Obsessive-Compulsive Personality Disorder Support Group

A support group for those with OCPD and their loved ones.
It is currently Fri Apr 28, 2017 7:44 pm

All times are UTC - 5 hours [ DST ]



Welcome
Welcome to ocpd

You are currently viewing our boards as a guest, which gives you limited access to view most discussions and access our other features. By joining our free community, you will have access to post topics, communicate privately with other members (PM), respond to polls, upload content, and access many other special features. In addition, registered members also see less advertisements. Registration is fast, simple, and absolutely free, so please, join our community today!




Post new topic Reply to topic  [ 21 posts ]  Go to page 1, 2  Next
Author Message
 Post subject: Internet talk radio show 10/24 3:00pm on OCPD and OCD
PostPosted: Wed Oct 23, 2013 10:55 pm 
Offline
Site Admin

Joined: Tue Nov 04, 2008 3:12 pm
Posts: 713
Hi Everyone,

There's an internet talk radio show on tomorrow (10/24) at 3:00pm EST New York time by the OCPD/OCD expert/researcher Anthony Pinto, PhD, live from Columbia University. You can email him questions, and listen online, or phone in and (I think) listen on the phone and/or ask questions. The info is here:

http://www.blogtalkradio.com/columbiaps ... y-disorder

You can email questions about OCPD and/or OCD for the show on 10/24 to Prema Martin here:
[email protected]

Sincerely, Paul


Top
 Profile  
 
 Post subject: Re: Internet talk radio show 10/24 3:00pm on OCPD and OCD
PostPosted: Wed Oct 23, 2013 10:59 pm 
Offline
Site Admin

Joined: Tue Nov 04, 2008 3:12 pm
Posts: 713
Hi all,

These are the five questions I emailed in:

1. If OCD is marked by repetitive obsessions and compulsions, then why is OCPD named OCPD, when such repetitive obsessions and compulsions aren't part of the disorder?

2. Do you find the similarity in the names OCD and OCPD confusing and even harmful to the process of educating professionals and lay people alike to exactly what these two disorders are? If so, do you have any personal anecdotes about this similarity in names making it hard for you to get your point across?

3. Is OCD more prevalent in OCPD than in those personalities that are the opposite of OCPD such as the narcissistic and psychopathic personalities?

4. Does OCD manifest differently in the "impulsive" personalities like narcissistic and psychopathic personality than it does in the "compulsive" personality of OCPD?

5. It's often said, to explain the difference between the two, that OCD is ego-dystonic, while OCPD is ego-syntonic. But how does this explain anything? Aren't all personality disorders ego-syntonic? Couldn't one just as well say, "the difference between NPD and OCD is that NPD is ego-syntonic and OCD is ego-dystonic"?

Sincerely, Paul


Top
 Profile  
 
 Post subject: Re: Internet talk radio show 10/24 3:00pm on OCPD and OCD
PostPosted: Thu Oct 24, 2013 12:53 pm 
Offline
Site Admin

Joined: Tue Nov 04, 2008 3:12 pm
Posts: 713
more questions ...

6. What is the role of conscience and guilt in OCPD?

7. Why does hidden anger seem to be present in all cases of OCPD?

8. A psychoanalytic theory is that OCPD is a defense against aggressive urges. Does this sound right to you?

9. Do you agree OCPD should be lumped in together with other OC spectrum disorders?

10. Many have noted a difficulty in differential diagnosis between Asperger's Syndrome and OCPD. What are some basic ways to use presenting symptoms to tell them apart?

11. Does one with OCPD favor the use of one side of their brain over the other?

12. Is there an attitude or mode of communication the spouse of someone with OCPD can use to best help him?

13. In his 1908 paper "Character and Anal Erotism", Freud linked an OCPD type of personality to what was later called an "anal character". These are the first sentences of his paper:

Freud wrote:
QUOTE
" Among those whom we try to help by our psycho-analytic efforts we often come across a type of person who is marked by the possession of a certain set of character-traits, while at the same time our attention is drawn to the behaviour in his childhood of one of his bodily functions and the organ concerned in it. I cannot say at this date what particular occasions began to give me an impression that there was some organic connection between this type of character and this behaviour of an organ, but I can assure the reader that no theoretical expectation played any part in that impression.

Accumulated experience has so much strengthened my belief in the existence of such a connection that I am venturing to make it the subject of a communication.

The people I am about to describe are noteworthy for a regular combination of the three following characteristics. They are especially ORDERLY, PARSIMONIOUS and OBSTINATE."
END QUOTE


Does your experience either support or refute this link?

14. Those with OCPD seem perpetually physically tense. Is there a reason for this?

15. Is there truth to the notion OCPD is caused by strict parenting? What about harsh toilet training?

16. Can OCPD be cured?

17. Are there sexual issues such as in performance, emotion, frequency, paraphilias, or promiscuity unique to OCPD?

18. Why are there so many more resources for the understanding and treatment of OCD than of OCPD?

19. Do SSRIs have a beneficial effect on the symptoms of OCPD?

20. Do any accurate portrayals of OCPD come to mind in TV, film, the theatre, or literature?


Top
 Profile  
 
 Post subject: Re: Internet talk radio show 10/24 3:00pm on OCPD and OCD
PostPosted: Thu Oct 24, 2013 4:56 pm 
Offline

Joined: Tue Feb 09, 2010 9:38 pm
Posts: 1978
thanks Paul!

_________________
'
People do not change when they see the light. They change when they feel the heat.  ― Freda Lewis-Hall


Top
 Profile  
 
 Post subject: Re: Internet talk radio show 10/24 3:00pm on OCPD and OCD
PostPosted: Thu Oct 24, 2013 6:09 pm 
Offline

Joined: Wed Oct 31, 2012 9:09 am
Posts: 1083
Is there any way to access this after the fact..is it archived anywhere???
Thanks Paul for posting this.
gs


Top
 Profile  
 
 Post subject: Re: Internet talk radio show 10/24 3:00pm on OCPD and OCD
PostPosted: Thu Oct 24, 2013 7:13 pm 
Offline

Joined: Sat Jan 16, 2010 4:40 pm
Posts: 1310
Location: Suburbs of Atlanta
gardensanity wrote:
Is there any way to access this after the fact..is it archived anywhere???
Thanks Paul for posting this.
gs


Just click on the link in Paul's original post.

_________________
Liza Jane

Peace is the result of training your mind to process life as it is, rather than as you think it should be. ~ Wayne Dyer


Top
 Profile  
 
 Post subject: Re: Internet talk radio show 10/24 3:00pm on OCPD and OCD
PostPosted: Thu Oct 24, 2013 7:28 pm 
Offline

Joined: Wed Oct 31, 2012 9:09 am
Posts: 1083
thanks liza.gs


Top
 Profile  
 
 Post subject: Re: Internet talk radio show 10/24 3:00pm on OCPD and OCD
PostPosted: Thu Oct 24, 2013 7:32 pm 
Offline

Joined: Fri Oct 04, 2013 11:03 pm
Posts: 252
Thanks Paul. I heard the talk today. Was good to hear a client of Dr. Pinto describing his symptoms and strategies he uses for them. CBT for issues of perfectionism and rigidity is used to challenge their high standards and tackle procrastination. The Dr.s also help clients work on emotional over control issues. It was mentioned about the difficulty in expressing both positive and neg. Emotions and argumentativeness in romantic relationships. Difficulty with spontaneity was spoken of..that things must be planned out in detail because otherwise it was more anxiety provoking. any chore is "a chore" to them because must be done right. Client said therapy has helped him to recognize more what he was feeling as well as describe his feelings. He can make links from his emotion back to his thoughts.He tests out his high standards by doing things purposefully contrary to what his reflex is to do..e.g. has a thought that if his shirt is not ironed when he goes to work people will notice and remark negatively..he found no one seems to notice or care if he wears an unironed shirt. Another example the client gave was going out without a plan. Challenging his beliefs and fears seems to be paying off. It makes sense..if u don't test your beliefs and fears out they loom like impending doom so the only way to lessen the anxiety is to feel the fear and anxiety and do it anyways as a popular book title says. Columbia U. Is starting a brain imaging study on ocpd...stay tuned


Top
 Profile  
 
 Post subject: Re: Internet talk radio show 10/24 3:00pm on OCPD and OCD
PostPosted: Thu Oct 24, 2013 8:29 pm 
Offline

Joined: Wed Aug 22, 2012 8:10 pm
Posts: 228
Really great radio show, thanks for posting, as noted above, you can listen anytime, just click on the link. It definitely made me feel some compassion for my ex.


Top
 Profile  
 
 Post subject: Re: Internet talk radio show 10/24 3:00pm on OCPD and OCD
PostPosted: Fri Oct 25, 2013 6:43 am 
Offline

Joined: Wed Oct 31, 2012 9:09 am
Posts: 1083
I felt compassion and hope . Having to continually remind my self that this is a hard wiring issue and not really a choice for my DH has been exhausting during our 6 months of separation. I will say that leaving him escalated the distorted thinking and demand resistance. Always worked in the past for him to control me but it is not working now . He flip flops daily/hourly between Jekyll and Hyde.


Top
 Profile  
 
 Post subject: Re: Internet talk radio show 10/24 3:00pm on OCPD and OCD
PostPosted: Fri Oct 25, 2013 11:35 am 
Offline

Joined: Mon Feb 09, 2009 9:25 am
Posts: 4874
I noticed that they broke down OCPD to perfectionism and rigidity. Rather than as in "The Right Stuff" they break OCPD into perfectionism and righteous indignation which I believe is far more hurtful than rigidity.

He mentioned treatment as CBT and emotion regulation. I wonder if scream therapy is part of the emotion regulation?

I thought it was interesting that they mentioned there is not enough documentation to determine if OCPD is genetic vs.
parenting.

I thought he said the difference between OCD and OCPD is OCD has anxious thoughts and OCPD does not. Did I get that right? I ask because my DH insists he does not have anxious thoughts which I thought was part of OCPD.

Nonetheless, it was good to hear someone with credentials actually know something about OCPD.

_________________
Married 10+ years
Diagnosed 18 years ago
Fairly good marriage


“ When people show you who they are, believe them, the first time."
― Maya Angelou


Last edited by more-freedom on Sat Oct 26, 2013 4:01 am, edited 1 time in total.

Top
 Profile  
 
 Post subject: Re: Internet talk radio show 10/24 3:00pm on OCPD and OCD
PostPosted: Fri Oct 25, 2013 7:17 pm 
Offline

Joined: Thu Aug 02, 2012 10:08 pm
Posts: 29
What a great link - great questions too. THANK YOU bigtime for posting this. The website says they will follow up with people who do not get
to have their questions answered on air - I wonder OCPD manager - have they done so?


Top
 Profile  
 
 Post subject: Re: Internet talk radio show 10/24 3:00pm on OCPD and OCD
PostPosted: Sat Oct 26, 2013 1:29 pm 
Offline

Joined: Wed Aug 22, 2012 8:10 pm
Posts: 228
I thought what Dr. Pinto said was that anxious thoughts are part of OCD, but not OCPD, but he did say that some people have both conditions.


Top
 Profile  
 
 Post subject: Re: Internet talk radio show 10/24 3:00pm on OCPD and OCD
PostPosted: Sun Oct 27, 2013 7:47 pm 
Offline
Site Admin

Joined: Tue Nov 04, 2008 3:12 pm
Posts: 713
Hi alci,

Thanks for the good summary. I too was touched by John's story. I made a transcript of the show which I'll post, and then post the live Twitter feed of the show too, which focused on John's story.

Sincerely, Paul


Top
 Profile  
 
 Post subject: Re: Internet talk radio show 10/24 3:00pm on OCPD and OCD
PostPosted: Sun Oct 27, 2013 7:49 pm 
Offline
Site Admin

Joined: Tue Nov 04, 2008 3:12 pm
Posts: 713
Pinto Talk 10/24/13 PintoTalk102413

BEGIN TRANSCRIPT
0:00
Announcer: Blog Talk Radio
Dr. Marcia Kimeldorf: Hello, everyone. Good afternoon, and welcome to our blog talk radio show – Novel treatments and developments for Obsessive-Compulsive Disorder. I'm Dr. Marcia Kimeldorf, and I am a clinical psychologist, and a project manager for OCD treatment and research at the New York State Psychiatric Institute and Columbia University Medical Center in Washington Heights, New York City. We are nearing the end of our series, which kicked off on October 1st with an overview of OCD by two of our OCD experts, Dr. Helen Blair-Simpson, adult psychiatrist, and director of the center for OCD and related disorders, and Dr. Moira Rynn, child psychiatrist, and director of the division of child and adolescent psychiatry here at Columbia. Throughout the month we've had some great talks, including ones about front line and novel treatments for OCD, nuts and bolts of therapy for OCD, how to parent a child with OCD, information about hoarding disorder, and how to support a loved one with OCD.
1:00
Today we are joined by Dr. Anthony Pinto, Assistant Professor of Clinical Psychology and Psychiatry, and Research Scientist here at Columbia. Today's show will have three parts – First, Dr. Pinto will be talking about Obsessive-Compulsive PERSONALITY Disorder, OCPD, and how it differs from Obsessive-Compulsive Disorder, OCD. Second, he'll be joined by a patient who we will call "John", to preserve his anonymity. John has struggled with OCPD traits and behaviors and he will describe how OCPD has impacted his life. Third, we'll take some questions from our listeners. Before we begin I'd like to cover a few housekeeping tips. Anyone can join this talk by either dialing 347-996-5875 on a phone, or by going to blogtalkradio.com/columbiapsychiatrynyspi. If you have a question for Dr. Pinto, you can press 1 to speak to our host at any time, or
2:00
send us a question through Twitter, by mentioning the handle, @columbiapsych. We will address questions in the order in which they're received. However, if you do submit a question that we are unable to get to, we'll follow up with you, offline. With that, Dr. Pinto, we're real excited to have you here today.
Dr. Anthony Pinto: Thanks, Dr. Kimeldorf, I'm really pleased to participate in this blog talk, and excited to talk about Obsessive-Compulsive Personality Disorder, OCPD, and my goal here today is really to raise awareness about this condition that is impairing, yet often overlooked, and it's been the focus of relatively little research given how common it is, and so my objective today will be to talk about what does OCPD look like, how does it impact functioning, how can it be differentiated from OCD, or Obsessive-Compulsive Disorder, and to talk a little bit about some treatment approaches.
MK: OK, that sounds great.
3:00
Can you start off by telling us then what is OCPD, and what would you say are its most prominent features.
AP: OCPD is one of the most frequently diagnosed of the personality disorders. In studies that have been done in the community, we find that up to 8% of people meet the criteria for OCPD. In studies that have been done in clinic settings or mental health settings, that number is higher, upwards of 10%. OCPD is a constellation of maladaptive personality traits that lead to functional impairment or distress. Two of the core clinical features are self-limiting perfectionism, or, perfectionism that's driven by very high standards, and leads to an individual not being able to meet deadlines. The other core feature is rigidity, which often impacts interpersonal functioning,
4:00
because the individual tends to only see things their way, and it's very difficult for other people to sway them, once they've made a decision, on a particular issue. Some other symptoms that have been described in the diagnostic and statistical manual, which is the manual used by mental health providers to make diagnoses, are the following: so, OCPD includes a preoccupation with order, details, rules, so these are people that are likely to make extensive lists. They are people that will insist on having objects or their possessions in a particular order, they tend to get bogged down in details. A second symptom is an excessive devotion to work and productivity. So these are people who will choose work or pursuits over leisure activities. They tend to be inflexible
5:00
about morals and ethics, they can be critical or judgmental of others, in terms of morals or values. They tend to have an inability to discard worn out or worthless items, which can result in clutter in their homes. They have a reluctance to delegate tasks, which means that they tend to want to complete work assignments on their own and not share work with others. If they do give parts of their work to other people, they tend to micromanage the others. And lastly, they tend to be miserly with regards to spending money both on themselves and others. Some associated features of OCPD are indecision or fear of making wrong choices. They have lots of difficulty when it comes to change, so any sudden changes in their schedule or routine will upset them,
6:00
because they tend to be rule-bound, and routine-oriented. They have difficulty sharing emotions, or tend to be emotionally over-controlled. They also tend to have anger outbursts when their sense of control is threatened. And finally, another feature of OCPD is procrastination which is often tied to their perfectionism.
MK: OK, great, that's very helpful. Can you now describe for us a case of someone who HAS OCPD so we can get a better idea of what these traits and behaviors look like?
AP: Sure. I'm thinking of a case of a patient I'll call "Betty" who I'd seen some time ago, but I think her case nicely illustrates some of the symptoms I just described. Betty is a 30 year old schoolteacher without previous treatment. She describes having a book collection that she dusted daily and would not let anyone else including her husband touch, insisting that she liked the books arranged a certain way.
7:00
She insisted her husband get into bed at night before her so that she could make sure that nothing in the house had been moved after she went to bed. If they were late for an engagement, she was unable to modify her routine of getting ready. Both at work and at home, she refused to allow others to do tasks that might be helpful to her as she felt that only she could perform these tasks correctly. When leaving the house, she insisted on driving or walking a predetermined route, despite any obstacles, such as traffic, that presented themselves along the way. She was critical and outspoken about shortcuts that she thought other teachers took in their work. These patterns of behavior and attitudes in her work caused major marital conflict and conflict with other teachers.
MK: Oh wow, OK, that's very interesting. So I think one of our main goals here is to differentiate between OCD and OCPD. So now perhaps you could speak about the difference between OCD and OCPD, and the commonalities as well, between these two disorders.
AP: Thanks, yeah.
8:00
There is unfortunately a lot of confusion out there, both amongst the lay public and clinicians about OCD and OCPD and that's one of the main reasons we wanted to do this talk, as part of OCD awareness month. One unfortunate thing is there's an overlap in the names between these conditions. They sound alike so people often lump them and some assume that OCPD is a minor version of OCD, but they are in fact qualitatively different conditions, though there is a relationship between them, as I will explain. Both OCD and OCPD are impairing disorders, marked by ritualized behaviors. So, what that means is, in both conditions you will see ritualized or methodical behaviors such as list-making, organizing belonging, or checking or editing work, the difference though is that in OCD
9:00
the compulsive behaviors are done in order to prevent or reduce distress, or prevent some dreaded event, and it's connected to their obsessions, which are these intrusive thoughts, or fears. In OCPD, the individuals do not have obsessive thoughts. They don't have these intrusive, unwanted thoughts that are distressing to them. In fact, in OCPD, they feel that the way their behaviors or attitudes are correct, and they often don't understand why others don't share their world-view. They would actually want other people to see things their way. So, just to recap that, in OCD the individual is performing behaviors and having thoughts that they don't want to be having, but they feel compelled
10:00
to do so because of anxiety related to their thoughts. In OCPD, the behaviors are consistent with how they see themselves, the traits are consistent with how they see their personality. There is evidence for a relationship between these conditions. If you look at samples of patients with OCD, about a quarter to a third of them will also have OCPD. We also know that when you look at the families of patients with OCD, the relatives of people with OCD are twice as likely to have OCPD. There is also an overlap in the symptom presentations. So in OCD, you may see a patient who has rituals that involve ordering, where they feel like objects need to be at right angles
11:00
or arranged symmetrically, and this does overlap with this preoccupation with order that you often see in OCPD. And in OCD patients often talk about incompleteness or an uncomfortable internal feeling unless actions are completed a certain way, and that overlaps with perfectionism, and OCD.
MK: OK, great. That's very helpful. So tell me, now that we sort of understand a little more about how they're different, tell me, is there any treatment for OCPD, and, so what does it consist of?
AP: We know from research that people with OCPD seek treatment at high rates, both in primary care settings, and in mental health settings. Even though these individuals don't always name OCPD traits as their presenting problem. To answer your question, there are a variety of psychotherapy or talk therapy approaches that have been applied to OCPD.
12:00
But what is lacking is treatment that's backed by research evidence, and that's something we've been working on here at Columbia. What we've been doing is trying to map the core features of OCPD onto established treatments and modifying these established treatments to better address the symptoms and presentation of OCPD. We've been working on combining different approaches that involve cognitive-behavioral therapy as well as emotion regulation. The emotional regulation will deal with the emotional overcontrol I talked about earlier, and the cognitive behavioral therapy is meant to directed at the perfectionism and the rigidity that often gets in the way of these individuals. I'll talk more about this when I talk to my patient "John" in a few minutes. In a nutshell, the treatment involves
13:00
teaching interpersonal skills, both to help the individual flexibly engage in relationships and help them to develop a stronger alliance with the therapist as well as with other significant others, and the treatment directed at perfectionism, rigidity, is helping them to challenge high standards by testing new behaviors and tackling procrastination. So with that being said, I'd like to turn to John, who we're really happy has come today, because we can talk about the features and talk about the treatment but the best way to learn about this condition is through a personal account, so I'm happy to have John here. I've been working with John here at the New York State psychiatric institute at Columbia Medical Center, and he has agreed to participate in this webcast. I want to clarify that John has been dealing with
14:00
OCPD for most of his life. He does not have OCD, so he is here to demonstrate the effect of OCPD on his functioning in his life. So first of all, thanks John for being here. When did you first notice these symptoms of OCPD?
John: I guess as far back as I can remember, maybe to around when I was 6 years old, I guess I do remember just kind of being preoccupied with order, how my room organized, how I had my toys set up. I really, that's the way I liked it, I like it that way, and I would have a problem, if my brothers or other people would come into my room and get things out of my order, the way I liked them. At least at that point, it was kind of just, things that really didn't kind of get in the way of my life, but then, as I grew up, and went to school, I definitely started to notice, writing assignments, I have a really big problem with procrastination, definitely my high standards getting in the way
15:00
of me completing assignments. So procrastination definitely started to show itself, as I went through school.
AP: So John, I think what would be really helpful to our listeners is if you could describe how OCPD has impacted some of the major domains of your life. So, if you don't mind, can we talk a little bit about how OCPD has been getting in the way in terms of your school or work, I know you are a graduate student and you're also working.
John: Ah, yeah, I guess the most pervasive thing seems to be perfectionism and a kind of getting bogged down in details, on any sort of assignment that I'm doing. If I have one little minor detail that I feel like I'm missing, that gets in the way of me completing the rest of the particular writing or research assignment because I really just feel like I have to find that one thing before I can move on, so any sort of paper that I'm writing, I find myself being stuck on page 1,
16:00
so often just trying to just get that just perfect, before I can even move on to the rest of the paper. I notice that in like readings at school, everything always kind of took a lot longer for me to compete than other people, and I think it was just having been obsessed with the details about the assignment or trying to understand every particular thing that I'm dealing with. One really good example is when I go to write an email, it should be an email that I think most people would take them 5 minutes, not even that to write, but for me, I would spend upwards of half hour to an hour sometimes, writing an email, making sure that all my grammar and punctuation was perfect, making sure that it said exactly what I wanted to say, that it came off just right. I especially at school with working in groups, has always been a huge problem for me, not only because I'd never felt comfortable delegating anything to anybody else, but I also just thought that, whatever way I thought we should do the project, that's the way
17:00
that it should be done. So naturally we've had some conflicts with that. And then, yeah, just overall procrastination would just be a huge problem for me. I always, every single assignment that I got, I said, OK, this is not going to happen, I'm going to get this done in time, I'm going to spend a lot of time on it, but then it came to the very last day before the deadline, I'm scrambling and doing it all at once, and I guess my goal was that I'd try to get it great, spend a lot of time on it and do it just the way I want, but then I would end up pushing it off and end up having it be no where near what I wanted it to be.
AP: Thank you. And let's talk a little bit about romantic relationships and how OCPD gets in the way there.
John: Ah, yeah, I guess because a lot of what I do to myself, is I have a lot of extremely high standards, I would also often hold my significant other to those high standards as well, and that was just
18:00
by myself would be a bad point but then I would be very argumentative with them, pretty much anything that we could argue about, where I thought we weren't seeing eye to eye, I would really harp on that. If I noticed a flaw in them, I tended really to focus on those and really just kind of ignore anything else good about them, and I guess as far as emotionally, it kind of became very hard to express affection toward them, but at the same time even if I had maybe negative emotions towards them I was also fearful of expressing THOSE emotions as well. So a lot of just, kind of fearful things going on in there.
AP: Great. Thank you for sharing that. In terms of hobbies or interests, I know this is something else that you have talked to me about, how does OCPD get in the way there?
John: I guess even in my free time, even if I'm doing something where I'm trying to enjoy myself, I still feel like
19:00
I have a really hard time being spontaneous, I would feel like, if I were going to go enjoy myself, everything had to be planned out, otherwise I wouldn't have a good time. I would be, maybe, frustrated if a friend came up to me and said, hey, do you want to go grab drinks right now or go do something that was, that I hadn't planned on, something, if I didn't think that things were set up to go right, then, I wouldn't have a good time.
AP: And finally, in terms of your home life, what have you noticed there, in terms of OCPD
John: Just, doing any sort of a chore, is, I guess, really a chore, with me, can be very frustrating because every little thing that I do, there's a right way to it. If it's not done in that right way, then I get really upset. The best example might be the dishwasher, I kinda always had this idea that the dishwasher had to be loaded in one particular way and if it didn't get loaded in that way then we were going to have horribly dirty dishes, I guess, and
20:00
I could not understand why any roommate I had, that didn't come across to them, they didn't get that, so anytime I'd open the dishwasher and they'd put something in there I'd freak out and have to reorganize it. With shirts I always thought that would be best, I had to have an ironed shirt, a perfectly iron shirt, before I could go into work. That's just the way it had to be. A lot of things around my house, I just kind of feel like, if I don't have control over it, then it makes me very uneasy.
AP: So let's talk a little bit now about treatment, I remember when you first called me, you had been in contact with other mental health providers, and you had described to them some trouble focusing, trouble getting tasks completed, and when you first approached me, you thought that perhaps you had attention deficit hyperactivity disorder,
21:00
and as we went through our evaluation, and you shared some of these traits and behaviors with me, it came clearer to us that this could be OCPD. And so, we've been working now in treatment, and I wonder if you could tell our listeners a little bit about what you have found to be helpful to you in treatment.
John: The first thing that's been very helpful with regulating my emotions, and I guess it's funny because up until when I was doing treatment I would often find that any time I would be asked how I'm feeling or what my emotions were like I wouldn't know, I would just say "I'm not sure what I'm feeling", or I always had a hard time expressing them. But now, I think the treatment has helped me a lot to be more emotionally aware, to be aware with what it is I'm feeling, and being able to
22:00
write out my feelings that I'm feeling at a particular time, and it's been very helpful to connect the feelings I'm having with thoughts that I'm having. You know, why am I feeling particularly, why the thought that I'm having in my head that's leading to that. So the emotional part has been very helpful. And then also just testing any of these high standards that I have, has been really helpful, and kind of doing these experiments, almost with myself, to, you know, OK, I think that whatever I'm doing has to be done a particular way, has to be done to a standard, if I test that and find out that it's OK not to, then it's been great, because, for instance, with my leisure time, I always thought that everything had to be specifically planned and that if I didn't have that, then I wasn't going to enjoy myself, but I did experiments where I went out without a plan, and had a wonderful time, you know, enjoying myself. Or back to ironing my shirts, I thought if I went to work with a wrinkled shirt that I would be, everyone would think I'm a fool,
23:00
and that I would be embarrassed, and that it would just be horrible, but I went to work with a wrinkled shirt one day, and the world didn't explode, everything was great, I had a great day at work, and nobody seemed to notice, so those are the biggest things that have been really helpful in overcoming a lot of this.
AP: Great. And I know we've also talked about behavioral exercises for procrastination, which was another piece, on that you had been dealing with.
John: Yeah. It's been so helpful. Even though I never though of it before, but testing it has been so helpful, and I just want to say, that I'm really grateful for the work the team at Columbia Medical has been helping me with this, and really grateful for all the work they're doing with OCPD and kind of bringing more awareness of it, and it's been great.
AP: Thanks a lot, John. This has been really great and I think very helpful for our listeners to hear the first-hand account of
24:00
your experiences with the condition, and with the treatment, I appreciate your time today.
John: Thank you.
MK: Absolutely, I agree. Thank you so much, John, and thank you Dr. Pinto as well, for educating us today. We have some really good questions from today's callers. I'd like to take a quick moment to welcome anyone who may have just tuned into the show to let them know we are here with Dr. Anthony Pinto, Assistant Professor of Clinical Psychology and Psychiatry and Research Scientist here at Columbia. If you would like to ask our expert a question, please press 1 to speak to our host at any time, or send us a question through Twitter, by mentioning the handle @columbiapsych. Now let's go on to our first question. OK, this one is from a Mom in Queens. She says, "my daughter is in treatment for her OCD, but she has OCPD as well. Can you explain a bit about how her OCPD might affect her ability to be successful with her exposure and response prevention therapy".
AP: Yeah, that's a great question and I appreciate
25:00
the listener calling in. When an individual has OCPD or if they have a maladaptive form of perfectionism, that can interfere in exposure and response prevention treatment. Remember, exposure and response prevention is one of the gold-standard treatments for OCD, and it involves the individual facing those situations or the particular triggers for their OCD and not doing their compulsions or their rituals. So when somebody has perfectionism, my experience has been these individuals tend to perseverate over details of therapy instructions and they become really worked up about whether they are doing the treatment correctly. They can also sometimes be argumentative about the rationale for the treatment, and
26:00
feel like it is wrong not to do rituals, and so that can impact their compliance or their adherence with the treatment. If the treatment is not going perfectly in their minds, they might be more likely to give up or throw in the towel feeling like why bother if it's not going to be perfect. Sometimes individuals with perfectionism in this OCD treatment might avoid doing the exposures on their own for fear that they're not doing them correctly. They might also resist generalizing these exposures to other related situations. The perfectionism and rigidity can sometimes cause difficulty in building the therapeutic alliance as I mentioned earlier, and these people might be more sensitive to feeling like a failure
27:00
if the progress in treatment is moving slowly. So these are all things that it is important for a clinician to be aware of if they have a patient that's presenting with perfectionism, so that these things can be addressed in addition to the frank OCD symptoms.
MK: OK, that's really helpful. Thank you. Here's our next question, from a professor in upstate New York. He asks, "Do we know what causes OCPD?"
AP: That is a big question, and I could spend a whole blog talk talking about that, but in the interests of time, what I can say is, sadly, we don't have all of the necessary research needed to answer that question. We do know from the research that has been done that there is certainly a genetic component to OCPD. When you look at twin studies, when they look at the concordance of one twin to another in terms of OCPD,
28:00
there's a very high rate of OCPD concordance, meaning, if one twin has it, the other one is very likely to have it. Those rates are high on the level of other conditions like bipolar disorder, even higher than you would see in some other conditions. So we have a sense that genetics are involved, as with many of the psychiatric conditions. We don't have a good handle on brain functioning or the role of neural circuits or neural pathways, because there's never been an imaging study of OCPD that's been done. We're excited here at New York Psychiatric Institute and Columbia Medical Center to be starting a brain imaging study now, and that's something that we're going to be focusing on and hope to get a better sense of what is happening in the brain. And,
29:00
the other aspect of this is the environment, what is the role of the environment in the development of OCPD and there have been lots of conjecture dating back to early 1900s, from Freud and other contemporaries about the role of the environment, and parenting, and unfortunately a lot of that has not been supported by empirical research. We need to better understand that as well. The short answer is, all of this is work in progress, so please stay tuned.
MK: Right, OK, sounds like, yes, there's a lot more to build, ever. OK, well our next question is from a man who emailed us all the way in Cincinnati, Ohio. He asked, "are there medications that can help with OCPD?"
AP: Another good question. And this is yet one more area where further study is needed. So far there's only been one small study on the use of serotonin medications in OCPD.
30:00
That study suggested that serotonin reuptake inhibitors, often referred to as SRIs, may be effective, but of course it's hard to draw any hard conclusions based on only one small study.
MK: Sure. OK. I think we have time for one more question. This question is from a young man in Brooklyn, who asks, "Why are there so many more resources for the understanding and treatment of OCD than there are for the treatment of OCPD?".
AP: I think that because OCPD is a personality condition there's a wrong assumption out there that this is just the way people are, and that they're not going to change, and that treatment won't help, but I hope we've demonstrated today with the powerful testimony of John that progress or treatment is certainly possible, and there are treatment approaches that are being developed,
31:00
there are psychotherapies out there, that can be helpful, if the clinician is informed about OCPD. OCD has received a lot of attention in the media, and there's a vastly growing awareness of what that is in the lay public. OCPD is not there yet, so what we need is more research to help us understand what the causes are, how to best treat it, we need more awareness in terms of the media, in terms of shedding light on this, and also spreading the word that even though something is a personality condition, it can be treated, there is help available for family members. We want to represent that hopeful message today. It is important for anyone who is seeking treatment to question their treatment provider,
32:00
about OCPD, and to access resources that are out there. The International OCD foundation is a foundation that is geared towards Obsessive-Compulsive Disorder, but many of those individuals, because of the high correspondence or relationship between OCD and OCPD, many of those clinicians that are treating OCD will also be informed about OCPD. Just to wrap up, I really want to encourage people to be good consumers, and to ask specifically about OCPD.
MK: Thank you. OK well we've reached the end of our show today. I'd like to thank Dr. Pinto very much for such an informative discussion on Obsessive-Compulsive Personality Disorder, and how it differs from Obsessive-Compulsive Disorder, and I also want to really thank John so much for sharing his experiences with us. Also thank you to all of our listeners for tuning into Blog Talk Radio for today's show.
33:00
If we couldn't get to your question today, do leave your contact information with our host, and we will be happy to follow up with you offline. I'm about to give out two important phone numbers, so this would be a good time to take out your pens, or your cell phones if you'd like to note them down. For more information about OCD treatment and research opportunities for adults, you can call us at 212-543-5462. And for information for children or teens, you can reach us at 212-543-5592. Now we are also always available to provide free, confidential screenings for OCD and OCPD during regular business hours, and you can schedule those by calling either of those numbers I just mentioned. For those of you who can't reach the New York City area, as Dr. Pinto mentioned, you should please visit ocfoundation.org for information about providers closer to you. If you enjoyed our show, be sure to join us for future episodes on OCD which have been taking place
34:00
every Tuesday and Thursday in October, from 3:00 to 3:30 Eastern Standard Time. We have two more really exciting talks lined up. Our next show will be on Tuesday, October 29, where Dr. Blair Simpson and Dr. Sameer Sheth will be talking about neurosurgery for OCD. Once again you can join the talk by either dialing 347-996-5875, or by going to blogtalkradio.com/columbiapsychiatrynyspi. Thank you for tuning in, and have a great day.

END TRANSCRIPT


Top
 Profile  
 
Display posts from previous:  Sort by  
Post new topic Reply to topic  [ 21 posts ]  Go to page 1, 2  Next

All times are UTC - 5 hours [ DST ]


Who is online

Users browsing this forum: No registered users and 1 guest


You cannot post new topics in this forum
You cannot reply to topics in this forum
You cannot edit your posts in this forum
You cannot delete your posts in this forum
You cannot post attachments in this forum

Search for:
Jump to:  
cron
suspicion-preferred