What is the hardest mental disorder to treat?

[Answered on Quora.com by David McPhee, Ph.D.]

Maybe OCPD. (Not OCD, which is an entirely different animal, and not particularly difficult to treat, by comparision).

And I’m just reporting on my own experience, and what I say may reveal more about my shortcomings than about OCPD.

Anyway, here’s a link with lots of information on OCPD: Obsessive Compulsive Personality Disorder (OCPD)

My experience has been that folks with OCPD can be extremely resistant to anything that looks like outside control, including medication and other treatments, that they tend to have rigidly held opinions and belief systems, and find it difficult to engage in a typical therapeutic process or even to have interpersonal relationships with any warmth, spontaneity, or reciprocity. And they can be serious hoarders. And indignant critics.

I have had folks with OCPD make me repeat things I said so they could write it down in their notebooks, furiously scribbling and filling pages, but with no sense that they would ever use any of these recorded quotes.

I confess that this was hard for me to write, because of my strong belief in the individuality of each client, and how I find myself talking about folks with OCPD as a group, but this is the disorder that has left me feeling ineffective and helpless more than any other.