Difference between ocd and narcissism

Narcissism and OCD | Psychology Today


Source: Carlos de Toro / Unsplash

The word narcissism seems to make people’s ears perk up. There seems to be a lot of curiosity about how to identify a narcissist and how to deal with them.

I feel this word, narcissist, gets misused very often in American culture. I hear a lot of people defining their former spouse or romantic partner as a "narcissist." It seems the second the relationship fails, the other person's narcissistic tendencies were to blame. How many times have we heard from our friends that their divorce attorney or therapist told them that their ex is a "narcissist?"

This verbiage also gets flung around to describe people who take a lot of selfies or put a ton of Tik Toks of themselves on social media. I want to make it clear, that none of this qualifies as actual criteria for Narcissistic Personality Disorder (NPD).

Narcissistic Personality Disorder involves a long-standing pattern of the sufferer needing admiration from other people. These individuals typically cannot handle critical feedback and have a grandiose sense of entitlement. People with this disorder lack a sense of empathy for those around them and are very critical towards others. They usually have a pattern of troubled relationships. People close to the narcissist usually see them as bossy, difficult, rigid, and unsympathetic.

People with NPD are extremely resistant to changing their behavior, even when it’s causing them problems. As with all personality disorders, it is typically those around the narcissist that have a problem with their behavior, but not the NPD sufferer. The NPD sufferer will blame all of the people around them for their struggles. They will not view the situation as their fault and, in therapy, they will present as being highly critical of the people in their environment. Their tendency is to turn the blame on to others.

The people close to the narcissist will usually go along with the NPD individual's requests and demands because it is much easier than dealing with the consequences of going against the narcissist. Some examples of how someone with NPD could react to another not doing what they ask might be an extremely long lecture, cold and distant demeanor, or years of the silent treatment.

When an OCD sufferer also has NPD, it looks different than the OCD person without NPD. For example, when an OCD sufferer has an unwanted and intrusive thought that involves another person, they will usually be aware and empathetic to the idea that they cannot control the other person. They do not feel others should be doing compulsions for them. An OCD sufferer who does not have NPD agrees that their compulsive behaviors are annoying and upsetting to those around them.

Whereas, the OCD individual with NPD operates under the philosophy that everyone around them should do anything and everything to make them feel comfortable. They feel entitled and deserving of that, so, the NPD/OCD person does not see a need to change their own behaviors, rather, they feel that others around them should change. When others do not change, they can become extremely enraged and excessively disappointed.

For example, I had a client who met the criteria for both OCD and NPD, he was a man in his mid-forties. He was obsessed with having clean floors in his house. He was unable to walk barefoot in his house no matter how clean the floors were. He was extremely controlling of his wife’s floor walking behavior. He once saw her walking barefoot around the house, he demanded that she immediately wash and disinfect her feet before she would get into the bed. She, who typically was always compulsion compliant, forgot one day and got into bed with “contaminated” feet. In response, he spent hours and hours talking to her about the pain she caused him. He spent the next month sleeping in another room and in another bed and ignored her for a few weeks.

An OCD spouse who does not have NPD would also become extremely upset and uncomfortable at the notion of their wife “contaminating” the bed. However, this type of husband would most likely do a lot of compulsive behaviors himself, not involving her, in order to make himself feel comfortable. He might change the sheets, avoid his foot meeting hers under the covers, or wear socks to bed. There is a very good chance he would not say anything at all to his spouse.

The major difference is the OCD spouse who does not have NPD will not feel that his "comfort” is his wife’s responsibility. Typically, he will feel compassionate and empathetic toward his wife. He may think, my wife is exhausted and she needs to sleep. The NPD/OCD individual will not think this way. This person would not have any problem watching their wife change sheets and do their compulsions all through the night.

Treatment for OCD becomes complicated when there is a co-morbid personality disorder. I utilize a combination of RIP-R and CBT for personality disorders with these clients. Couples and family therapy may also be helpful, as well as Dialectical Behavior Therapy. If you feel you or a loved one is suffering from OCD, please reach out to a licensed mental health professional in your area.

To find a therapist, please visit the Psychology Today Therapy Directory.

How Narcissism Changes Obsessive Compulsive Disorder

Medically reviewed by Scientific Advisory Board — By Christine Hammond, MS, LMHC on March 1, 2017

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.

CharacteristicNPD w/ OCDOCD
MotiveOCD behavior reinforces and justifies NPD behaviorOCD 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 loveFantasizes that the OCD behavior is not severe and hides the full extent of their disorder
AdmirationPerforms OCD behaviors to gain admiration and praise from othersBelieves their mild OCD behaviors should be admired but not the severe aspects
SpecialOCD behavior is a way of further distinguishing an NPD from the pack and placing them in special statusKnows the OCD behavior isolates them; doesn’t like being thought of as special
EmpathyNo concern or empathy for how their OCD behavior negatively impacts othersConstantly feels bad for how their OCD behavior impacts others
EntitledDemands automatic compliance from others for OCD behaviors regardless of other’s beliefs or the impactDemands compliance from others to ease anxiety and has a hard time seeing the negative impact on others
ExploitativeExploits other’s lack of OCD behaviors as evidence of perfectionismTakes advantage of other’s compliance with their behavioral OCD nature to justify their continued behavior
JealousBelieves others are jealous of their OCD behaviors and methodsIs jealous of others who do not have OCD behavior
ArrogantIs proud and boastful of their OCD behaviors, frequently encourages others to be like themIs 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.

90,000 Narcissistic versus obsessive-compulsive personalities. Psychoanalytic Diagnosis [Understanding Personality Structure in the Clinical Process] Narcissistic versus obsessive-compulsive personalities. Psychoanalytic Diagnosis [Understanding Personality Structure in the Clinical Process]


Psychoanalytic Diagnosis [Understanding Personality Structure in the Clinical Process]
McWilliams Nancy


Narcissistic versus obsessive-compulsive

The narcissistic individual is easily misunderstood as being obsessive or compulsive due to attention to detail. This attention can become part of the narcissistic search for perfection. In the early days of psychoanalytic practice, fundamentally narcissistic people were often viewed as obsessive or compulsive because their symptoms easily fit into one or both of these categories. They were treated according to assumptions relating to the etiology of the obsessive-compulsive nature, which emphasize struggles for control and blame for anger and fantasized aggression.

Narcissistic patients, more empty than angry, did not achieve much success in such therapy. They felt misunderstood and criticized when the therapist seemed to dwell on issues that were not central to the patient's subjectivity. Many people have both narcissistic and more classically obsessive personality traits. Those patients whose personality was dominated by narcissistic tendencies received little benefit from analytic pattern therapy until the 1970s, a milestone when theories of etiology and therapy for pathological narcissism radically expanded our ability to help people with self-disorders. I know several patients who were treated analytically before this period. They still carry dissatisfaction with both their therapist and psychoanalysis in general. In popular explanations of the psychotherapeutic experience, one can find what may exemplify the result of such a diagnostic error. For example, David Viscott (1972), describing his failed therapy with "Dr. Frost", believed that his analyst had adopted a style that might be appropriate for an obsessive personality, but was markedly at odds with Wiskott's desire for empathic reflection and confirmation of his own "I". A more detailed description of the differences and consequences of such diagnostic errors can be found in Chapter 13.

4.3. Narcissistic Personality Disorders

4.3. Narcissistic Personality Disorders In the theory of narcissism (Kohut, 1971) and in the psychology of the self (Kohut, 1977), narcissistic personality disorders are placed between psychoses and borderline disorders. Structural and dynamic features of this group of patients

Pedantic (anancaste or obsessive-compulsive) personalities

Pedantic (anancastic or obsessive-compulsive) personalities The so-called pedantic personalities were once brilliantly described by the German psychiatrist Karl Leonhard in his book Accentuated Personalities. They are also called anancastes or obsessive-compulsive

Narcissistic personalities

Narcissistic Personalities The name of this type of problematic person comes from the name of the hero of Greek mythology, Narcissus. According to legend, he saw his own reflection in the water, fell in love with it, could not tear himself away from the contemplation of his own beauty and died. after death gods

8. Narcissistic Personalities

8. Narcissistic Personalities People whose personality is organized around maintaining self-respect by obtaining outside validation are called narcissists by psychoanalysts. We all have some vulnerability about who we are and

Narcissistic versus psychopathic personalities

Narcissistic versus psychopathic personalities In the last section of the previous chapter, I noted the importance of distinguishing between a predominantly sociopathic and an essentially narcissistic personality structure. Kohut's attempts to establish an empathic relationship (by

Narcissistic versus depressive personalities

Narcissistic versus Depressive Personalities The more depressive type of narcissistic person can easily be mistaken for being depressed. If we sum up the data of numerous theories and clinical observations and present them in the form of a simple image, there are

Schizoids versus obsessive and compulsive personalities

Schizoids versus obsessive and compulsive personalities Schizoid personalities often self-isolate and spend long periods of time thinking, perhaps obsessively, about the major issues in their fantasy life. Often they, due to their conflict related to

Paranoid versus obsessive

Paranoid versus obsessive personalities Obsessive personalities are similar to paranoid individuals in sensitivity to questions of justice and rules, in rigidity and denial of "gentle" emotions, in preoccupation with control, in susceptibility to shame, and

Obsessive Compulsive Self

Obsessive Compulsive Self In accordance with traditional usage of terms, I will confine myself in this section to describing the manifestations of self-concept and self-esteem that prevail in the classic obsessive-compulsive personality structure based on

Transference and countertransference with obsessive and compulsive patients

Transference and countertransference with obsessive and compulsive patients Obsessive and compulsive personalities tend to be "good patients" (with the exception of those at the bottom of the developmental continuum: they pose formidable

Obsessive Compulsive Disorder

Obsessive Compulsive Disorder Gale Outwardly, Gale looked completely normal. She went to work every day, was married to a man she fell in love with in high school, and they had two young children. In her heart, she felt terrible. her husband

Obsessive Compulsive Style

obsessive-compulsive style Wilhelm Reich called compulsive people "living machines." the description turns out to be quite appropriate, because it corresponds to their subjective experience. However, it is a good example of a common

Obsessive Compulsive Personality Disorder

Obsessive Compulsive Personality Disorder Brooks stopped by the library for a couple of minutes after therapy on his way home, so that when his wife, Mary Jo, asked him the inevitable question of why he was late, he would "frankly" answer that he was in the library. Within two years

Obsessive Compulsive Personality Disorder

Obsessive Compulsive Personality Disorder Key words for obsessive-compulsive personalities are "control" and "should. " These people choose the means necessary to achieve the end so carefully that the means themselves become the end. For them "order is

Chapter 14 Obsessive Compulsive Personality Disorder

Chapter 14 In modern Western culture, obsessive-compulsive personality disorder (OCPD) is quite common, especially among men (APA, 1987). This is partly because society values ​​moderation

How to recognize a person with narcissism

July 19 Likbez Health

Psychotherapy may be required even for those who associate with a narcissist.

You can listen to the article. If it's more convenient for you, turn on the podcast.

Narcissists are traditionally called narcissists, fixated on their own person. However, not every narcissist suffers from narcissism.

Narcissistic personality disorder has very specific symptoms.

How to Recognize a Person with Narcissistic Personality Disorder

Every psychotherapist's reference book, the current edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5), lists nine signs of a true narcissist. At the same time, it is enough to make a diagnosis if a person meets only five of them.

1. Maintains relationships with "special" people

The narcissist always has authoritative, influential acquaintances from circles, access to which is difficult for "mere mortals": businessmen from the top hundred of the Forbes list, brilliant artists, owners of various rarities, close friends and lovers of world famous stars. Well, at least the narcissist himself likes to talk about such connections.

A person with a narcissistic disorder uses the status of acquaintances as a way to increase self-esteem and authority in the eyes of others.

By the way, this is one of the reasons why daffodils seem so attractive, why it is easy to fall in love with them and difficult to leave them. When a person is “with such connections!”, “so sophisticated!” suddenly draws attention to you, it tickles pride very much. It’s as if you are on the same social level with the narcissist’s great acquaintances and begin to feel “special” too. And this is a kind of psychological drug, which is hard to give up.

2. Often talks about his own victories and achievements

Whether it's a controversial moment at work, a conflict in a store or public transport, a random race from a traffic light - the narcissist emerges victorious from any situation. In fact, that's what he tells the people around him.

It is important for Narcissus to demonstrate that he is the best and smartest of all. This helps him feel more confident.

Jacqueline Krol

Psychotherapist, for Healthline online edition

It is typical that stories about victories always proceed in the form of monologues. Narcissists need admiring listeners. As soon as one of them begins to pull the blanket over himself and talk about his own achievements, the person with narcissism gets bored and turns off the conversation.

3. Needs compliments and can't stand criticism

From the outside, the narcissist seems to be an extremely self-confident person. But, as experts suggest, most people with narcissistic personality disorder have serious problems with self-esteem.

That is why they expect constant compliments from others. If admiration is not enough, or worse, the narcissist is criticized, they react very emotionally. Can theatrically exclaim: "I'm not appreciated here!" Often reproaches relatives and colleagues for inattention and callousness. Because of the slightest remark, he may cry or run away, slamming the door and shouting something insulting in the end.

Then, perhaps, he will return to still get recognition from you. For this, the narcissist manipulates guilt: it is not he who is emotionally unrestrained, but you meanly offended him, underestimated and provoked him.

4. Seems to be a dreamer and idealist

Narcissus seems ideal to himself and therefore counts on a special, impeccable life. And if something does not work out, the responsibility for it shifts to the people around.

If there are difficulties in love or family relationships, the partner is to blame: he didn't look the right way, did the wrong thing, didn't appreciate it. “All women are bitches, and I am looking for that one, my soul mate who will understand me” is the demonstrative position of the classic narcissist.

Narcissistic personality disorder is more common in men. At risk are young (under 45) unmarried people.

If it doesn't work out with a career and money, the society is to blame, of course. More precisely, his successful representatives, who (from the point of view of a narcissist) probably achieved their position with the help of influential relatives, through bed, by deceit. Narcissists often oppose themselves to society, emphasizing their status as an unrecognized genius and a lone wolf, disappointed in an imperfect world.

5. Feels worthy of special treatment

This means that the narcissist demands more rights for himself than for others. He will not stand in line - he will find a way to get into the right office or to the counter first, even if it turns into a scandal. He expects priority service at the restaurant. Or he sincerely counts on an “understanding” attitude from his superiors, even if he is late for the fifth time in a week or misses a deadline.

He "needs" to sit at the window, open (or close) the window or do his hobby - instead of washing the dishes, cleaning or going shopping.

The interests of a person with narcissistic personality disorder always come first. People around are encouraged to come to terms with it.

6. Often haughty, shows disrespect for those who are lower in status

One of the characteristics of the classic narcissist is a sense of superiority over others. This is clearly shown in situations where a person suffering from narcissism is faced with the service industry. He can be rude to waiters, wardrobe workers, consultants, petty clerks. Subordinates or those who are younger also suffer from his arrogance.

If the narcissist is reproached for this, he will explain his behavior with shortcomings in the work of the "lower class" and say that he simply demands a little respect for himself.

7. Exploits others

For a narcissist, it is in the order of things to be served, and he is not interested in what forces and at the expense of what this is achieved. For example, in family relationships, he will expect dinner, cleanliness and excellent physical shape from his partner - simply because he “should” (even if he has two jobs, a child and an objective lack of time for sports).

If the partner tries to rebel, discounting, gaslighting and other abuse techniques will be used.

8. Openly manipulates people

Pressing on pity, hitting on feelings of guilt and conscience, twisting the facts and blaming others for what they did not do - this is not a complete list of what the narcissist does to achieve his goals.

It cannot be said that he manipulates consciously. It’s just that this is how his psyche works on justifying himself and blaming others.

9. Not able to empathize

Lack of empathy (sympathy for the experiences and problems of others) is one of the most characteristic signs of a narcissist.

A person with narcissistic personality disorder is completely self-centered. To delve into other people's problems, to provide support for him is simply boring.

This is one of the reasons why narcissists almost never have long-term relationships, either friendships or romantics.

What to do if a person is a narcissist

Narcissism is one of the least studied personality disorders. It is extremely difficult to treat, as narcissists usually do not believe that they have mental health problems. On the contrary: they are sure that others have problems, which means that they should be treated.

In addition, narcissism is often accompanied by other types of mental disorders - manic-depressive psychosis (bipolar disorder), depression, anxiety and dissocial (sociopathic) disorders. So therapy, even if the narcissist agrees to it, runs the risk of being long and complicated.

What should you do if you encounter a narcissist? The least energy-consuming, but also the least humane way is to run away from him.

If you have the opportunity not to take on the solution of other people's psychological problems, it makes sense not to do this.

However, this is not always the case. After all, a colleague, a valuable business partner, a close relative, or even a loved one can be a narcissist. Refusal to communicate will be tantamount to a complete severing of these important ties.

In this case, the only thing left is to persuade the narcissist to see a psychotherapist. The doctor will get to know the patient better and, depending on his condition, will select the most effective type of psychotherapy. Sometimes, in addition to it, medication may be needed - antidepressants and antipsychotics.

Psychotherapy will also be useful for you if you are forced to contact a narcissist every day.

Learn more