Sunday, March 4, 2012

Structuring the therapeutic relationship with the Obsessive Compulsive personality type

When working with any client a therapist is always considering two factors

What you are doing with the client


How you are doing it

For instance with the OC client one is working on how to deal with the anxiety and ways by which they can perhaps give up their obsessions and/or compulsions. Maybe doing redecision work with injunctions like “Don’t be a child” and giving up control. This what the therapist does with the client but it does not consider how it is done. By this I mean the therapeutic relationship.

OCs can be very orderly with their food.

All clients will establish relationships with others in their lives that fit with their personality type and life script. As they go through life they will structure relationships that fit for their life script such that it is reinforced over an over again. This is what all people do including you and me.

Of course a client’s relationship with the therapist is no exception. The client will set out to establish the same quality of relationship with the therapist such that it reinforces their life script and their personality type. This is not what they do in therapy but how they do it.

The goal of course is for the therapist to structure the therapeutic relationship such that it does not reinforce the life script. How easy this is to do varies from personality type to personality type. With the narcissistic personality type it can be quite difficult. They have a sense of grandiosity and others are somewhat inconsequential. Their only consequence is to serve the immediate need of the narcissist.

Amy winehouse

The therapist is wanting to establish a relationship with this individual such that he is of some consequence to the client. That is not an easy thing to do. What can a therapist do such the he becomes emotionally important to the narcissist? How can he make the narcissist fall in love with him? A difficult task indeed.

However with the OC personality type this task is less difficult. Indeed of all the personality types it is one of the easier ones. The OC will endeavor to be in control in the relationship. This does not mean he will battle with the therapist for control of the relationship but he will strongly resist the therapist being in control of him. The therapist is wanting the OC to experience a sense of being out of control in the relationship with the therapist. He can be out of control because the therapist is in control and will make sure everything will be OK. That the OC will be alright when they let go of their self control in the therapeutic relationship. The OC may find this a very difficult thing to do but it is not a hard thing for the therapist to encourage, (unlike with the narcissist).

The OC is too uptight, needs to lighten up and let go of the control. Their Child ego state believes that if they can just get control of things then everything will be OK, they will be safe. So that’s what they try to do and hence you end up with perfectionism, orderliness, cleanliness and so on.

Running free child
What the OC craves and fears at the same time

The solution is the opposite of that. The more they seek control the more rigid and uptight they become. If they let go and loose control then the uptightness disappears as does the need for order, perfection and so forth. Thus the therapist is wanting to establish a therapeutic relationship where the OC can experience a sense of being not in control. If that happens then what is being done is consistent with how it is being done.



  1. This has been an interesting topic because I know a couple of people who are OC. I’m not OC, but the idea that OCs want to be in control and fear being in control at the same time gave me something to think about. I like to be in control because it’s preferable to depending on other people; however, when I’m in control that makes me responsible for outcomes. If the outcome isn’t good, I can be blamed which is a source of fear.

    The caption on the pepper picture “OCs can be very orderly with their food” – is being orderly with food an obsession or a compulsion…or both?

  2. Good comments KYLady,

    The other thing about being in control of others is that it is tiring. It takes effort. I say to people like that, "When's it your turn?." Others around you can be carefree and irresponsible at times so when is it your turn to get that.

    Regarding being orderly with food. The usual way to use the terms is obsessing relates to thinking. So one does obsessive thinking. Compulsion relates to behaviour, so one is said to have compulsive behaviour. The OC can at times think obsessively about food or can have compulsive behaviours with food, or do both.

    Are the cans of food in your cupboards randomly crammed in or in orderly lines going from smallest to largest from left to right? I am just trying to have some fun KYLady. Thanks for making the comments that you do they are appreciated.