How to Survive Manipulative People

Scott Carroll
Scott CarrollPediatric Neuropsychiatrist
How to Survive Manipulative People 
Scott Carroll, MD 
Ayni Neuroscience Institute 
www.scottcarrollmd.com
Personality Disorders vs Traits 
• Personality disorders are enduring, inflexible, 
maladaptive patterns of behavior and relating to 
others that cause significant dysfunction. 
• Personality traits are repetitive patterns that are 
not constantly present or may be suppressed when 
necessary and do not cause significant 
dysfunction.
Personality Disorder Clusters 
• Cluster A - “Weird” - strange, bizarre, eccentric 
• Cluster B - “Wild” - impulsive, dramatic, 
aggressive, self-destructive 
• Cluster C - “Wimpy”- anxious, rigid, ineffective
Cluster A Personality Disorders 
• Schizoid - “loner”, lacks desire for social contact, 
usually avoids relationships and social interaction 
• Schizotypal - “eccentric”, odd with magical 
thinking, attribute events to illogical causes, 
family members of schizophrenics 
• Paranoid - “conspiracy addicts”, wonder if 
FBI/CIA follow them, distrusts others, especially 
authority figures (police, doctors, lawyers, etc.)
Cluster B Personality Disorders 
• Histrionic - “actress”, very dramatic, overly 
emotional, frequently exaggerates, wants reaction 
• Narcissistic - “name dropper”, arrogant, critical, 
condescending to staff, will only talk to the doctor 
• Borderline - “Marilyn Monroe”, fears being alone, 
intense relationships, idealizes/devalues, recurrent 
suicide attempts/ideation, dissociates/psychosis 
• Antisocial - “career criminal”, disregards rights of 
others, lies/cons/threatens others to meet goals
Cluster C Personality Disorders 
• Dependent - requires presence of the person they 
are dependent on to feel safe/happy or to make 
decisions, otherwise they are ineffective 
• Avoidant - extreme low self-esteem and fear of 
criticism or embarrassment, avoids other people 
• Obsessive-Compulsive - “perfectionist”, rigid, 
legalistic, inflexible, obsessed with lists and 
schedules, may hoard, not the same as OCD
Common Manipulation Strategies 
• Regression - may regress both mentally (magical 
thinking) and emotionally, clear limits/directions 
• Situational depression - extreme shame/guilt, even 
suicidal thoughts, needs strong support/hosp 
• Transference - may idealize or devalue (both) you 
or anyone else, be aware and don’t get sucked in 
• Counter-Transference – your unconscious reaction 
to them; may cause excessive sympathy or anger; 
also desires to rescue or punish; awareness is key
More Common Strategies 
• Hysteria - intense emotion to “engage” you or feel 
“seen”, acknowledge distress, but don’t fix 
• Splitting - idealizes provider, devalues staff or 
vice versa, may flip-flop, manipulator not aware, 
good team communication usually prevents this 
• Boundaries - must be communicated in advance, 
be flexible within those limits 
• Self-care - essential, have realistic expectations, 
care for your self before trying to help others
How Manipulators Control You 
• They seek resolution of internal chaos, by creating 
chaos around them, may lie/act incompetent 
• Their goal is to control you with pathological 
displays of power to induce you to fail or look 
“incompetence” 
• They use “illicit currency” (threats, complaints, 
refusal, etc.) to emotionally engage/manipulate 
• Avoiding such pathological relationships may 
limit their self-harm and can even help them
Judo Techniques for Self Defense 
• Incompetence - They’re going to prove you are 
anyway, so present yourself that way early 
• Benign Neutrality – be concerned about their well 
being, but “Zen” about whether they like or hate you 
• Specific techniques - slowing down, use silence, 
acknowledge distress, use paradoxical statements. 
• Be honest, neutral, non-reactive listeners to promote 
their competence and avoid destructive interactions
Final Exam 
A client is banging her head on your desk, screaming 
you are incompetent and that she is going to 
destroy you. 
A. Beg her to stop 
B. Call security to remove her 
C. Personally wrestle her to the ground 
D. Go get a cup of coffee and check your email 
E. Patiently wait for her to stop, then continue
1 of 11

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How to Survive Manipulative People

  • 1. How to Survive Manipulative People Scott Carroll, MD Ayni Neuroscience Institute www.scottcarrollmd.com
  • 2. Personality Disorders vs Traits • Personality disorders are enduring, inflexible, maladaptive patterns of behavior and relating to others that cause significant dysfunction. • Personality traits are repetitive patterns that are not constantly present or may be suppressed when necessary and do not cause significant dysfunction.
  • 3. Personality Disorder Clusters • Cluster A - “Weird” - strange, bizarre, eccentric • Cluster B - “Wild” - impulsive, dramatic, aggressive, self-destructive • Cluster C - “Wimpy”- anxious, rigid, ineffective
  • 4. Cluster A Personality Disorders • Schizoid - “loner”, lacks desire for social contact, usually avoids relationships and social interaction • Schizotypal - “eccentric”, odd with magical thinking, attribute events to illogical causes, family members of schizophrenics • Paranoid - “conspiracy addicts”, wonder if FBI/CIA follow them, distrusts others, especially authority figures (police, doctors, lawyers, etc.)
  • 5. Cluster B Personality Disorders • Histrionic - “actress”, very dramatic, overly emotional, frequently exaggerates, wants reaction • Narcissistic - “name dropper”, arrogant, critical, condescending to staff, will only talk to the doctor • Borderline - “Marilyn Monroe”, fears being alone, intense relationships, idealizes/devalues, recurrent suicide attempts/ideation, dissociates/psychosis • Antisocial - “career criminal”, disregards rights of others, lies/cons/threatens others to meet goals
  • 6. Cluster C Personality Disorders • Dependent - requires presence of the person they are dependent on to feel safe/happy or to make decisions, otherwise they are ineffective • Avoidant - extreme low self-esteem and fear of criticism or embarrassment, avoids other people • Obsessive-Compulsive - “perfectionist”, rigid, legalistic, inflexible, obsessed with lists and schedules, may hoard, not the same as OCD
  • 7. Common Manipulation Strategies • Regression - may regress both mentally (magical thinking) and emotionally, clear limits/directions • Situational depression - extreme shame/guilt, even suicidal thoughts, needs strong support/hosp • Transference - may idealize or devalue (both) you or anyone else, be aware and don’t get sucked in • Counter-Transference – your unconscious reaction to them; may cause excessive sympathy or anger; also desires to rescue or punish; awareness is key
  • 8. More Common Strategies • Hysteria - intense emotion to “engage” you or feel “seen”, acknowledge distress, but don’t fix • Splitting - idealizes provider, devalues staff or vice versa, may flip-flop, manipulator not aware, good team communication usually prevents this • Boundaries - must be communicated in advance, be flexible within those limits • Self-care - essential, have realistic expectations, care for your self before trying to help others
  • 9. How Manipulators Control You • They seek resolution of internal chaos, by creating chaos around them, may lie/act incompetent • Their goal is to control you with pathological displays of power to induce you to fail or look “incompetence” • They use “illicit currency” (threats, complaints, refusal, etc.) to emotionally engage/manipulate • Avoiding such pathological relationships may limit their self-harm and can even help them
  • 10. Judo Techniques for Self Defense • Incompetence - They’re going to prove you are anyway, so present yourself that way early • Benign Neutrality – be concerned about their well being, but “Zen” about whether they like or hate you • Specific techniques - slowing down, use silence, acknowledge distress, use paradoxical statements. • Be honest, neutral, non-reactive listeners to promote their competence and avoid destructive interactions
  • 11. Final Exam A client is banging her head on your desk, screaming you are incompetent and that she is going to destroy you. A. Beg her to stop B. Call security to remove her C. Personally wrestle her to the ground D. Go get a cup of coffee and check your email E. Patiently wait for her to stop, then continue