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Shapiro, although not presenting a comprehensive theory of OCPD, discussed what he saw as three of its primary characteristics. The first characteristic was a rigid, intense, sharply focused style of thinking. Shapiro found compulsives to have a “stimulus-bound” quality to their cognition, comparab…

Avoidant patients may engage in wishful thinking about their future. They may believe that one day the perfect relationship or perfect job will effortlessly arise from out of the blue. In fact, they often do not believe they will be able to reach their goals through their own efforts: “One day I’ll…

When failed expectations or dreams are the presenting problem, it may be that ruminative comparisons, minimization of the necessity of effort, and contempt or dismissal of partial results stem from similar rigid expectations for superlative achievement. Further, the NPD patient may be minimizing or…

The belief about the importance of appearances will frequently, although not always, extend to those whom the patient views as an exten- sion of him- or herself (e.g., spouse, child): thus the assumption, “My child (spouse) has to make me look good.” Perplexing double binds may arise out of this vi…

Another conditional assumption of power is the belief of exemption from normal rules and laws, even the laws of science and nature. Risk is viewed as remote, minimal, or easily managed. The patient may dismiss or actively distort evidence indicating risk, even when overwhelming, because of the firm…