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OCD Family Podcast
S4E160: Season Finale: The First OCPD Workbook Is Finally Here — And It Might Change Everything with Dr. Anthony Pinto
01:31:49
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- [00:00]
A
Want a recipe for success? Step 1 Visit ocdfamilypodcast.com courses Step 2 Click on my link to browse OCD Training School's amazing course catalog. Step 3 Enroll and Step 4 Enjoy learning with no added cost to you. You can support the OCD family community while grabbing some continuing education or learning how to bridge yourself to self help strategies for OCD. Again, that's ocdfamilypodcast.com courses and use my special link to sign up today. Hey fam. Welcome back to the O C D Family Podcast for our Season four finale of the long form interview content that we know and love. Honestly, I couldn't think of a more meaningful way to close out the season than with this conversation. Because today we're welcoming back one of the most influential voices this podcast has ever had, Dr. Anthony Pinto. I'm Nicole Morris, licensed marriage and family therapist and mental health correspondent and let me be the first to say welcome to the family, the OCD family that is. I am here to create a community of support for family members, spouses, partners, parents, adult children, as there may be adult words, and chosen family of OCD sufferers and their community. I've had over 22 years of experience in the mental health field, but please please note that this information does not qualify or substitute as a diagnostic evaluation, therapy or treatment and it is presented on an as is basis. Please follow up with a qualified mental health provider in your area regarding concerns for yourself or loved ones. Thank you for joining us today. Now let's get started. All right. Okay fam, we are launching into a holiday weekend here in the States and my kiddos just got out of school so they are thrilling thrilled. Which means it's that time of year where I shift from going into these longer, more comprehensive chats into our summer Water Cooler series. The Water Cooler chats are those bite sized episodes where we are rolling out facts, evidence based resources all summer long, but they also allow for more of that intentional time focusing on my own family while my kiddos are on break. So like I said, we are being joined by the one and only Dr. Anthony Pinto. And I state that he is one of the most influential voices. And I truly mean that because when Anthony first joined us way back in season one for episode 18 all the way through today, his fifth recording with the fam, he introduced us to a hope filled understanding of Obsessive Compulsive personality disorder or OCPD. Years later, that very episode, season one, episode 18 is still one of the most downloaded episodes in the history of this pod, which tells me something really important. People have been craving a language, an understanding, validation and hope around OCPD for a very long time. And honestly, Anthony has helped to shape so much of that conversation. So let me reintroduce you to Dr. Anthony Pinto, fam especially for any newer family joining us, Dr. Anthony Pinto is the Senior Director of the Northwell Health OCD center at Zucker Hillside Hospital on Long island and he's the Associate professor of Psychiatry at the Donald and Barbara Zucker School of Medicine at Hofstra Northwell. He has published over 100 manuscripts and chapters on OCD and related conditions and is widely considered the leading clinical and research authority on ocpd. He serves on the International OCD Foundation Scientific and Clinical Advisory Board and is also on the teaching Faculty for the IOCDF's Behavioral Therapy Training Institute. And today we are talking about his brand new co authored book with Dr. Michael Wheaton entitled the Obsessive Compulsive Personality Disorder Workbook. CBT skills to overcome rigidity, Allow imperfection, and improve your relationships. Either available for pre order or available More broadly starting July 1, 2026, depending on when you are catching this combo. Now, Michael unfortunately couldn't join us for this recording despite all of us trying very hard to make the schedules align, but his presence is still very much felt throughout the conversation. In fact, I was saying to Anthony before we even started recording how my own familiarity with Michael's work goes back years to that 2022 review article he co authored alongside Anthony and fellow podcast guest John Teller on OCPD functioning and treatment. They were able to describe the hidden suffering underneath OCPD that can lead to a life quietly consumed by pressure, rigidity, self criticism and exhaustion. And something I noticed then, which continues in a very much appreciated way with their newest workbook, is that with Anthony and Michael and their work, they never reduce people to a diagnosis. It's about helping people loosen the grip of perfectionism enough to actually reconnect with their values, their relationships and themselves. So it's really a celebration of being able to embrace who we are and how, how to manage that. So with that, all the information and resources that Anthony and I are going to discuss are going to be linked over on this episode's blog@ocdfamilypodcast.com if you're watching on YouTube, you can also find that link in the description below. But without further ado, let's get to chatting with Dr. Anthony Pinto. Well, welcome back to the OCD Family Podcast and I'm thrilled to have one of our favorite guests here. And I say that because by content alone, I was just telling Anthony some of the most downloaded, if not the most downloaded, episodes across my catalog include ocpd. That stands for Obsessive Compulsive Personality Disorder. And so I am just pleased and thrilled I get to hang out with you again. So welcome back, Anthony.
- [06:24]
B
Thanks so much, Nicole. I can't believe that this is the fifth time I've been on the show, and you've been so generous to have me back. And I'm really excited to be here today and to talk about some new developments in ocpd, particularly this new workbook, which I'm very excited about, because it's an opportunity to get some of these CBT strategies that have been tested and validated in the hands of people and families that are affected by ocpd.
- [06:50]
A
Such a great point. And it's kind of a fun moment, too, because over the years, we've checked in with each other, and I knew that you were working on this book, and I was like, hey, when you get it done, if you want to come share it with the fam, I know the FAM would be so excited to hear about it. And so now we're here. It has to be a little bit, like, pinch yourself.
- [07:09]
B
Yes, yes, I know. It's. It's. You know, it is a. It's been a process of getting to this point. And. And I think a good way to start is really, I want to thank all of the patients that I've had the honor of working with over the years, because this has been an accumulation of all of those clinical experiences. Now, going back, it's almost 25 years since I've gotten my doctorate, and my career has been intensely focused in OCD and ocpd. And so those interactions with patients have really informed what both I and Michael decided to include in this book. And so, yeah, I wanted. I want to salute them as well as the mentors that I've had over the years.
- [07:51]
A
Yes, yes. And definitely we want to also thank you for just the dedication you've had. There has been conversation, and I know we have talked, whether here on the POD or privately, even about the need and the hope that people are here and want to be inspired to learn more about how to bring hope to family members, lived, experienced folks, friends, loved ones about ocpd. There is a stigma around mental health generally, but also around personality disorders more broadly. And one of the things you and I were discussing even before we started recording is how much. We feel privileged to have struck a tone with people living with this disorder or loving on someone with this disorder to feel hope, to feel resilient, to feel that they can still be themselves and function in a way that is going to bring more value to themselves and the ones they love. So it's a privilege to help facilitate the message and grateful that you have entrusted me with helping to share that message, because it's been a privilege to learn more and fight and champion all these people working so hard to live more fully.
- [09:07]
B
Yeah, absolutely. Yeah. And I think it's just important to remind the listeners that OCPD is common. It's under recognized and unfortunately misunderstood. It's often a blind spot for clinicians. And just to remind any new listeners that OCPD is prevalent. It occurs in about 1 in 15 adults. It's estimated to be about 6.5% of the population. So anyone listening to this likely knows someone or has someone in their life that is impacted by ocpd. And as I said, few therapists specialize in this area, so it can be difficult to find the treatment. And so the thinking behind this workbook was to take those strategies that we have been seeing in the clinical room to be effective and to put them together in a way that is practical and accessible so that individuals who are currently struggling with these traits can start doing the work on their own or in combination with the work they're doing with a therapist. And so one of the things that I'll be hitting on is just this message of if perfectionism and rigidity are crowding out joy or relationships or efficiency in your life and you're having trouble finding help, this could be one strategy, using the tools in this workbook as a way to have a roadmap towards change and towards living the life you ultimately want.
- [10:38]
A
Yes, absolutely. And so just a quick housekeeping note for the family listening. I'm going to have all the resources and things that we're discussing today over on this episode's blog@ OCD family podcast.com and the book that we're going to be referencing will be available, I think, July 1st, right?
- [10:59]
B
Correct. The book is called the Obsessive Compulsive Personality Disorder Workbook, and it's published by New Harbinger and it will be available as of July 1st. And it's available now for pre order on Amazon.
- [11:12]
A
It's definitely available for pre order. I'm going to have the link to Amazon if you guys are like, I want to hop on that and please do. But what I will say too is if you get the book and we're going to talk more comprehensively about it, but if you get it and you find value in it, another thing I'm just going to put in a plug for Anthony and for Michael, the co authors, please leave a review. It helps it show up in the algorithm or in the suggested reads over on Amazon. And that's part of the way that we can support just our broader community that needs more evidence based information when we look at CBT and just really understanding and compassion. You know, one of the things that struck me and I was lucky enough to have Anthony send me a reader copy of the book. And one of the things just even in the brief time that I've had to kind of overview it, is really how we're shifting. And I think this has been our aim all along anyway. Anthony, we're shifting from seeing people as disorders or a caricature of a cluster of symptoms to really having compassion, to understanding the style of interacting with the world and really allowing room for separating identity of symptoms from who you are as a person. And so I think that is really, really valuable. And I just, I can't wait to dig in more. So enough of me yammering on, I'm going to go ahead and turn it over to Anthony. But first of all, I mentioned, I want to note that Michael Wheaton, Dr. Michael Wheaton also is a co author on this book we had. And I'm just gonna be fully transparent, fam, because that's how we do it in the family. Right? But Michael would love to have been here and schedules and all the things, mainly mine, have interfered with the ability for him to join. Michael, if you're listening, you are welcome to come on the podcast anytime if you would like to share more. And so that's still an open invitation. But starting off, I would love to hear how you and Michael came together to collaborate on this work and would love to hear the inception story of how this came to be.
- [13:21]
B
Yeah, yeah. Thank you. Yeah. So, yeah. So Dr. Michael Wheaton is on the faculty at Barnard and he is affiliated with Columbia University Medical Center. He and I have known each other since I worked at Columbia and that was going back now almost 20 years. But we met through our work in the OCD program that's led by Dr. Lar Simpson, who was a mentor to both of us. And we, so we started collaborating on some of Dr. Simpson's studies and we, you know, over the years have been collaborating on a number of projects related to OCPD We've done various trainings on how to use CBT for ocpd. We've given talks at the IOCDF conference and over the past several years have been talking about how to take some of that work and to package it for the consumer and families so they could, as I mentioned, start using these strategies on their own. So, yeah, it's probably been now we started the work on the book is it goes back about two years. I think we were approached by New Harbinger even before that, but then just, you know, getting the timing, you know, for us to. To be able to work on it. So it's about two years ago that we started writing and about a year ago this summer we completed the book and then it went through the various stages of edits and being finalized. Yeah. So the thinking behind it was, as I mentioned, to really take the skills that we have been using with patients and to present them in a way that can be applied as self help. So that's really the motivation here is to. To give people the resources where they can start doing this work. And you know, as you mentioned, we start off the book and we, and we. And this is the same in our therapy sessions, we always start off with honoring who the person is, what their unique personality is. We all have our own stamp on how we interact with the world. And this book and the CBT for OCPD starts there. Honoring who the person is. It's not about changing the core of who they are, but about honing in on those areas where they're getting stuck. And for people with ocpd, typically that means feeling backlogged or feeling a sense of working so hard to get through the tasks of life that they often burn out. And there could be conflicts with family, friends, co workers because of these traits. And so we're really trying to find the ways in which this is causing pain points and trying to look at how can we make changes in those areas to lead toward better quality of life, better fulfillment, more balance. So that's what this book is about. Like trying to increase efficiencies, increase leisure time, joy and. And not about turning the person into someone who, you know, doesn't care or is settling for mediocrity, rather that there is a better balance of energy and effort as well as fulfillment and pleasure.
- [16:45]
A
Yeah, it's such a great point. And you know, whether we're talking here for folks with OCPD or whether we're talking about, say, our neurodivergent population or a whole host of different People deal with burnout and it can be absolutely toxic when we think about that functional impairment, how this interferes with your home life, your work life, your social life, or all of the above. Burnout is really, really hard. It's not all of it, but it's a huge piece of it. And I think especially here in the States where there's like a go, go, go, go mentality, there's not really a break. We don't take siestas. I think we could lean into that Anthony, from the European model, but we're not taking breaks as often. And just even when you're a person dealing with that really, really strong urge to continue to perfect, you know, it can be better. It's value driven or another word we've used and you talk about a lot in the book to distinguish is it's egosyntonic. Right. And so if we can again, we're not going to be like going into full on this is what the disorder is. We're going to be emphasizing the book and even some questions so folks can go back and those episodes are going to be linked over on the blog where you can learn more fully about ocpd. But if we could maybe just again, overview and really emphasize the understanding of what it means for something to be egosyntonic.
- [18:21]
B
Sure, yeah. So egosyntonic. Just to differentiate from ego dystonic, we often are asked what's the difference between OCD and ocpd? And that naturally is confusion because these names are so similar. But just to you know, reiterate, OCD is where there's the presence of unwanted, or we usually say intrusive thought content and that is typically fear based. And it's coupled with ritualized mental behaviors or physical behaviors that the person is doing for a very particular reason because they're desperately trying to get rid of the distress related to this content. They're trying to ward off a feared outcome. These individuals with we, we describe this phenomenon as ego dystonic because they do not want to be thinking about this material. Like I said, it's fear based. They do not want to be doing these compulsions. They feel like they have no choice. They feel, like I said, desperate to do these behaviors so that they can have some relief in the distress. Ocpd, on the other hand, you have a collection of personality traits and behaviors. Typically that includes things like perfectionism. And here we're talking about a maladaptive form of perfectionism which is striving for unrealistic high standards as well as rigidity. Like an insistence on one way of doing things and having difficulty with change. Those are some of the core features of OCPD as well as some other things that we can get into, like difficulty delegating, sharing responsibility with other people because they won't do it as well, or a fixation on order and details, rules and lists. These people tend to be hyper moral or judgmental of other people in terms of morality and ethics. So that collection of traits and behaviors we call ego syntonic because usually these individuals are prideful in these behaviors and the way that they see the world and they believe that other people should behave in these ways as well. These behaviors are driven by their standards, their values, and the behaviors are typically seen as necessary and like I said, related to their goals. So that's a main differential here between OCD and ocd. The other piece just to mention again, in ocpd, unlike ocd, you're not going to see a preoccupation with unwanted thought content. So obsessionality is something that you would see within OCD that you're not going to see in ocpd. So that's the differentiation there. But OCPD creates functional impairment because as we mentioned, these people tend to overwork their lives, become imbalanced in that they're not making time for leisure or pleasure or relationships. They then experience burnout and often low mood. They have conflict in their relationships because of the need for things to be the right way. They can also have a paralysis in making decisions. And this is something else that we talk about in the book because that's a, it's. That is not a diagnostic criterion of ocpd. But it is very common in people with OCPD to labor to make decisions, to research heavily, to try to figure out what is the best option, whether it's a purchase or how to spend time.
- [21:48]
A
Right.
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B
That they then often don't make the decision because they're, you know, so worn out from trying to, to research and consider all the options. So that's another way that it's impairing as well as procrastination because the, especially in those that have perfectionism, the completing something is very much distressing because they are concerned they're not going to get to their high standard. And so they tend to put off starting or they'll do things that seem adjacent to the activity. Like if they're writing a paper, they might read all the other articles they can find on this topic, but don't actually write. So they're doing things that look like the activity but not actually the activity. And so we call that productive procrastination. It looks like you're busy, but you're not actually doing the thing. So that's another way that this gets in the way as well as like having some difficulty with managing and expressing emotions. So these are some of the ways that OCPD interferes.
- [22:47]
A
Yeah. You know, just as a clinician myself, and for folks listening, whether you have lived experience or you're also clinicians, you might be going, oh, well, that sounds to me a lot like adhd, or for a autistic family, that might resonate as well. And both can be there. But I think in general, when we are thinking about how things are functioning for us, that's really where we have to zoom in. We have to understand the function that is the highlight. So while it can be both, and sometimes if, if it's really hard to initiate a task or follow through and there may be some procrastination or struggles with that, we also have to look at the function a lot of times, again, we're going to have that ego syntonic, that value driven. I want to get this right, and this is so important and I don't want to make a mistake. Again, we talk about that perfectionism, it has to function in this way. And I think so many people with OCPD or loved ones loving on their OCPD warriors are like, yes, that, that resonates. One of the things you talked about in the book that kind of also helped portray this idea of egosyntonic versus ego dystonic that I like because I'm an analogies girl and it's how my brain operates is the idea of like the onion versus the garlic symptoms in terms of that. And I thought, what a great way of making this really digestible. No pun intended.
- [24:13]
B
Right? The garlic may be something that we enjoy eating, but it can be something that other people are more aware of because of the fact that it, you know, affects your breath.
- [24:24]
A
Yes, it does. You're right. There is moderation. And what's good for you isn't necessarily good for other people. However, when we think about this, even in the framework of ocpd, what's good for you, we want to distinguish, is it functioning as good for you? You can care about it, you can value it, but to what point does it actually have a social tax, an emotional tax, a relational tax that gets in the way of you being able to live more fully across the spectrum of your life? And so you can love garlic, but also you can see how maybe relationships might be impacted if you smell like a clove and, and you know, all the different things. So. Yeah, yeah, I think it's such a great point.
- [25:11]
B
Yeah. Just to add to that. And I'm a big garlic fan, I'm an Italian, so it's a big part of our cuisine.
- [25:17]
A
Yes.
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B
But the thing about the values in OCPD is that there tends to be, and this might be related to rigidity, but a tunnel vision towards one particular value at a time. And so if someone's working on a project, they might get really hyper focused on making sure that they do the project to the best of their ability and they create a product that is perfect, but that is then at the expense of their own self care, perhaps their relationships, spending time with loved ones. And so part of this work is to say, yes, we honor that you are somebody who's conscientious and likes to produce high quality products and to do well in your work. But how do we balance that part of you with the other parts of you that does want to have fulfilling relationships and wants to have hobbies and interests and more diversity in terms of how you spend your time? So that's part of the work here is like, how do we look at your life, you know, and we talk about the pie chart of like how do we diversify the different ways in which you're spending your time and effort so that you don't get caught in this tunnel vision of just over investing in one area of your life at the expense of others.
- [26:43]
A
Yeah, such a great point. And with that basis of CBT being cognitive behavioral therapy, I was noticing even on the book How Dr. Deibler Was One of the professionals that kind of previewed and highlighted some strengths and emphasis on what's in this book. And it just reminds me too, even on BFRBs or whatever, the thing is not being body focused repetitive behaviors is that sometimes we do really need to look at that pie chart. And it's not that those pieces of the pie don't matter and you can't care about it, but all the pieces of the pie matter and how do we make room for the whole pie when it all is really important? And if you're sitting here listening, being like, exactly how do I do that? You're in the right place because we're going to be again talking about how this book can really help support whether you're doing this on your own or with a therapist. I always recommend, you know, self help books. Workbooks are a beautiful, wonderful thing. But if you can work with a therapist. I always recommend that. However, you've already highlighted just the shortage and the misunderstanding or maybe just naivete around understanding OCPD across practitioners. And so this book is such a gift to not only people that want to kind of learn along by themselves, but for practitioners that are like, yeah, what is this? And you can do it with your client and you are going to learn a lot. And so this is, it's such a great thing. So we have talked about before and you talk about in the book really how there's two distinct presentations where a person can have both and. But there are two distinct presentations of this more anxious type and this more controlling type of ocpd. And the good news is the book has you covered no matter where you fall in that. But would love to hear you share more about that.
- [28:42]
B
Yeah. So to get the diagnosis of OCPD through the Diagnostic and Statistical Manual, which is the collection of all different mental health conditions, to get the diagnosis, the individual needs to have a pattern of distress as well as functional impairment in four of these criteria, four out of eight, including the things like I mentioned before, perfectionism, rigidity, hypermorality, reluctance to delegate, et cetera. So because of that, that system of diagnosing it, it leads to heterogeneity in this population of ocpd. So what Michael and I have found to be helpful clinically in thinking about our cases is to consider more homogeneous style types. And what we have found is that thinking about, rather than thinking about OCPD as like one thing, if you think about what is the way in which this person is usually presenting, what's their predominant style type? Do they tend to present in a more anxious style or in a more controlling style? And so somebody with that anxious style is going to be the type that has more difficulty making decisions, tends to be more self critical. They're more likely to have time management problems and to procrastinate. They will tend to be the ones that over explain because they get really mired in details, they have difficulty filtering and they tend to have a very detailed way of processing information. Even things like reading a novel for pleasure. Somebody with this style is going to have a hard time because they will want to make sure they have every detail and their reading tends to be more like studying and so it becomes not restorative or pleasurable. Yeah, those people with the anxious style are also the ones that are going to be, you know, very much concerned about like what are other people thinking about me? They tend to be the ones that are more likely to have comorbid OCD as well as other anxiety conditions. And I should mention that the comorbidity between OCPD and OCD is about 25%. So about a quarter of people with OCD will also have ocpd.
- [30:54]
A
Anthony too. I'll say that we know because I think this is. OCPD is underdiagnosed, I would imagine. Right. And so.
- [31:01]
B
Oh yeah, yeah, yeah. And then. And that's part of the reason we need to get more education out there because people are not looking for it when they're doing their assessments. The controlling style are people who are going to be more rigid and rule bound and insist on one way of doing things more outwardly critical. Whereas those that are the anxious style are going to be inwardly critical. So the controlling style is going to be judgmental of other people. I like to use the word or the phrase. They like to provide unsolicited mentorship or problem solving to people in their lives. And unsolicited meaning they're, you know, they might be well intentioned and advising people how to do something, but it can be very annoying to the people who they live with or who they associate with because they're providing all of this guidance that people are not looking for. They have difficulty sharing and relating to emotions and can have anger outbursts when their sense of control is threatened. So for the controlling type, you know, tend to need a somewhat different approach, at least initially, where you're going to focus a bit more on emotion regulation strategies which are included in the book as well, prior to going into some of the other change strategies which are going to be more about willingness and behavioral experiments. So that's the, the sort of the how we, we view this. And, and like you said, somebody can have both of these styles, but generally people have a predominant one.
- [32:26]
A
Yeah, yeah. Makes me think of just someone I know in my personal life too. Anytime we might play a game at a gathering or something, the amount of we need to download and process these rules in every which way. Again, you talk about kind of that anxious style of really wanting to make sure they understand. And then for our broader listeners that are more familiar with ocd, you can see in a case where maybe somebody has both, there can also be that intrusive fear of if you mess up, what is going to be the consequence? It feels very dire, very distressing. And so understanding. Building compassion, I think that's going to be a huge theme here. But building compassion for oneself and how they process information is going to be so Incredibly important. And so with this book having some of the different tools, and again, we've talked and you've even heard from some of the patients that Anthony has worked with that have had the bravery and vulnerability to share their stories on the podcast. They've used these tools. And so I love those examples. But now we have this workbook where it really can map out how we use these different tools. And so I don't know how much you want to go in on those or if you're like, hey, check it out in the book. It, it'll outline it for you. You tell me.
- [33:52]
B
Yeah, well, one of the things that when you're writing a self help book, especially in those that are doing it totally on their own without the assistance of a professional, we wanted to provide some tools for helping the individual see themselves in this material and helping them to start to assess, you know, is this something that's impacting my life? And so what we include in the book are we created this long list of behaviors that over 25 years of working with patients with OCD and OCPD I have found and Michael has found there are certain behaviors that come up a lot.
- [34:30]
A
Yeah.
- [34:31]
B
And so we created a checklist list of OCPD behaviors that can help somebody who's new to this say, oh, you know, that is something that I do. And it's not that if you do one of those, that that is necessarily a problem. But if you're starting to notice a pattern of insisting on one way of doing things or a pattern of fixation on like high standards and perfectionism that's getting in the way of completing tasks. We included a list of things even on this podcast. How many times have we talked about the conflicts overloading the dishwasher. Right. That is seems to be a pretty universal thing that comes up with people with OCPD because they have difficulty delegating. So that's just one example of the kinds of like, practical behaviors that we included on this list. And then the other thing we included in the book is the pops, the Pathological Obsessive Compulsive Personality Disorder Scale. So P O, P S, it's included in the book. So you can complete this questionnaire and get a sense of what your profile is in terms of the traits of ocpd. And so that's available in the book. It's also available for free on ocpd.org so people can complete the measure and then get a feedback report, which is anonymous, that you can then use to get a sense of how Are these treats showing up for you? You can then bring that to your therapist and it could help guide your treatment. And you can also use the scale throughout the process of completing the exercises in the book or as you go through your treatment to see how you're progressing.
- [36:08]
A
Yeah, I really love it as a baseline measure. If we take it, as with any of the measures we use in the mental health field and medical field for that matter, it allows us to see some of the progress. Sometimes now you can go like the minutiae of the day to day and things can change gradually enough sometimes. Sometimes it's also very apparent, but it can be like, am I making progress? So I love the ability of going in and the fact that you've made that resource free. In case you don't know, family, this is Anthony's measure that he's been able to create. I'm sure that there may have been other people collaborating with you on that, but the, the fact that not everything is free, I can just tell you, especially when it comes to measures and that they've made that an open source shareable resource is huge. So again, we're going to have those linked over on the blog. They're linked on all the past blogs for OCPD episodes we've done as well. But like you said, also you can find it in the book and that is such a valuable resource and you know, it makes me think of one of the questions even that came up that we have a little bit of a Q and A where we're going to go through and apply it back to the book where we can. But before I go into that question, I want to make sure if this seems like a nice natural time for us to do so or is there another thing you wanted to highlight before we did so.
- [37:24]
B
Yeah, I want to credit my collaborators on the Pops, Emily Ansell and Aiden Wright. This measure has been very helpful in clinical practice. It's a, it's a very useful self report screener and has shown an ability to pick up on ocpd. So for a busy clinician, having a self report measure that they can then complete online is a great way to supplement your assessment and to get a sense as to is OCPD part of the conceptualization for this person's treatment. And now it's in the book as well so the readers will be able to have those items. So yeah, so I think thinking about assessment is a good first step before moving into the different exercises. And the book includes lots of worksheets that you can fill out. And it's really meant to be user friendly.
- [38:14]
A
Yeah.
- [38:15]
B
And something that you can, you know, come back to and do some parts of it and apply it to your life and continue chipping away. And so this is about, like, trying to take the next step in whatever your journey is of making changes with regard to these maladaptive behaviors and traits. And we try to encourage, okay, what's the, the smallest step you can do to move the bull up the field towards the life you want. And so we try to break that down. And we also include in the book, you know, some strategies for helping you get ready to make behavior change, because changing these behaviors is in itself taxing. And so we want to make sure that you're in the best shape to do that. And we include a self care tracker in there so that you can make, you know, some adjustments to things like sleep and exercise, eating, socializing, leisure, all the foundational things that are going to give you the resources you need in your tank in order to do the work in the book. So those are, those are in there as well.
- [39:19]
A
Yeah. Yeah. Such a great point. Hey, real talk, if you've made it this far into the pod, chances are you love learning about ocd, so why not take it up a notch? Head over to ocdfamilypodcast.com course courses to browse the OCD Training School's incredible lineup. And when you use my special link, you're not just investing in great education, you're also supporting this podcast at zero extra cost with courses ranging from self help to continuing education for clinicians, offering live and on demand options to fit your needs or your time zone. The opportunities are vast. OCD Training School has your back. And when you use my link, you have the fam spec too. So go check it out at OCD family podcast.com forward/courses. And now back to the show. And you know what triggered my thought? And one of the questions that we received, which, if you've been listening over the last couple weeks to any of these OCPD episodes on OCD Family Podcast, you knew that Anthony was coming. And one of the questions that I received, some folks wanted to be anonymous. Some people were like, it's okay if you name first letter. But we received this question from Katie N. And she said, how do you know when perfectionism has crossed the line from high standards into something unhealthy? And I think what made me think of this, as you were talking through even that symptom checklist, that robust list of things that can occur for Folks, when O, C P D is a factor is that sometimes it is hard to leverage. How much of this is. Well, this is just me. It's not pathological, it's me. It's. It's traits that have been praised about over time. And you know, I actually pride myself in a lot of these different traits. At what point do we go from having those different standards for ourselves and really identifying with that to it being something that's actually unhealthy or as you and I might say, dysfunctional?
- [41:18]
B
Right, Yeah, I think it's a great question. I appreciate Katie sending that in. So perfectionism, when we think about it as a trait, includes striving for high standards. And so the striving aspect can be adaptive. You know, it could be something that leads to professional success. And so that in itself is not the problem. Where it becomes impairing and where it becomes like clinically diagnostic is when the striving for high standards, which are unreasonable or excessive to achieve, leads to difficulty completing tasks. And so that's really important for coding a clinical level of perfectionism. And that's why we use the word maladaptive perfectionism, meaning is the person's striving for these high standards causing them not to be able to get things done? You know, they're not able to turn in assignments on time, they're not able to complete work tasks, and perhaps even if they are completing it, they are needing to seek extensions on a regular basis, or they're needing to do lots of self sacrifice, pulling all nighters, consistently sacrificing their nutrition by skipping meals because they're trying to rally on a regular basis. Says we're not talking about like you pull an all nighter for a final. We're talking about this is a chronic pattern where the person is needing to do all of this, you know, self sacrifice in order to get something done or they're just not able to turn it in at all either because they are so delayed in starting, related to procrastination, or because they never feel like the product is good enough to submit. And so you have, you know, then people caught in this, like this limbo of not being able to get complete, not finishing a degree, not being able to turn in assignments at work, you know, it, it creates significant problems in advancing.
- [43:20]
A
Yeah, an example that I thought of with a client is they love rehabbing furniture and they, you know, whether it's a garage sale or somebody knows that they're really skilled at this and they're like, hey, you want this? I Don't need it anymore or whatever the case may be. And so they were rehabbing some furniture that they were gifting to a friend. I think they were getting married or something of the sort. And the client really, really struggled because every time they'd nearly get these furniture pieces done, they'd see one little thing that they'd be like, that could be better. And actually if we kind of zoom out and look at that, tinkering with this might change that. And they would just re. Take off the paint, take off whatever the varnish was and start over to try and make it perfect. And it got into the cycle where, you know, nine months after the wedding, they're still working on this furniture. And now that shame and guilt is weighing so heavily on them. Like I wanted to gift them this. I still haven't been able to give them this. Every time I see the furniture or walk by my garage, if I'm working on it in the garage, I just feel the weight of that. And so that I think helps to illustrate how, how that can function. Right. Where it's not because they're not procrastinating, because they don't want to do it, but it's not good enough. Sometimes we need to start over. I don't have the time to start over now. I'm just feeling bad about it. So I'm just going to shut the door and not go in there for a while. Right. And it just, you can see how that would weigh on someone.
- [44:59]
B
Yeah, I think that's a great example. The shame piece is a big part of it because when somebody has this form of maladaptive perfectionism, the way they see themselves, their worth is disproportionately connected to productivity and achievement and at the expense of other ways of evaluating themselves. And so if they, in this case that you're describing, are not able to actually complete the project, there's a lot of shaming that happens because that is one of the main ways that they see their value, their worth as a human. And so another aspect of OCPD treatment is self compassion and trying to help the individual diversify the way they see themselves in terms of not just your value, in terms of your work productivity or your school achievement, but, but also the other aspects of who you are, you know, as a friend, as a partner, as a family member, member of your community, and that's one piece of it, but, but also self compassion strategies to try to quiet this ever present inner critic and helping them to use certain acceptance strategies to be able to allow for that noise of the inner critic while you continue forward in your life. And so we include some metaphors in the book about how to try to create some distance from this critic. And we talk about the hard driving coach versus, like the more like drill sergeant type.
- [46:29]
A
Yes. And we've talked about, even in past episodes, the passengers on the bus or how the inner voices can really challenge your sense of am I doing this right? Second guessing yourself, all those different things. And you know, one of the things that another one of our questions, this one from Saila T. Sent me, is how much is OCPD actually fueled by shame? She distinguishes that perfectionism and control stuff seems less about wanting everything perfect. It's about not wanting to mess up, be judged, or not being good enough. And so I think that really highlights the point you were just making those inner voices. Now, here is the tricky part, and I'm sure you've run into this. I know I've run into this within and outside of ocpd, Anthony, but sometimes people go, well, I will do the self compassion piece if I earn it. Meaning if I complete all my other stuff, then I'll sit there and prioritize whatever it is, self care, me time this, that I can't do that in good conscience unless I've gotten the other things off my list, check marked. And so sometimes there really is maybe even that behavioral experiment where you have to test and go, well, is it going to be really unproductive and not helpful, or are you going to go, oh my gosh, I feel so much more recharged because I allowed myself some self compassion and self care. And so what would you say to that piece?
- [47:55]
B
Yeah, yeah. And I think this is a great question. The individuals that are in that more like anxious style that we described before, they tend to be more sensitive to what others think of them. So there's a piece there about am I being judged? The other piece I was saying in terms of worth helping the person diversify in terms of how they see themselves so not just evaluating based on productivity and achievement. You know, I think the book talks about willingness and behavioral experiments as like two key behavioral strategies for making change. And if somebody has this view that I can't take time for myself unless I've completed all of the chores on my list, that's a great behavioral experiment opportunity. And this is, you know, just reminding me of a recent example that a patient gave in which it was Sunday morning. Usually after breakfast, he starts doing all of his kitchen cleanup. But because of the work that we've been doing, decided, you know what, I'm going to have my cup of coffee here and spend some time with my daughter and leave the dishes in the sink. And that was a important turning point for him because he was able to then prioritize the value of nurturing the parent child relationship over the value of having a clean kitchen. And what he shared with me was doing that experiment helped him to be more open or willing to look for opportunities to nurture the relationship at other times of the day. So that change in the morning helped him later in the day to think about continuing to prioritize the relationship. Because ultimately in this case, this person really wanted to make some headway towards prioritizing relationships over productivity. So it's those experiments are very helpful in terms of learning a new way of orienting. Because like I was saying before, if you don't take that moment to pause, which this, this person did, and consider, I can go now and do my usual habitual behavior of cleanup, or I can go in a different direction and spend time with my daughter. That pause was really helpful in creating a space for him to try a new behavior. So something we emphasize is if you don't take the time to pause, your body and your brain will just go into its normal auto pilot, which is doing what it always does in cleaning up, because the cleanup feels good in the moment. So the other piece that I'm thinking about here is that what I have found from my research is that people with OCPD tend to have a delay of gratification or tend to favor going for later rewards. And sometimes that can be adaptive in that it helps you to save your money for the future. It can help you to, you know, put away, you know, funds for college or retirement. But the downside is that you're not nurturing your needs in present day and maybe not taking time for breaks. So being able to incorporate that in this treatment or in the self help is important that pause and consider other values besides productivity.
- [51:17]
A
Yeah, I really like that we talk sometimes, especially when it comes to perfectionism, about just how rigid it can feel, whether it's the person with the lived experience or maybe someone in relationship with that person, they feel that rigidity. So you're talking about really how he was able to compromise within himself. And it makes me think too of that dimmer switch analogy where he can kind of say, hey, both matter. And here's the reality, folks too, for anybody listening. It's not that the dishes for this patient, and I don't know this patient And I don't presume to know this patient, but just thinking more broadly, it's not that this patient didn't care in the first place about the relationship with the daughter. He cared about all of it so much. He cared about the cleaning so much, the daughter so much. I'm sure a list of other things so much. And you're set up to fail if everything matters that much. And there's only so much time in the day. Right. And so he being able to take that pause, was able to go, hey, dishes matter, but my daughter matters. And how I'm going to practice having that negotiation, that doing a little less here for this moment to spend time here and connect with my daughter. And he found that that really paid off. And you're going to find in those behavioral experiments, is the payoff worth it? If it's worth it, then you're gonna feel more motivation and encouragement to try that again. And naturally that's gonna blossom, that openness.
- [52:48]
B
Yeah. And when somebody does an experiment like in this case, it's important to think about this concept of willingness. So willingness is a decision to go towards something that is uncomfortable in the short term and to allow for that discomfort because you're moving towards a value that's important to you. So he needed to be prepared that when he decided to sit with his daughter and had the dishes in the sink initially that was gonna be uncomfortable for him. And so he expected to feel that so that it wasn't a surprise. And he, while he was sitting there though, he was, you know, glad to have that time. He's having thoughts about what about the dishes and when is that gonna get done and, and you know, am I a slob or. Oh, you know, all this kind of self critical stuff. So expecting that to be uncomfortable in exchange for the, you know, nurturing the, in this case, the value of the relationship, that's important that it's. You're choosing to go in a different direction, which is going to create some discomfort, but you're doing it for a very specific reason.
- [53:54]
A
Yeah, such a great point. And hedging expectations, I think just in general, such such a helpful thing, not having overly high expectations, but also hedging expectations. It's really hard to sit with that discomfort. And if you doing the dishes per your autopilot typical mode helps decrease some of that distress, then we see how that had functioned for you in a way. Right. We have empathy and understanding for that. And we also understand it's both okay to have some of that distress that you're not working on that in that moment. And that might come up a little bit depending on the age of the child, whether you're playing, you know, dolls or. Or, you know, talking about the latest TikTok or whatever the kids are into. But it's definitely going to be a piece of it. Change is hard, even good change that ends up more fulfilling. Change is hard. And so expecting there to be a level of distress and practicing that behavioral experiment going, I know there's going to be distress and worth it. It's worth it to test. And if your test fails and you're like, nope, wasn't worth it, then you learn something. But also, we retest when we do experiments. Right. Part of the scientific method. We retest because we understand, too. So much goes on for us day in day, our sensory systems build up what the emotional load for the day is this and that. And so an experiment that might work one Sunday might be less successful the next Sunday. Does that mean the experiment was bad necessarily? It just means, hey, that was a little harder or maybe it was a little more distressing than I expected, but I made it through and it's worth trying those experiments again.
- [55:41]
B
Yeah, you. You brought up the use of the word. And I think that is an important piece here because the black and white thinking, sometimes we call it dichotomous thinking, is something that we see quite a lot in individuals with these traits, particularly those with rigidity. And so being able to say, I like a clean kitchen and I, I can choose to spend time with my daughter now and get to it later using that dimmer switch, which is basically a metaphor for regulating how much effort a task really needs. Because people with OCPD and it's like black and white weight, tend to, you know, operate on a switch which is all in or not at all.
- [56:19]
A
Yeah.
- [56:20]
B
So thinking about the dimmer is a way to modulate how much effort do I actually need to put into the dishes. And if I can turn that down and think about what does it look like to turn down that dimmer, you know, to 80% or 60%, rather than full on. Maximizing perfection, having a sense of what that's going to look like in advance, that turning down of the dimmer creates more time and effort that you can then invest somewhere else. So the dimmer switch is a tool for reallocating time, re. Budgeting time into other slices of your life that are not getting as much attention because of the focus on perfectionism and maximizing.
- [57:03]
A
Yeah, yeah. Really great points. And, you know, it's A nuancing. It takes practice. It's effortful. Right. And it's effortful to engage even in the perfectionism. Right. We certainly know that's effortful. And so it's going to feel a little uncomfortable, it's going to feel a little distressing, but in time, in practice. And I think a lot of people that have found great success using these tools could tell you, and it's one of the benefits that we've talked about in prior episodes with your group therapy format where folks can speak into each other and be like, I get it, and, and that. And again. Right. But it's so important to be able to have that balance. And I'm going to shift a little bit toward Emily Aspect we got a comment off of Reddit. This is from National Health 4898. It states, Does OCPD suddenly just appear? I will say the too long don't read version of this is that this family had children. And after the children, I even think the children maybe were dealing with different sensory issues or different things of their own, but they really noticed a huge difference after the kids were present. And so they were like, hey, can OCPD just appear? I have my thoughts on it, but I would love to hear what you have to say first.
- [58:34]
B
Well, yeah, no, I appreciated this question, and it's actually one that we haven't gotten before. So what I would say is that unlikely that OCPD would just suddenly onset. What I have found in my research is that you tend to see some presence of these traits in childhood where there's more of a tendency towards routines and rules. I mean, some of this, like as we've talked about before, can be normative in kids, but you start to see more of that and maybe some perfectionism as well, developing. But the actual meeting of criteria for OCPD tends to happen in late adolescence, early adulthood. We might think about that as like, you know, college age, you know, where you have independent living, difficulty living with other people because of the way in which they conduct their lives. On average, I tend to see onset in that period of late adolescence, early adulthood. So in the response to this question, what I can say though is you can have exacerbations in these traits as compensatory mechanisms to life changes or to life stressors. And so in this case, what the person is describing is a second child is brought into the home, everything gets upended, all of the routines are thrown out the window. And this person is also describing having a change in employment, having worked out of the home. Now a full time parent.
- [60:08]
A
Yeah.
- [60:08]
B
You can see exacerbations around a need for control around life stressors like this. And again, to compensate for, you know, sort of this out of control feeling of a life that is completely different than way it had been.
- [60:25]
A
Yeah.
- [60:26]
B
And then another time of life where I see this is that movement from work to retirement. And so for individuals who haven't had the diversity, putting in time towards like interests and relationships, they can struggle when they retire because the thing that had provided so much meaning is no longer there, which is their job. And then you can have some difficulty in managing that transition because now they suddenly have a lot of time and unclear what to do with it. And so they start to then get focused on rigid routines for managing like day to day life as a sense of, to, you know, to get a sense of purpose. And so that, that could be another area. So, so I guess the, the, the to answer the question, generally you see these traits develop over time. You can have exacerbations related to stressful life events.
- [61:21]
A
Yeah. It makes me think of just the casual conversation we were having when we first connected today, before we were recording. I was talking about, oh, I'm so glad we could, you know, have time for this interview because my kids go on school break soon and it's really hard to get anything done when I'm mommy ing it right and joking about becoming parents time. What's that like? You were now devoted to raising these little humans to become big humans that hopefully have a good compass with them. And so it is one of those things where whether we're talking OCD and we see different developmental periods, like when kids go to college or something, there's a big environmental change. We might see heightening of symptoms. It's not that they weren't there, but the environmental change has had a big impact. And so your sense of control or safety or creating regulation for yourself might look very different. Especially if you now have two kiddos and you now are dealing with some employment changes and just life happening. And so I think that's a really good point. If we look back, once we know what we're looking at, we can probably trace the symptoms and the different aspects, characteristics of that back, but it doesn't necessarily come out of nowhere.
- [62:44]
B
Agreed.
- [62:47]
A
All right, Bam. If you're getting value out of our conversation, but you haven't hit subscribe or followed OCD Family Podcast, wherever you enjoy your podcasts and YouTube, please take a moment, no time like the present to hit that button. It's Free. It's easy. And it ensures that not only will you never miss an episode, but that more folks can find the OCD family community. Because, fam, we know we're better together. Now, back to today's chat. All right, so when we think about this again, from that family aspect, I'm going to guess the context for this even is probably within a romantic relationship, if I had to guess. But we have A question from TrickyAstronaut5328 that says, is there a comorbidity, meaning is that a co occurring disorder or thing that can happen between OCPD and narcissistic personality disorder, otherwise known as npd? And I thought this is a really interesting question because somebody might look at their spouse, especially with that controlling type, and go, oh my gosh, they're, they're so narcissistic. Everything has to be about them. They're the only one that knows how to do something correct. And so we'd love for you to distinguish more your thoughts on the comorbidity or even the differential between NPD and ocpd.
- [64:10]
B
Yeah, so narcissism, which is something that has gotten quite a bit of attention in recent years, we think about that as a trait. And there's also a personality disorder, narcissistic personality disorder, which some of the hallmarks of NPD are a profound lack of empathy, attending to use charm as like a manipulation. And so I would say in terms of the research looking at how many people with OCPD have npd, we have very, very little data. There is some data from the Collaborative Longitudinal Personality Disorder Study that looked at people with OCPD and they found in that study about 16% had NPD. So there was some presence there and it's something to keep an eye out for. I tend not to see it much in the clinic here at Northwell, where we tend to see more of people in that anxious style presenting with co occurring anxiety disorders, particularly ocd. But when it does show up, like you said, Nicole, it tends to be in those that have that controlling style. And that would be certainly a significant barrier to change, especially in a therapeutic context, because somebody who has narcissism is going to have a hard time trusting the clinician will be judging that individual in terms of their credentials or their competency and will have difficulty with the willingness to engage in the process of being vulnerable in order to make these changes. So. So that would be certainly something to be on the lookout for as a potential barrier to change. And yeah, again, that's something I see a lot in my clinical practice.
- [65:59]
A
Yeah, I think that the idea or concept of narcissism gets watered down a little bit in our colloquial use of the word. Right. If we don't like somebody making a decision for themselves, especially if it rubs against the decision we would prefer or one for ourselves, the. The term of, oh, my gosh, they're so narcissistic. I mean, how many times have we heard it in. In so many different aspects. Narcissism, especially within that NPD personality disorder is very different. And I think a lot of people don't understand that piece. And again, there's a lot of stigma around personality disorders. And so that's part of the battle is getting out good information and helping with that psychoeducation to really understand some of the distinguishing differences. Also, in general, in life, if we go out and we just pathologize people, you're a narcissist. That's just gonna go over well. How many people have you ever said something or seen a comment, oh, my gosh, the comments on social media and things where they're like, oh, thank you for pointing that out. I've been enlightened and I will reevaluate my social skills and stuff? No, they get nasty, they troll each other, and it's not productive in terms of helping educate people. So it's part of the reason why we come together and do things like this podcast as well, and all the great work and the books and the publications you've done over time, too, to help people better understand what we're talking about when we talk about whether it's ocpd, npd. So that's really helpful. Okay, so if somebody is sitting here going, yep, yep, yep, I know all of this stuff sounds very familiar. We've talked about before. Insight level is pretty good for folks hearing this. And they can go, oh, this registers. I. I can. I can identify with some of these different characteristics or for someone in your family, how do we broach that conversation? How do we help introduce somebody? I think there's a lot of fear, especially sometimes within that controlling type, to be like, hey, I think you might have something that fits with this because it feels, well, for lack of a better word, that discomfort. Just like we were talking about earlier. It's. It's really uncomfortable to sit there and have that kind of conversation or confrontation with someone. And so how can we help our loved ones and introduce this idea? Because introducing. Well, again, we don't want to over pathologize people. We want to provide hope and tools that can help people feel more fulfilled in their lives and relationships. And so what would you say, you know, someone sitting here going, this book would be perfect for my brother, sister, mother, father, whoever. How would you encourage broaching that?
- [68:55]
B
Yeah, that's a great question. I think the first step to any kind of pathway towards change is awareness. So providing resources where the individual can start to see themselves in the content, whether it's sending a link to a podcast. What I've had some of the family members I work with say is they. They put it on during a car ride.
- [69:19]
A
Yeah.
- [69:20]
B
And it's a way to have a conversation like, oh, no, I. I came across this podcast. What. What do you think? You may not even reference the person right. Directly and just say, look, what do you. What do you think about this? Are you aware that there are people that struggle with these traits? And then you can start to get a little bit closer towards. Is that something that resonates with you? So I think the podcasts are a helpful tool for hearing, especially the ones that we've done recently, which have included people with lived experience. Hearing it from the voice of people that are living. This can be particularly helpful. So podcasts can be helpful. The workbook is also designed as a way to. To be an entry point towards, does this relate to you? And like I said in those early chapters, we do talk quite a bit about, is this something that might be relevant to you? Is this an area that might be worth looking into? The term personality disorder, as you said, can be stigmatizing. So we are trying to be really careful to say here, this is, again, like I mentioned earlier, not about changing it, but this. There is a collection of maladaptive traits and behaviors that we can give a name to. And the reason we give a name to it is so that we have an understanding of what it is. And we've researched it. We know that they respond to certain interventions. And so. So it's. That's why it's important to have the label. But we don't want people to feel consumed by the label because we want to still see the individuality. But having the book, the podcast, ocpd.org as a place where someone can go to learn, that's really the first step. Learn. Does this sound like you? Does this resonate? No. Typically, when people have OCPD and they hear these discussions or they read articles about ocpd, they're able to see themselves and be like, oh, A lot of times people have come up to me like, oh, I thought that article was about me. And that's an important first step because they're, they have that realization that like this relates to me. And then there's other resources out there. There's a book called the Healthy Compulsive by Gary Trasklair which can also be very helpful in terms of getting more awareness. He has a website as well. On OCPD.org, there's also a virtual support group which is open to anyone, regardless of where you live. It's not treatment, but it's a discussion group for individuals and families with OCPD to start those conversations about does this relate to you? Where might you consider going for help or you know, what do you want to do next in your own journey? So thankfully we have these resources and hopefully it's a good way to start the conversation.
- [71:54]
A
Yeah, yeah. And again, sometimes because as we've discussed, even during the course of this episode, the researching aspect, those value driven pieces within one that may sometimes lead to burnout might also again we would hope to in a dimmed down way, in a way that you have margin for. Folks can hear about something, if it resonates, they can go and learn more. And a lot of people do, they go and they seek out that information. And so having that right information, having the right tools versus, you know what? I think work for my brother, sister's mother's daughter is really, really important so that we can really help people understand their strengths, understand their humanity, understand and really build that compassion for themselves so that they can grow into the best version of themselves, one that has room for all the things that matter for them. And so I think that is such an important point. If someone has a loved one that isn't necessarily at this moment ready to kind of engage or deep dive into that, say it's your spouse that has ocpd that getting this book and going through it at least to help your brain understand their brain a little more. Would you recommend people picking up a copy just for that empathy and understanding?
- [73:17]
B
Yeah, I think it's a great point. We are hoping that this can also be a tool for the loved ones of somebody with OCPD who may or may not be ready to start doing any work in this area, but to give the understanding of what it's like to live with OCPD in a non stigmatizing way. As you mentioned, these individuals are goal driven. They have a sense of how the world should be, but it's not working for them because they're investing so much time and effort, and they're tending to get into the minutiae of details to the point where they're feeling stuck and often burnt out. And it can often lead to low mood. So having an understanding if you're the family member about what that person's life is like can be really helpful in terms of empathy. And we've also included some ways to have that conversation. When somebody is engaged in behavior change, the family member can then help call them out in a helpful way, in a supportive way to say, hey, listen, is that OCPD talking right now? Is that really what you want to be doing now? Is that in line with the bigger picture values that we've been talking about? So the family member can help assist the behavior change by reminding the person or helping them stay accountable to some of the goals that are making in terms of OCPD change.
- [74:39]
A
Yeah, I love that. I am always a big fan of externalizing these different traits that sometimes can overwhelm a person from who you are. Right. Because, well, we can go, yeah, my personality is a part of me. It's a part of me. And back to what we were talking about at the beginning. It's not defining you. It also is so important for that self compassion and that reduction in shame to go like, okay, my striving to do things well isn't bad, but it can get in the way of me living a full and more functional life. And so being able to externalize that. This is the OCPD being real loud right now. And what do I want to choose? I get to choose on how I'm going to respond to it, which is where that pause, take a breath can be so incredibly helpful. And so having that compassion and understanding, even as a loved one, sometimes it feels very personal, like, oh, he, he or she harps on me about every little thing. I feel like I can't do anything right. I'm pretty sure I did it the same way. And they're like, no, you didn't. And it's like, oh, realizing that while you're allowed to be upset, realizing that there is this process going on for the other person can be really helpful. It doesn't mean you can't talk about it or discuss how you would like to see things improved as a family member. But if you're interested in hearing more about that, I would encourage you to go back to the episode we just did in November with Adam and Rebecca, because I think they really paint a beautiful balance and picture of what this process looked like. And it wasn't always easy and it was painful, but it also has led to a very rewarding journey for them. And so I think that if there's
- [76:27]
B
anyone out there that's living with someone who's hypercritical and rigid, having this awareness can help that loved one to not personalize this and to create some distance when the individual is in the mode of providing that unsolicited feedback and that criticism to say, you know, look, I know this is how you see the world, but I'm going to step back from it because it's not healthy for me to be receiving that right now.
- [76:52]
A
Yeah. And I think I can't remember which episode, maybe more than one even, that we highlighted it on. But we're not endorsing or saying it's okay if anyone rises to the level of being abusive or blames their OCPD to justify any kind of domestic violence, emotional abuse, physical, any of the kinds of abuses. And I would just distinguish when we're talking about ocpd, we're not talking about abusers or abusive. Different things. So I understand and I've heard feedback from people where it can feel injurious in terms of the dynamic that has grown a lot of times in different parent, child relationships and friendships and partnerships. And so just wanted to highlight that. Do you have anything you would add to that piece?
- [77:39]
B
Yeah, I mean, if there is any form of violation of the rights of another person, any form of abuse, full stop, it's important for the safety of that loved one to have a plan for removing themselves from that situation. A hundred percent. Yeah. This book is really geared towards those that want more awareness of OCPD and ideally for those individuals that are affected and are open to, to change. But yeah, I'm glad you made that distinction.
- [78:09]
A
Yeah. So with that, I'm cognizant of our time. Really enjoyed this conversation. Are there any kind of final notes that you would like to highlight before we wrap up today?
- [78:21]
B
Yeah, this was a great way to kind of give an overview of the tools that are available in the book. I just want to highlight a few things. One is want to thank John Hirschfield, who wrote the foreword for the book. And so we're really appreciative to him as well as all the clinicians and others who endorsed the book and provided their feedback. So I'm really thankful to them and wanted to just remind people that the Northwell Health OCD center offers specialized treatment for OCD as well as OCPD and individuals with both. And so that is a resource for people in the New York area where we offer individual therapy, cognitive behavioral therapy, exposure and response prevention for OCD and ocpd, individual group as well as medication management. I'm going to be doing trainings for clinicians in how to use CBT for OCPD and the next one will be an in person training. A full day at the IOCDF conference in Seattle on July 9. At the part of the pre conference there will be a full day dedicated to OCPD and how to use CBT and then there will be some virtual trainings coming up. I know of one in January that we're going to be doing and that will be hosted by McLean Hospital. Michael and I will be doing a full day there and that's available virtually for those that can't come to Seattle. And then the last thing I wanted to mention, and we've talked about this before, Nicole, how there is such a need for more focused research and ocpd. And I'm happy to say that a colleague and collaborator of mine, Dr. Ann Haynes, H A Y N O S she's at Virginia Commonwealth University. She was awarded funding from the National Institute of Mental Health to do a study on decision making and she is comparing different patient groups, including ocd, including anorexia nervosa, as well as a group with OCPD and comparing them to healthy controls in terms of how they make decisions. And that study involves functional MRI and so I wanted to just give a plug for that. And this study is available, you know, enrolling now. So this study does provide payments as well as travel reimbursement to get to their lab in Virginia. So something to consider for those that are in those patient groups. Really happy to see that she's doing this work and so important for us to learn more about the biology of OCPD in terms of how it works on a brain level and how this could ultimately inform treatment development.
- [81:06]
A
Oh, that's amazing. That's amazing. So again, if you jump over to this episode's blog@ocdfamilypodcast.com, i'm going to link the deets on all of that if you are interested. And I love that it's financially compensated. Travel can be compensated because sometimes that's a barrier, right. If you don't live regionally. And so that's huge. I love that. Also the in person training and the virtual training. Again, let me just say this to y', all. I, for the majority of my career was not in the OCD field until I was right. And I went out on a limb early on in my experience of practicing within the specialty of ocd. I sent a message to Anthony and said, hey, would you be willing to come talk with me about ocpd? Because all I had heard as a clinician was if we're looking at the distress in ocd, but it's actually more like aggressive or agitated, it's probably ocpd, which is not even close to an accurate description and it's not fair. And it's part of why there is a stigma. And again, this is from the helping professionals that have a lot of compassion and empathy and hope for supporting people. And so there is a huge, huge way that we can contribute as professionals learning more. And I think there has been a big interest in people wanting to participate in training. So the fact that the IOCDF is doing this pre conference training all day, boy, it's going to be a busy conference for you. Your book comes out, right? I mean again available for pre order but it comes out days before this. It's going to be very productive. Busy July for you? There will be a pause after, I'm sure. But what I will say is if you can take the time, if you're going to be at the conference this year, go for it. I know there are people that are like regionally, I can't afford the travel virtual. So that January training is a great option. And also Anthony is one person folks. So if you want to learn, continue to grow in this, maybe even have a dissertation study that could focus on bringing more hope value research to OCPD and the broader community. I definitely am also going to endorse you looking@ocpd.org find out about opportunities, connect with professionals.
- [83:34]
B
Yeah, there will be a book signing event at the conference in Seattle on that Saturday, the 11th. And so please come by and say hello. I'd be happy to talk more about O C D O C P D. What do you do when someone has both? How do you sequence treatments? And so there's, there's so much to discuss.
- [83:52]
A
Well, look at you. I mean you're gonna be busy, busy, but what a cool thing. And so again, thank you so much for your time. You've been very generous. And y', all, you can hear how busy the man is with all of that. Him coming by and sharing this hope and information and practical tools with just the broader global community is such a gift. And so one last question. Do you know, will New Harbinger have any translated other copies of this or do you know do they do English only?
- [84:21]
B
Yeah, the what they have said is based on interest. They do translation. So we'll see how the book does and then I expect that will happen. And there's a need to get this information out internationally. So. Yeah, I would love that.
- [84:37]
A
Yes. So if you're interested, you can contact New Harbinger, let them know that you would like that in your primary language or go on Amazon, Goodreads, any of the different sites and give a review, give the feedback that you would like. More accessibility to this material. That would be fantastic. And Anthony, I mean, I'm going to see you in a quick minute. It's going to, we're going to blink and it's going to be July. But I just thank you for the time that you took today. I also thank Dr. Michael Wheaton for his blessing in us just going ahead and having this conversation and you know, next time, Michael, you are absolutely invited but thank you so much. I really appreciate your time and this has been fantastic as always. Just learning more with you.
- [85:23]
B
Yeah, thank you, Nicole. I really just want to salute all the work that you've been doing in helping get this information out. Always enjoy talking to you and thanks again to Michael who's been an outstanding colleague and friend and so we look forward to coming back again.
- [85:40]
A
Intrusive thoughts. All right. That was so good. It was so helpful. And just another huge thank you to Anthony and to Michael in Absentia for sharing more about this new workbook with the fam. We you thank. Thank you for your time and your dedication and the resources that you pulled together to really help OCPD warriors and families increase their hope. And that brings us to the Intrusive Thought segment, which for newer family joining is my application segment of the show. It's that time where, dare I say I take a pause and reflect on what stood out from the conversation or how we can apply it in real life. And one thing that has really stayed with me today is this idea that people with OCPD are often trying so hard to get things right, so hard to be responsible, so hard to live according to their values. And underneath all of that can be so much burnout, shame, pressure and isolation. And like Anthony said, since we all probably know at least one person with ocpd, we need more evidence based resources out there. So if you're lucky enough to live in New York and can get into Northwell's program, that is a wonderful option. Or again, I absolutely love and encourage you to check out more information on that virtual support group through ocpd.org but beyond that, access has been more limited. So here's where I actually think our community, the OCD family community, can genuinely help to make a difference. That might look like sharing this episode with someone who has never heard of O C P D before, but even more so, can I ask you for this? If you're listening right now and you're like, you know what? I am getting a lot out of this. I'm learning. Would you do me a favor? Pause the episode and take gosh, two, three extra minutes to leave a quick review on your favorite podcasting app, or even leave a comment over on YouTube or hey, jump on social media. I know Reddit has a really robust community and shout out to the mods over there. They do a great job like false pay 5737. I'm always like, look, they are on top of it. I appreciate their diligence so much. But I swear, if even 10% of the people listening now or posting on Reddit took a quick moment to leave a review on a conversation like Anthony and I had today, it would massively help boost visibility and awareness around ocpd. So if you would, and you can take as little or as long as you like, but I'm telling you, a minute, two minutes. Wow. This really helped me. Wow. I want to get this book and learn more. Your review can help increase visibility, which will help increase accessibility. And to that end, when you grab your copy of the Obsessive Compulsive Personality Disorder workbook from the Good Docs here, please also consider leaving a review whether you get it on Amazon, Amazon, whether you're tracking it on your Goodreads list, Kindle, wherever you engage with books, those reviews matter. Requesting translations matter, adding books to lists matter. The algorithm really does notice these patterns. And while this idea of algorithms can sometimes be hard to understand, or get us stuck watching videos of hummingbirds or what have you, because we watched that one video that one time. But here's an example where we can use that algorithm for good promoting the content and the awareness about OCPD and man. Imagine if you or your family has been coping or struggling with knowing how to get more out of life when OCPD has been really loud. Just imagine if you were able to find and access this kind of information sooner. We can help reduce that weight for other people. So again, thanks so much for your time. And hey, if you are a person with that lived experience of OCPD and you are willing, please check out the link over on this episode's blog about that research study Anthony mentioned going on in Virginia. Don't book travel just yet. I'm sure there is an application process and things to be figured out, but what a cool opportunity to make a difference and to support people and help them live more flexible and fulfilling lives. I mean, that's so cool. School particularly, I'm going to say, if you sometimes think about research and you're like, you know what? I don't feel like it reflects me. Whether it's the way I process the world, whether it has to do with ethnicity, gender, socioeconomic status, you name it. This is an opportunity to help change that. Not only to get more much needed research for ocpd, but an opportunity to expand representation. So again, you can see that link over on this episode's blog. Also, I'll have a flyer about this book and so many of the opportunities coming up that IOCDF Pre Conference Training and the January Virtual Training. So thank you for your time and thank you for hanging out fam. Also, a big thanks to Anthony, to Michael, and to all the incredible guests who have joined us all season long to help bring humor, hope, vulnerability and evidence based resources we can count on to make a real difference for our ocd, OCPD and OCRD warriors and families. And hey, that's a wrap because next week fam, you can catch me over at the water cooler. Thank you for joining me and our OCD Family community. If you enjoyed what you heard today, please like and subscribe. Subscribe to the OCD Family Podcast wherever you enjoy your podcasts. Did you find this content helpful? Please consider leaving a review. The more people that know they're not alone, the better. For more information regarding today's podcast, please visit ocdfamilypodcast.com and remember to join the email list while you're there. It will provide you with the most up to date information, resources and the download on the family chatter. Oem. Yeah, nothing says family like talking about OCPD with a new workbook based in cbt. That's right, I went there and you can too@ocdfamilypodcast.com. Hey practitioners, if you're looking to deepen your understanding of obsessive compulsive related disorders, check out the OCD Training School's amazing course catalog on emetophobia. What to do when you have co occurring eating disorders and OCD and process based therapy for BFRBs. Plus tons of OCD trainings and self help courses. Add that many of the trainings are APA aswb and NBCC CE eligible with both live and on demand options. I mean say less. So head on over to ocdfamilypodcast.com courses to learn more because when you use my special link, you will be supporting the pod at no extra cost to you. So let's get to learning family because we are better together.