Navigating the Intersection of OCD and Perceptions of Manipulation

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Janet Singer's son Dan suffered from obsessive-compulsive disorder (OCD) so severe he could not even eat. What followed was a journey from seven therapists to ...Read More

What is the Relationship Between OCD and Manipulation?

Obsessive-compulsive disorder (OCD) is a mental health condition characterized by persistent, unwanted thoughts, images, or urges (obsessions) that cause anxiety or distress. To alleviate these feelings, a person may engage in repetitive behaviors or rituals (compulsions) as a way to temporarily relieve the anxiety or prevent perceived harm.[1]

It’s important to recognize that OCD is a psychiatric disorder, not a behavioral choice or a matter of personal preference. People do not choose to have OCD, nor do they use it for manipulation or attention-seeking purposes. OCD is a legitimate condition that can significantly impact a person’s daily life and well-being, and seeking professional help is essential for managing symptoms effectively. 

Decoding the Misconception: OCD vs. Manipulative Behavior

Unfortunately, some people may misinterpret certain OCD compulsions as manipulative behaviors due to their repetitive and seemingly purposeful nature.

For example, an individual with OCD may repeatedly check locks or wash their hands excessively, which could be mistaken as deliberate attempts to gain attention or control. However, these compulsions stem from intense anxiety and the need to alleviate distress rather than a desire to manipulate others. The repetitive nature of OCD compulsions can sometimes give the false impression of intentional behavior, leading to misunderstandings, stigma, and blame.[3]


It’s crucial to differentiate between the involuntary nature of OCD compulsions and the intentional actions characteristic of manipulation. Individuals with OCD experience intrusive thoughts and intense anxiety, driving them to engage in compulsive behaviors as a way to manage their distress.

In contrast, manipulation involves deliberate and purposeful actions aimed at influencing or controlling others for personal gain. While OCD compulsions may appear intentional to observers, they are driven by internal distress and are not intended to manipulate or deceive others.[4]

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The Reality of Living with OCD

OCD can be a distressing mental health condition characterized by intrusive thoughts and compulsive behaviors. For individuals grappling with OCD, the intense anxiety and fear fueling their compulsions can be overwhelming, often plunging them into a relentless cycle of distress. 

OCD sufferers often experience intrusive thoughts that are distressing, intrusive, and difficult to control.[1] These intrusive thoughts can range from fears of contamination, harming oneself or others, to doubts about safety and security. Despite recognizing the irrationality of these thoughts, they find themselves unable to shake them off, leading to profound feelings of anxiety and fear.

The anxiety and fear experienced by people with OCD serve as potent fuel for their compulsions. These compulsions are repetitive behaviors or mental acts aimed at reducing the distress caused by obsessions.[1] For instance, someone who fears contamination may engage in excessive hand washing, while those plagued by intrusive thoughts of harming others may develop elaborate rituals to prevent such actions. These compulsions provide temporary relief from anxiety but perpetuate the vicious cycle of OCD, reinforcing the belief that engaging in these behaviors is necessary to alleviate distress.

One case study involves John, who is a 56-year-old man with OCD. His symptoms were gradual at first and he recalls always having been anxious and worrisome. He reported that he was terrified he would get HIV by touching doorknobs even though he knew that wasn’t possible and was an irrational belief.[5]

However, about ten years ago, after a few major life changes and stressors, his intrusive thoughts got much worse. He began washing his hands excessively and developed an extreme fear that someone would break into his house. Because of this intense anxiety, he repeatedly checked doors and windows in a very specific order. This upset his wife deeply and caused tension between them.[5]

Eventually, he sought treatment because his symptoms continued to get worse. For example, he uses an entire soap bar in a single hand-washing, leading to dry and cracked hands. He checks the windows and doors throughout the day and has even driven home from work to ensure his house is locked up. If he sees even a bit of dirt or dust, he cleans his entire house.[5]

He experiences severe distress and impairment from these symptoms, reporting that they take up a lot of time and cause issues in his family and work life.[5]

Supporting Without Judging: Advice for Friends and Family

Recognizing the difference between behaviors driven by OCD and those stemming from manipulation can be challenging. However, understanding the nuances between the two is crucial for providing effective support without reinforcing the OCD cycle or mislabeling genuine struggles. Here are practical tips to help you discern between OCD-driven behaviors and manipulation, along with guidance on providing support:

  • Understanding the motivation: OCD-driven behaviors are typically motivated by intense anxiety and fear. Individuals with OCD engage in compulsions to alleviate distress caused by intrusive thoughts. In contrast, manipulation is driven by a desire to control or influence others for personal gain or advantage.
  • Consistency of behavior: OCD behaviors are often repetitive, ritualistic, and consistent across various situations. These behaviors are aimed at reducing anxiety and follow a pattern. On the other hand, manipulative behaviors may vary based on the desired outcome and can be selective depending on the context.
  • Internal distress: Individuals with OCD experience significant internal distress and discomfort due to their obsessions and compulsions. Their behaviors are driven by a genuine need to manage anxiety and are not intended to deceive or exploit others. In contrast, manipulative individuals may display a lack of genuine distress and may exploit emotional vulnerabilities for personal gain.

Here are some tips on providing support without reinforcing OCD or mislabeling manipulation:

  • Empathetic listening: When supporting someone with OCD, listen to their experiences with empathy and without judgment. Acknowledge their distress and validate their feelings while recognizing the difference between OCD-driven behaviors and intentional manipulation.
  • Encouraging professional help: Encourage the individual to seek professional help from a mental health professional experienced in treating OCD. Cognitive-behavioral therapy (CBT) and exposure and response prevention (ERP) techniques are evidence-based treatments for OCD that can help individuals learn to manage their symptoms effectively.
  • Setting boundaries: While offering support, it’s important to establish clear boundaries to prevent enabling OCD behaviors. Encourage the individual to take gradual steps towards confronting their fears and resisting compulsions, while providing reassurance and encouragement along the way.
  • Educating yourself and others: Learn more about OCD and its symptoms to better understand the challenges faced by individuals with the disorder. Educate friends, family members, and peers about OCD to reduce stigma and promote understanding and support within the community.

By recognizing the difference between OCD-driven behaviors and manipulation and providing compassionate support, you can help loved ones with OCD navigate their struggles while fostering their journey towards recovery and well-being.

A Personal Story of OCD

Soon after my son Dan was diagnosed with OCD, he and I were out with some friends and decided to get a bite to eat. We were all casually chatting about various restaurant choices when Dan suddenly insisted we go to one particular place. He was adamant; we needed to eat there. So off we went. If I remember correctly some glances were exchanged (“What’s up with him?”) but nobody complained and we all went along.

I knew very little about OCD at the time, but what I did know was that this seemingly selfish behavior was totally out of character for my son. In fact, it was the exact opposite of the “real Dan” who’d always been so easy-going and eager to please others. Unfortunately, OCD operates in a convoluted way, and it often makes sense for OCD sufferers to do just the opposite of what their disorder demands. I think it’s also true that OCD sometimes gives non-sufferers the wrong impression, indeed the opposite impression, of the true nature of those suffering from the disorder.

Our friends didn’t know that Dan had OCD, but I’m not convinced that would have mattered. They likely thought Dan was selfish because he demanded we eat where he wanted to eat, with no regard for anyone else’s preference. The truth was Dan’s OCD made him believe we all had to go to that particular restaurant or something bad would happen. He wasn’t being selfish; he believed he was protecting those he cared about. Compulsions involving doing certain things at specific times or in a particular way, or being inflexible in various ways, all can be misconstrued as acts of selfishness.

There are many other examples where the actions of those with OCD could be misconstrued as selfish. Perhaps an OCD sufferer has contamination fears, and can’t bring herself to let anyone use her bathroom. Unfortunately she can’t bring herself to tell her friend she has OCD either. And so she comes across as selfish, or strange, and might even lose her friend. Or maybe an OCD sufferer is asked to drive a coworker to the airport, but can’t because he has a strong feeling that the passenger will be severely hurt, or possibly even killed, in an accident that he will cause. And so he’s seen as selfish and not willing to help someone out. The possibilities are endless and I’m sure many OCD sufferers and their loved ones could easily come up with their own examples.

Not only do OCD sufferers have to deal with being perceived as selfish and likely annoying, they themselves often feel guilty for “having” to manipulate people and situations in order to follow what their OCD is dictating. They know how they appear to other people, and this knowledge only contributes to the torment, as well as isolation, the OCD sufferer already feels.

But really, it’s all a big misunderstanding. It’s extremely hard for those of us without the disorder to understand that those with OCD feel they do not have a choice. They don’t choose, or even want, to act this way; they have to. It’s not about what they want; it’s about what their OCD demands. They are held captive by obsessive-compulsive disorder, and are at its beck and call.

Education is as important for loved ones as treatment is for sufferers. If I had understood what was happening when Dan insisted on going to that restaurant, I could have not enabled him. And while it’s true OCD can be misleading and deceptive, it’s also true that OCD is treatable. Sufferers need to get the appropriate treatment, and choose to fight. Only then will it be clear to others, as well as to themselves, who they really are.


  1. American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders (5th ed.).
  2. American Psychiatric Association. (2022). What is Obsessive Compulsive Disorder?
  3. Abramowitz, J. S., McKay, D., & Storch, E. A. (2009). The Wiley handbook of obsessive compulsive disorders. Wiley.
  4. Koran, L. M., Hanna, G. L., Hollander, E., & Nestadt, G. (2007). Practice guideline for the treatment of patients with obsessive-compulsive disorder. The American Journal of Psychiatry, 164(7 Suppl), 5-53.
  5. Society of Clinical Psychology. (2022). Case Study: John (Obsessive-Compulsive Disorder).
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