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Handle the manipulative aspect of OCD?


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I have a friend who have OCD and I try to help him from time to time but just like me he sometimes get a little bit tricky. I have found that I can get quite manipulative when I get an obsession, just to get the answers I search for. 

This person have healthanxieties and I have contaminationfears and it is easier to just say to me that "no there is no danger" but this guy will exaggerate just to get the help he wants. Yesterday he had some pain in his chest, which he sometimes get from anxiety and he has been to the doctors and they have told him he is ok. So he knows that he needs to exaggerate. So yesterday he was at the hospital again because he had called them and said he had chestpains and so on and son on. But first he called me and I said that no don't go. I even said so when he said he had extreme pains and I hang up. Then he apparently called the hospital and they can't deny him when he says he has chestpains.

So how do I/we manage this bit of OCD? I know he lies and he know he lies but then what? It feels like it's impossible to help something like this?

Edited by Getmeout
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Okay...well first of all you need to determine whether he's manipulating you, or whether he legitimately believes he has a serious health problem. I don't doubt your friend has OCD but hypochondria (health anxiety) is classed as a different illness. People with hypochondria legitimately believe they are dying from a health issue. 

From what you have written I don't think he is lying or manipulating you. I can understand how to you saying 'no there is no danger' is reassuring, but health anxiety is different from OCD. Saying there is no danger feels to somebody with hypochondria like you aren't listening to them, you are dismissing their concerns, or even that you don't care if they die. I've had hypochondria before and it drove me nuts that people didn't listen when I genuinely thought I was dying.

It's also possible your friend legitimately has chest pains caused by his rising anxiety. I have heard that panic attacks can feel like heart attacks.

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  • 2 weeks later...

I am still very intrested in how you do this. 

I am totally certain that I have done this and people with OCD do this. When you have such a strong anxiety which tells you that your lfe is in danger manipulation is OK. OCD just doesn't go into sleepmode. 

He is continuing to go there and he tell them the same story over and over again. ´He don't trust them and he won't be satisifed before the give him EKG, he is not stupid so he knows he has to exaggerate. 

 

 

Edited by Getmeout
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On 10/04/2021 at 22:25, hetty said:

... hypochondria (health anxiety) is classed as a different illness. People with hypochondria legitimately believe they are dying from a health issue.

I can understand how to you saying 'no there is no danger' is reassuring, but health anxiety is different from OCD. Saying there is no danger feels to somebody with hypochondria like you aren't listening to them, you are dismissing their concerns, or even that you don't care if they die. I've had hypochondria before and it drove me nuts that people didn't listen when I genuinely thought I was dying.

Hi Hetty,

I think we need to challenge what you said here. :unsure:

Health anxiety (hypochondria) is very similar to OCD (some consider it a sub-type of OCD). However you classify it, it works in exactly the same way.

People with OCD can legitimately believe there is danger/contamination etc. It depends how much insight the person has. Same with hypochondria, some people have insight and realise they fear dying, others have less insight and think their symptoms mean they are dying. The difference is the degree of insight rather than the label for the illness.

It can feel like somebody isn't listening when they dismiss your concerns, however the reason people dismiss it isn't because they haven't heard you. Rather they recognise it as anxiety-related and not the disease the symptoms suggest to the sufferer. Typically people hope that by dismissing it you will see through your anxiety-clouded vision what they see so clearly. Although it's never nice to feel unheard, it doesn't mean the person didn't care.

 

On 10/04/2021 at 22:25, hetty said:

you need to determine whether he's manipulating you, or whether he legitimately believes he has a serious health problem.

It's also possible your friend legitimately has chest pains caused by his rising anxiety. I have heard that panic attacks can feel like heart attacks.

As I said above, people with anxiety disorders can legitimately believe whatever it is they are thinking/feeling. Doesn't mean they have the problem they think they have.

Physical symptoms which occur as a result of anxiety are always genuine/real/legitimate.

That doesn't make the sufferer's interpretation of what those symptoms mean correct.

Of course it's possible someone could be lying about the symptoms they're experiencing, but I'd say that was relatively rare. Most anxiety sufferers do experience the symptoms they describe and to the extent/severity they say. But while the feeling you're having a heart attack is genuine, having the feeling doesn't mean you are having a heart attack (or whatever symptom it is.)

You talk about your hypochondria in the past tense, so I hope this means you got therapy and are recovered from your health anxiety. :)

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On 22/04/2021 at 17:51, Getmeout said:

I am totally certain that I have done this and people with OCD do this. When you have such a strong anxiety which tells you that your lfe is in danger manipulation is OK.

Hi Getmeout,

I've done it too. :blushing:  When my OCD demanded certainty I acted as a horrible bully and manipulator - anything to ensure things were done as my OCD demanded they be done.

However, while the degree of anxiety fuelling it behaviour explains the behaviour, it doesn't excuse the behaviour. Manipulation, bullying, and lying aren't ok. :no:

That's where we need to be brave and have some open and honest heart-to-hearts about

-what we're feeling

-why we're bahaving as we are

-what's acceptable and not acceptable behaviour

- where we can compromise to find a short term solution

- how we're going to achieve change (get CBT /help with the anxiety)) so the behaviour doesn't continue long term.

 

On 22/04/2021 at 17:51, Getmeout said:

He is continuing to go there and he tell them the same story over and over again. ´He don't trust them and he won't be satisifed before the give him EKG, he is not stupid so he knows he has to exaggerate.

When you are certain someone is exaggerating in order to get attention you can always tell them the story of 'the boy who cried wolf'. (If you don't know it, google it.)

Health professionals have to take each assessment at face value. With your friend they have come to the same conclusion each time (he's cring wolf and no EKG is needed). If they are good at their job (and have time) they will usually explain to the person why they aren't doing an EKG and will then shift the conversation into discussing the person's anxiety disorder and the appropriate treatment for that.

That your friend interprets this as not being able to trust the professionals and that he needs to exaggerate/lie to make them reconsider is just making the problem worse. Maybe you can get him to see that?

On 10/04/2021 at 21:26, Getmeout said:

So how do I/we manage this bit of OCD? I know he lies and he know he lies but then what? It feels like it's impossible to help something like this?

Happily it's not impossible. :) But you do need to choose a time to have the sort of heart-to-heart I described before. Begin by showing him you understand and aren't blaming him or accusing him of anything. Keep it factual - this happens - you respond by doing this - the result is....

Any time the conversation goes off track (if he tries to make it about the symptoms/chest pains) you listen for a moment (to show you are listening) then gently interupt and steer the conversation back to the real problem - his anxiety disorder.

Step one is to get him to accept he has an anxiety disorder. Step 2 is to get him to accept he needs therapy. And step 3 is to get him to engage in CBT.

Good luck! :)

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On 23/04/2021 at 21:36, snowbear said:

Hi Hetty,

I think we need to challenge what you said here. :unsure:

Health anxiety (hypochondria) is very similar to OCD (some consider it a sub-type of OCD). However you classify it, it works in exactly the same way.

People with OCD can legitimately believe there is danger/contamination etc. It depends how much insight the person has. Same with hypochondria, some people have insight and realise they fear dying, others have less insight and think their symptoms mean they are dying. The difference is the degree of insight rather than the label for the illness.

It can feel like somebody isn't listening when they dismiss your concerns, however the reason people dismiss it isn't because they haven't heard you. Rather they recognise it as anxiety-related and not the disease the symptoms suggest to the sufferer. Typically people hope that by dismissing it you will see through your anxiety-clouded vision what they see so clearly. Although it's never nice to feel unheard, it doesn't mean the person didn't care.

 

As I said above, people with anxiety disorders can legitimately believe whatever it is they are thinking/feeling. Doesn't mean they have the problem they think they have.

Physical symptoms which occur as a result of anxiety are always genuine/real/legitimate.

That doesn't make the sufferer's interpretation of what those symptoms mean correct.

Of course it's possible someone could be lying about the symptoms they're experiencing, but I'd say that was relatively rare. Most anxiety sufferers do experience the symptoms they describe and to the extent/severity they say. But while the feeling you're having a heart attack is genuine, having the feeling doesn't mean you are having a heart attack (or whatever symptom it is.)

You talk about your hypochondria in the past tense, so I hope this means you got therapy and are recovered from your health anxiety. :)

Hi,

I do see what you are saying here. In my experience, hypochondria and OCD was very different. With OCD, reassurance that 'nothing's wrong' helps me. With hypochondria, it made me feel like people weren't listening to me. 

I can really see how people still care about me; I was just referencing what I was feeling when in the very midst of the hypochondria, which was that I felt I wasn't being listened to. I think there are ways of communicatng to a health anxiety sufferer that they're being irrational, whilst also not acting like they're being silly or stupid for being so anxious. I think there's a difference between a response of 'I can see why you're anxious but I do think you're not thinking about this clearly', and a response of 'you're being so silly nothing's wrong'. One is putting the sufferer right whilst also being understanding, the other seems really dismissive. Does that makes sense?

I think we both actually agree here that what the sufferer thinks is happening isn't always the same as what's actually happening. My point was more that even though it's not actually happening, you still need to empathize that the sufferer thinks it's happening. I hope I got that across clearly in a way that makes sense since even typing it I can see how it could be confusing.

I have (generally) recovered from my health anxiety thank you :) I actually have been diagnosed as having the possibility of having quite a serious health problem later in my life (heart condition) and am dealing with that okay, albeit with a few issues sometimes where I get quite upset over it. But in general I am coping with it far better than I ever would have done during my health anxiety times. Also managed to get through the pandemic without freaking out so success there I suppose ?

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5 hours ago, hetty said:

I think there's a difference between a response of 'I can see why you're anxious but I do think you're not thinking about this clearly', and a response of 'you're being so silly nothing's wrong'. One is putting the sufferer right whilst also being understanding, the other seems really dismissive. Does that makes sense?

Yes. You may be right that hypochondria receives more dismissive attitudes. I wonder if it's because everybody has experience of out-of-proportion health anxiety fears at some time, but they force themselves to be realistic and dismissive within minutes of thinking the worst. Because they were able to dismiss it easily in themselves they have less empathy for those with hypochondria whose fears are not so easily resolved?

5 hours ago, hetty said:

I have (generally) recovered from my health anxiety thank you :) I actually have been diagnosed as having the possibility of having quite a serious health problem later in my life (heart condition) and am dealing with that okay, albeit with a few issues sometimes where I get quite upset over it. But in general I am coping with it far better than I ever would have done during my health anxiety times. Also managed to get through the pandemic without freaking out so success there I suppose ?

You sound well on top of things. Good for you! :)

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