The key words for obsessive–compulsives are “control” and “should.” These individuals make a virtue of justifying the means to achieve the end to such an extent that the means becomes an end in itself. To them, “orderliness is godliness.”

Self-view: They see themselves as responsible for themselves and others. They believe they have to depend on themselves to see that things get done. They are accountable to their own perfectionistic conscience. They are driven by the “shoulds.” Many of the people with this disorder have a core image of themselves as inept or helpless. The deep concern about being helpless is linked to a fear of being overwhelmed, unable to function. In these cases, their overemphasis on systems is a compensation for their perception of defectiveness and helplessness.

View of others: They perceive others as too casual, often irresponsible, self-indulgent, or incompetent. They liberally apply the “shoulds” to others in an attempt to shore up their own weaknesses.

Beliefs: In the serious obsessive–compulsive disorder, the core beliefs are “I could be overwhelmed,” “I am basically disorganized or disoriented,” “I need order, systems, and rules in order to survive.” Their conditional beliefs are “If I don’t have systems, everything will fall apart,” “Any flaw or defect in performance will produce a landslide,” “If I or others don’t perform at the highest standards, we will fail,” “If I fail in this, I am a failure as a person,” “If I have a perfect system, I will be successful/happy.” Their instrumental beliefs are imperative: “I must be in control,” “I must do virtually anything just right,” “I know what’s best,” “You have to do it my way,” “Details are crucial,” “People should do better and try harder,” “I have to push myself (and others) all the time,” “People should be criticized in order to prevent future mistakes.” Frequent automatic thoughts tinged with criticalness are “Why can’t they do it right?” or “Why do I always slip up?”

Threats: The main threats are flaws, mistakes, disorganization, or imperfections. They tend to “catastrophize” that “things will get out of control” or that they “won’t be able to get things done.”

Strategy: Their strategy revolves around a system of rules, standards, and “shoulds.” In applying rules, they evaluate and rate other people’s performance as well as their own. In order to reach their goals, they try to exert maximum control over their own behavior and that of others involved in carrying out their goals. They attempt to assert control over their own behavior by “shoulds” and self-reproaches, and over other people’s behavior by overly directing, or disapproving and punishing them. This instrumental behavior amounts to coercing and slave driving themselves or others.

Affect: Because of their perfectionistic standards, these individuals are particularly prone to experience regrets, disappointment, and anger toward themselves and others. The affective response to their anticipation of substandard performance is anxiety or anger. When serious “fail- ure” does occur, they may become depressed.