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Truthfully, it is not uncommon for people to struggle with OCD and narcissistic tendencies. As a result, some researchers believe that there is a link between the two conditions. While the exact mechanisms behind this link are still unknown, there are some possible contributors to this comorbid condition. 

In this article, I will define OCD and narcissism, explain the similarities and differences between the two conditions, explain how OCD and narcissism are connected, and provide you with some tips on how to manage the comorbidity of OCD and narcissism, so that you have a better understanding of what it means to have both conditions. My hope is that with more information you can make an informed decision on the best way to treat the two conditions.

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What is OCD?

Obsessive-compulsive disorder – also known as OCD, is a type of anxiety condition that involves unwanted and repetitive, intrusive thoughts, doubts, negative emotions, fears, mental images, etc. (obsessions), and rituals or routines (compulsions). OCD is a lonely condition that can cause you to drift away from friends and loved ones, quit your job, or be fired from it (due to repeated “call-outs” and/or a lack of focus on the tasks at hand, develop low self-esteem and self-confidence, etc.

In other words, OCD can affect almost all areas of your life. But although OCD can, and often is, debilitating – there is hope. More specifically, there are various OCD treatments available, such as cognitive-behavioral therapy (CBT), acceptance and commitment therapy (ACT), exposure and response prevention (ERP) therapy, along with TMS therapy, hypnotherapy/hypnosis, grief counseling, trauma counseling, individual counseling, couples or marriage counseling, family therapy, and/or addiction counseling.

OCD medications typically involve SSRI antidepressants, such as Luvox, Zoloft, and Prozac, although other medications, like SNRIs, tricyclic antidepressants, MAOIs, or prescription antihistamines may also be used in cases of treatment-resistant OCD. Lifestyle changes are also encouraged in the treatment of OCD.

These lifestyle changes can include getting enough sleep at night, eating fresh and healthy foods, and moving or exercising regularly. Alternative treatments, natural remedies, and self-help tools, such as mindfulness mediation, journaling, OCD support groups and forums, art therapy, acupuncture, CBD, vitamin supplements, OCD books and workbooks, healthy coping skills and strategies, and online OCD treatment programs, like Impulse Therapy, are also starting to take off as viable “non-traditional” OCD treatment options.

What is Narcissism?

Narcissism, also referred to as narcissistic personality disorder, is a mental health condition that causes people to have an exaggerated sense of their value and importance, and an intense need for a lot of attention, praise, and admiration. Narcissistic individuals tend to have unhealthy or dysfunctional relationships and lack compassion for others. But behind this facade of high confidence lies a fragile self-esteem that falters at the slightest hint of criticism.

Narcissism can cause problems in various areas of a person’s life, such as relationships, work productivity, academic success, and/or finances. People with narcissistic tendencies tend to be unhappy, dissatisfied, and disappointed when they are not awarded the “special favors,” praise, attention, or admiration they *think* they deserve.

A narcissistic person may find that most, if not all of their relationships are unfulfilling. These individuals typically do not enjoy being around others, except for the object of their “fascination” – i.e., potential partners. The best and most effective way to treat this personality disorder is with psychotherapy.

Is OCD Linked to Narcissism?

Yes, OCD appears to be linked to narcissism.

Studies suggest that OCD and narcissism may be linked.

According to researchers, people with OCD may develop narcissistic tendencies as a coping mechanism for the condition. When an OCD sufferer feels “out of control,” unloved, and unappreciated, they will try to control themselves, other people, and their environments. This is an attempt to attempt at control is to relieve their stress and anxiety, and reduce their obsessions and/or compulsions. The belief that they can control people and situations can lead to narcissistic tendencies, such as constantly needing admiration, praise, and attention. It can also cause OCD sufferers to appear to lack empathy for others.

Researchers have also found that narcissistic people have an elevated risk of developing OCD due to a constant need to attain approval, attention, acceptance, and validation from others. This need for approval, attention, acceptance, and validation can trigger intrusive thoughts, urges, emotions, doubts, etc. For instance, a narcissistic person may become “obsessed” with the appearance of their partner or their achievements. They may also try to compulsively “draw out” other people for attention, admiration, and praise.

Also, understand that some people with OCD lack empathy for how their obsessions and/or compulsions are affecting others – this resembles narcissism. More specifically, narcissists also tend to lack empathy when it comes to other people and how their words and actions hurt or disturb others. This lack of empathy is a commonality between the two conditions.

According to studies, people with OCD have a habit of trying to control the people in their orbits to ease their stress and anxiety, which can lead to narcissistic behaviors, such as manipulating or deceiving others to get them to comply with their demands. Some researchers have found narcissists have a high risk of developing OCD because they tend to be “perfectionists.” It is this need for “perfection” that can trigger obsessive thoughts and/or compulsive behaviors.

It is also believed that OCD and narcissism may share a similar neurotransmitter imbalance (serotonin deficiency or low serotonin levels). More specifically, people with OCD have a genetic link, and so do people with narcissism. In other words, both conditions appear to be genetic, suggesting that the same brain chemical imbalances occur in both of them.

Also, both OCD and narcissism share common symptoms, such as chronic stress, anxiety, depression, and compulsions. The connection between OCD and narcissism is still being studied, so the exact connection is still unknown. More research is needed to determine the exact relationship between the two conditions.

What Are Some of The Similarities Between OCD and Narcissistic Personality Disorder?

The main similarity between OCD and narcissism is that they both have a faulty sense of self. Narcissists tend to feel like they are always right and while OCD sufferers tend to worry that they are wrong. Both OCD and narcissists share obsessions or intrusive thoughts, urges, and compulsions based on those thoughts and urges. Also, both OCD and narcissism can lead to failed relationships and friendships. Narcissists and OCD sufferers can become obsessed with being “perfect,” although, with OCD sufferers, this is a quest to be “perfect,” while narcissists think they are “perfect.”

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What Are Some of The Differences Between OCD and Narcissistic Personality Disorder?

One of the biggest differences is that narcissism is a personality disorder, while OCD is a thought-processing disorder. In other words, OCD is based on intrusive thoughts, doubts, and mental images. It involves a “could,” “maybe,” or “what if” mentality. There is usually some logic or rational thought behind OCD intrusive thoughts (obsessions) – although this logic or rationale is usually faulty.

OCD sufferers tend to view facts, generalizations, abstractions, hearsay, myths, rules, and personal experiences as “equally valid,” which is then used to justify compulsive behaviors or rituals or routines, such as excessive and repetitive counting, checking, cleaning, organizing, etc. OCD sufferers also tend to constantly think about the different types of conditions they may have, or about things that they may have seen or experienced that were upsetting or traumatic. It is also possible that if you have OCD, you may constantly be wondering if you have compulsive narcissistic personality disorder (CNPD) – but not necessarily have the condition. This could also be an OCD symptom.

Another difference between OCD and narcissistic personality disorder is that narcissists typically do not care about their diagnosis, while people with OCD do typically care about their diagnosis – in fact, they tend to excessively worry about it or obsess over it. Also, OCD sufferers tend to be “perfectionists” while narcissists pretend to be “perfect.” OCD sufferers also worry about doing things “just right” or being “good enough,” while narcissists believe they are always right, and other people are wrong. Narcissists have an inflated sense of worth and value. they also tend to have a superiority complex, believing that they are how better or smarter than other people.

OCD sufferers, on the other hand, worry about these things. These individuals tend to have an inferiority complex. Another significant difference between OCD and narcissism is that OCD involves repetitive, uncontrollable behaviors while people with narcissism can control their behaviors.

What is It Like to Live with Both OCD and Narcissistic Personality Disorder?

The best way to understand how it feels to live with both OCD and narcissistic personality disorder or NPD is to hear from real-life people who are living with both conditions.

Listed below are personal narratives of people living with OCD and NPD:

Thalia

“I am pretty sure I have narcissistic personality disorder and OCD. Since reading about it online, I have felt shame, emptiness, and thoughts that life is not worth living if I have this condition. This obsessing is severe – more than 4-5 hours a day. I just feel so sure that I am a covert narcissist aka a shy narcissist.

This practically describes my Reddit behavior, and my inability to admit any ‘wrongdoing.’ This also describes my hyper-competitiveness, which means I turn everything into a competition. I will argue for hours until I get the last word, and subconsciously feel like I ”won” the argument. On the other hand, I also have a non-stop fear of abandonment, which is why my emotions are so unstable. What I mean is I can snap, get super sad, and/or feel urges to hurt myself.”

Conner

“Does anyone have OCD or OCD traits and NPD or NPD traits? If so, how does that manifest for you? For me, I have an extreme preoccupation/obsession with my looks, and how much attention I get in public. It’s literally on my mind 24×7, and it tortures me. The intrusive thoughts are horrible and fluctuate between two extremes – a broken record of repetitive (over and over and over) thoughts, like ‘you will never be sexy,’ or the opposite, which I know is not true, so it is equally cringeworthy and ego-dystonic. The flip side is ‘Everyone is into you/looking at you.’ Or, ‘You’re so freaking hot.'”

Steffy

“Has anyone ever heard of someone having OCD and NPD at the same time? My man has OCD, but he also has a few NPD traits from the list – i.e., requiring excessive admiration, having a sense of entitlement, etc. He also has strange sexual quirks, and talks about his own interests all the time, but takes no interest in mine. My man is always afraid that I’m going to leave him to the point that it is excessive.

I can’t go outside without him questioning me about when I am coming back. He also tries to dissuade me from leaving him by telling me that no one else will love me like him and that he is the best I will ever get. So, he is also controlling. I’m just curious as to what is going on with him because I love him and want to help him.”

Jason

“I am very controlling. I guess I just need to have complete control of my environment, and that includes taking the lead, and making the decisions even if there is another person present. I make a big show of soliciting the other person’s input, but get very angry inside when things don’t go my way, especially when the choices others make aren’t entirely in line with my own. I habitually bite back my annoyance, saying nothing, and just smiling to mask my anger. I can keep this up for a few hours, but when I am with someone 24/7 eventually, I explode with rage.”

How are OCD and Narcissism Treated?

Truthfully, there is no one treatment for the comorbidity of OCD and narcissism. Rather, these conditions are addressed using a multi-treatment approach with medication, therapy, or both. The most common treatments involve OCD therapies, such as CBT, ACT, and/or ERP therapy, and/or SSRI antidepressants or other anti-anxiety medications. The go-to treatment for OCD is ERP therapy, while the go-to treatment for narcissistic personality disorder is CBT.

ERP therapy is a subtype of CBT, so either treatment can be used to treat a comorbid condition of OCD and narcissism. The goal of treatment for both conditions is to change thought processes, so in the case of OCD, people can stop obsessing or worrying about things, and for narcissistic personality disorder to stop overinflating things.

Neither group holds an accurate of who they are and what is actually happening in their lives. Online OCD treatment groups, like Impulse Therapy, can help you manage both conditions, so you can live a healthy and productive life. In other words, these groups can help you see yourself, others, and the world around you more realistically.

References

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Author

DR. R. Y. Langham

Dr. R. Y. Langham has a B.A. in English, an M.M.F.T in Marriage and Family Therapy (Psychology), and a Ph.D. in Family Psychology. She is currently a medical, health & wellness contributor, copywriter, and psychological consultant

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