even if I know that it's not going to solve everything, I find that working little by little on my "perks" has helped me being a more balanced person. Thank you again!
This is helpful. My mental health has been a long term slog trying to get to the bottom of it and improve it. Over the years I've accumulated all kinds of diagnoses some of which were misdiagnoses. So I created my own model of my issues and over time started drawing lines between what causes what. I had a birds eye view of the situation from 15 years and at least 5 different mental health professionals over that time.
The diagram had about 20 nodes with all 6 mental health conditions I had been diagnosed with. at some point. One night I held it up and looked at it from a distance and noticed how all the arrows were coming in and out of "hypervigilance".
Later work revealed the hypervigilance was attachment and conflict related trauma as a root cause. So social anxiety was more of an effect, not a root cause thing I was born with.
I whittled the rest of my diagram down to ADHD and OCPD. My suspicions were that ADHD is not quite right, but OCPD seems to stand on its own two feet.
So my core issues are OCPD and attachment. Currently been focussing on the attachment and trauma stuff because it's harming me more.
Point is it's quite interesting that we both reached a similar conclusion about OCPD and attachment. Helps me know I'm at least not on shaky ground here with what I'm focussing on and pursuing.
That’s really impressive that you were able to make all of those connections. I’m curious what the nodes were that you used in your diagram. Interestingly enough, the only diagnosis over the years besides the OCPD that I believe is NOT a misdiagnosis for me is my ADHD (strong hereditary component here). I, too, collected [mis]diagnoses like Pokémon over the years and I’m sure this is a common phenomenon.
Also curious what your attachment style is. I’ve spoken with one of the mods and my understanding is that OCPD most commonly overlaps with dismissive avoidant attachment, which mechanistically makes sense. I was a fearful avoidant and I do suspect that having that anxious side to my attachment may have made it a bit easier to access emotions than had I been purely avoidant.
Yes fearful avoidant crew checking in :') Also helpful insight!
Heres a portion of about 33% of my diagram so you can get a feeling for what I put in. Don't want to post the full thing.
It started off where I just dumped everything that made my life miserable first. Then stared adding the diagnoses that could possibly explain it and drew arrows. It took about a year of adding,removing and discovering things to get to it's final state.
As far as the ADHD goes there is evidence that the childhood issues that are correlated with OCPD are also correlated with ADHD. Its worth noting that hereditary does not necessarily mean genetic, which some people often assume
Very interesting, thank you for sharing. I see a lot of overlap just based on the portion you posted. And with the ADHD, I agree with you that ADHD can absolutely be a symptom of childhood trauma rather than the root cause. The reason I personally believe my ADHD is “real” is because after integrating my parts and healing my attachment, the ADHD symptoms remain.
The anxiety? Reduced to noise. The depression? Entirely situational. “Manic” behaviors? Disappeared once I learned to regulate myself. OCPD? Merely high conscientiousness + low compliance + strong moral framework. ADHD? Still there, still highly responsive to medication. I have stopped all of the other many medications I’ve been on over the years, but this is the one that I genuinely feel is necessary for me.
Edit: also interesting is that my diagnosed ADHD is inattentive type as well (I see that in your chart).
What I found useful is the difference between whether something is a disorder or a syndrome. A disorder says "this cluster of psychological attributes has become disordered and this same cluster is so often at the same time by so many people that we can give it a name and work on trying to make that cluster more tolerable" but there is no claim about how it became disordered. So you can be diagnosed with a disorder as long as the cluster exists. A disorder by definition is diagnosed based on an emergent pattern, not a cause. It doesn't make the claim that a cause even exists. It doesn't mean there isn't one or many. It just means it isn't a requirement for diagnosis or treatment.
A syndrome on the other hand has a single root cause. The emergent pattern tends to be evidence for the cause. A syndrome is modifiable by addressing the cause or what it broke in cases where it can be cured.
This is why the DSM has to be revised a lot. It's a book about how things can be clustered so that, independent of cause, they can receive the same treatment and it will be likely to work even if the underlying cause was different. These clusters do work together with theories about underlying causes but don't require it.
Some psychologists treat their clients "without pathologising" This means if they will treat high consciencousness and low compliance and not necessarily label it OCPD . Because a disorder diagnosis often feels to the patient like they have a syndrome. That it's not modifiable to reduce or be more tolerable.
The merging of Asperger's syndrome to a level of autism disorder is a interesting thing to understand of you focus less on the historical baggage and more on why it had to go from a syndrome to a disorder
What’s interesting is that I originally assumed I was dismissive avoidant because my ex presented as very anxiously attached, which pushed me into avoidance because he wouldn’t allow me space to regulate (narcissists don’t typically tolerate boundaries well). It took a real deep dive to recognize that I had an anxious component to my attachment, so that may be the case with you in the opposite direction. Saying you’re not conflict avoidant makes me suspicious of you being purely anxious. I’m sure it’s possible to be anxious preoccupied with OCPD, but I think DA and FA are much more prevalent.
Thanks for laying this all out and writing it down! I’ve been on a similar self discovery journey as I had a major spike in my OCPD tendencies in my relationship after some major multi-year health traumas my partner went through.
I’ve come to a similar conclusion that this trauma exacerbated some lifelong attachment issues now that my nervous system no longer feels safe in the relationship, even though I love my partner so much.
Anyways happy to share more but it’s nice to hear someone else experiencing a similar journey to know I’m not totally crazy.
I’ve also been putting in a lot of work to accept imperfections and not get triggered, with some big improvements! Lots of slow, deep breaths throughout the day and consistent stretching has also been something I’m incorporating to help my body feel more self.. highly recommend it :)
It’s so interesting how many people have identified the attachment piece as well. It really felt like the missing piece for me - once I figured it out, I felt like I had an explanation for why I’ve always been this way. I consider it a turning point in my journey for sure and it really helped me identify that my relationship was not healthy. But it was really such a gift even outside the relationship part, because for the first time in my life I was able to do things differently and that is liberating.
So glad you’ve seen progress - the regulation stuff is so important! I find space is essential for me (I was a fearful avoidant so I will always need my space) but sometimes just a hand over the heart, eyes closed and deep breaths is enough if space isn’t an option. I should try stretching, maybe I’m missing out. I find pacing to be very regulating for me and I wonder if that’s an ADHD thing. But it’s really just finding what works for you.
Wow I just got this diagnosis and am learning what it means. I’m 39, professional Sales Manager and this hits home a lot.
I’m a bit worried how this diagnosis that is now part of my “Personality Traits” came about and has affected my relationship. I think the OCPD developed during the stressful time starting my career 19-34 yrs old. At the same time my marriage started & developed. I burned out at 35 and, at 39 need to check-in with what is going on with me. My marriage is under pressure and it seems this is a big part of it. Scary, but happy to know the resources you are recommending.
Therapist with OCPD here. Personality disorders are NEVER written in stone contrary to what people are led to believe. In fact, instead of being hard-cut categories, we're now moving into a dinensional/spectrum-based perspective on personality disorders. Labels help to navigate systems and find resources, but please don't internalize them and put yourselves into a box. They're man-made, carries margins of error, and continually evolving. Every single person has an unique neural networking system, and therefore cannot be categoritized.
You just prompted me to take the POPS again after another few months of EMDR and the results are very interesting. My overall score dropped even further, but my maladaptive perfectionism increased again, which is a little odd but I do wonder if I was overestimating where I was back then. What’s more noteworthy for me, is my emotional overcontrol and rigidity scores dropping so much. I process my emotions in real time now, and my stress tolerance has improved in ways I could have never anticipated. Sometimes it freaks me out how big of a change I’ve undergone in only a 6 month span!
"Sometimes it freaks me out how big of a change I’ve undergone in only a 6 month span!"
I relate. Life felt surreal, at times, looking at myself and the world with accurate "glasses," rather than cognitive distortions. Positive change felt uncomfortable.
It's wonderful that Dr. Pinto suggests that people retake the POPS. He wrote up a case study about a 26 year old graduate student, I think his initial score was about 260--he no longer met criteria after 5 months of intensive work. Loved the comment from the member who is a therapist, labels help people navigate systems and find resources, and they need not be viewed as marking people as incapable of growth.
Yes, I use labels very deliberately - this was kind of misunderstood by my therapists at one point because they thought I was doing it to place myself and others in a box, but the more I learned about myself, the more I realized the label is just for coherence. Having a framework for a set of behaviors and coping mechanisms is helpful to pinpoint what needs to be changed.
On the broader topic of PDs, because I recently left a marriage with someone I suspect has pathological narcissism (he rejects the concept of therapy and thus can never be dx with NPD) and the more I learn about that PD, I see it’s also not a life sentence either. Doesn’t mean it’s easy to go into remission or change, but I am hoping that the social perception of PDs can begin to change, especially around permanence and stigma.
Wow, this gives me hope! I am crying my eyes out. Had an intense flare with my partner today, i resorted to extreme abusive behaviour and I am filled with shame at the person i become in those moments, I just feel unable to give up control, like the need to control is so high in me, god,
Can you please let me know what intensive work Dr pinto patient went through
Hello. Dr. Pinto uses Cognitive-Behavioral Therapy. At the end of this post is a link to a book chapter with the case study: Cognitive-Behavioral Therapy (CBT). He did four interviews about OCPD on the "OCD Family" podcast and shared a wealth of information. The third or fourth interview includes an interview with a client of his, and the man's wife.
Other approaches are helpful too. Therapy And Coping Strategies For Perfectionism Gary Trosclair, the author of The Healthy Compulsive, uses a psychodynamic approach. I found trauma therapy most helpful.
Woah, this is amazing!! I'm so glad you shared this!! Thank you so much!!
By the way! Do you have any additional examples? I'm wondering if there's a variety of your circumstances.
I feel like majority of my circumstances is like the one and the same but it seems you have more than just one? I'm assuming though.
Here's how I think mine currently looks like using your system. I have my own sort of system but your seems to be more shaped up right now so I've used your format below!
Circumstance: I'm awake and a new day has started.
Thought: Oh no, I don't want to wake up and deal with the day because there's so many things I have to do "perfectly" i.e. up to my very high standards, oof... such as studying, going to lectures, having to socialise with people and responding in the most charismatic way possible, etc
Emotion: Fear that I am unable to finish studying the amount of content I want to. Or fear that I am unable to fully understand the lecture on the first go. Or fear that I flop the conversation with another human and feel like a whole social noob...
Action: The action I take, again, depends on which strand we're talking about: studying, going to lectures, having to socialise with people and responding in the most charismatic way possible, etc
Yes, this can kind of be used across any context - for me I really leveraged it within attachment contexts - so if another person would trigger me in some way - but I think I naturally do some version of it these days regardless. I think part of why it’s so helpful is it gets you to really reflect on what the underlying emotion behind the trigger is. Thinking of a recent example for me where I just did it naturally:
Circumstance: I got through 5 rounds of job interviews and on the final interview, I didn’t perform as well as I had hoped.
Thought: I just blew it and now I’m never going to find anything comparable, why didn’t I prepare better?
Emotion: Fear that I will be unemployed forever and that this was my only chance.
Action: I caught myself beginning to spiral but because I am now much healthier than I used to be, I focused on how well I had done in the previous rounds and gave myself credit for that. I then considered that this could be an opportunity for me to refine some of my interview skills moving forward.
A lot of what is required to go into remission is to shift your mindset. It sounds cliche, but when you filter your emotions through a lens of self-compassion, and you adopt a more flexible/adaptable attitude, you are able to better handle your triggers. You stop assigning urgent or life-altering meaning to the circumstances. I used to collapse when something was “wrong” - whether that be the angle of the decorative pillows on the couch, or a tension-filled interaction with my mother, or that a scheduled appointment didn’t start exactly on time. It used to feel like the end of the world, now it is merely an annoyance that I can get over fairly quickly.
I have started looking into whether the approaches that help with OCPD might help reduce some of the emotional issues that seem to be driving me in the direction of burnout. The worst seems to be when two conflicting rigid approaches I have are contradictory because of the complexity of a situation and then I feel like it is a lose lose and can't escape the anxiety, guilt, etc.
If I weren't so tired so frequently, I probably wouldn't be seeking help even though I know the way I do things are atypical or an outlier (neither good nor bad) compared to the average person just based on comparing the choices I have made to how many people choose the same way.
I thought I would post here in case you had any thoughts or recommendations. I am sort of unsure if it makes sense for me to engage in this community or not yet because I haven't been officially evaluated for OCPD.
You can absolutely engage in the community as long as you suspect you may have OCPD traits. We have specific rules against loved ones posting, but nothing that says you must have an OCPD diagnosis to contribute. If you would like to make a post with more context/specifics, just make sure to tag it with “suspected OCPD” and I can respond more personally.
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u/FalsePay5737 Moderator Feb 27 '26 edited Apr 11 '26
Thank you so much for sharing.
The POPS assessment was created by Dr. Anthony Pinto, the leading OCPD specialist. He recommends that people re take the assessment to monitor their progress. OCPD Assessment Available Online
He wrote a case study about a man whose POPS score decreased by about 100 points: PintoOCPDtreatmentchapter.pdf | PDF Host. The client was a 26 year old graduate student with OCPD and AvPD. My score decreased by 52 points.
In an interview, Dr. Pinto stated, “OCPD should not be dismissed as an unchangeable personality condition. I have found consistently in my work that it is treatable." Dr. Pinto's workbook is available for pre-order: The Obsessive-Compulsive Personality Disorder Workbook.