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The Exhausted Woman
with Christine Hammond, MS, LMHC

How Narcissism Changes Obsessive Compulsive Disorder

Recently a teenager came into my office complaining about the anxiety they were experiencing from their Obsessive Compulsive Disorder (OCD) parent. They gave me a few examples. The compulsive handwashing that led to dry and sometimes bloody hands were imposed on everyone in the household. There was a sense of superiority that this family did things such as proper cleaning and sterilized laundry better than others. The excessive rituals before and after people would leave the house were designed to impress a magazine decorating editor. Unable to keep up with the expectations of the parent, the teenager felt defeated.

But after meeting the parent, it became apparent that in addition to the OCD they had Narcissistic Personality Disorder (NPD). This changes everything: the approach, the treatment planning, and the management of the OCD because the underlying motive is completely different. A person who has NPD and OCD is not likely to change their behavior but it can be guided so as not to impose destructively it onto others. By contrast, a person with OCD frequently wants their behavior to change and is embarrassed when they impose it onto others.

Here is a chart demonstrating the difference using the characteristics of NPD.

Characteristic NPD w/ OCD OCD
Motive OCD behavior reinforces and justifies NPD behavior OCD behavior is done as coping mechanism when feeling out of control
Superior OCD behavior is done as a visual demonstration of their superior status (they like being thought of as outdoing their competition) OCD behavior is done to ease anxiety even though they most likely are doing things a better way
Fantasizes Fantasizes that the OCD behavior proves their worth and desire for power, success, beauty or ideal love Fantasizes that the OCD behavior is not severe and hides the full extent of their disorder
Admiration Performs OCD behaviors to gain admiration and praise from others Believes their mild OCD behaviors should be admired but not the severe aspects
Special OCD behavior is a way of further distinguishing an NPD from the pack and placing them in special status Knows the OCD behavior isolates them; doesn’t like being thought of as special
Empathy No concern or empathy for how their OCD behavior negatively impacts others Constantly feels bad for how their OCD behavior impacts others
Entitled Demands automatic compliance from others for OCD behaviors regardless of other’s beliefs or the impact Demands compliance from others to ease anxiety and has a hard time seeing the negative impact on others
Exploitative Exploits other’s lack of OCD behaviors as evidence of perfectionism Takes advantage of other’s compliance with their behavioral OCD nature to justify their continued behavior
Jealous Believes others are jealous of their OCD behaviors and methods Is jealous of others who do not have OCD behavior
Arrogant Is proud and boastful of their OCD behaviors, frequently encourages others to be like them Is prideful of the mild OCD behaviors but shameful of the more severe behaviors

 

While cognitive behavioral therapy is highly effective for the treatment of OCD, it is not as efficient when the person is also narcissistic. Rather the underlying narcissistic characteristics need to tackled first before addressing the OCD behaviors.

 

How Narcissism Changes Obsessive Compulsive Disorder


Christine Hammond, MS, LMHC

Christine Hammond is a leading mental health influencer, author, and guest speaker. As an author of the award-winning “The Exhausted Woman’s Handbook,” and more than 500 articles, Christine has more than one million people downloading her podcast “Understanding Today’s Narcissist,” and more than 400,000 views on YouTube. Her practice specializes in treating families of abuse, and trauma, with personality disorders involved which are based on her own personal experience. Her new book, Abuse Exposed: Identifying Family Secrets that Breed Dysfunction will be published in 2020. Christine is a Licensed Mental Health Counselor and Qualified Supervisor by the State of Florida, a National Certified Counselor, Certified Family Trauma Professional, with extensive training in crisis intervention and peaceful resolution. Based in Orlando, you may connect with Christine at Grow with Christine (www.growwithchristine.com).

 


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APA Reference
Hammond, C. (2019). How Narcissism Changes Obsessive Compulsive Disorder. Psych Central. Retrieved on November 26, 2020, from https://pro.psychcentral.com/exhausted-woman/2017/03/how-narcissism-changes-obsessive-compulsive-disorder/