What is manipulation? Manipulation generally refers to behaviours that someone exhibits to get their needs met.

This may include the following types of behaviours an actions; Attempt to maintain control and power over others Playing one staff member off against another, sometimes called splitting Evoke guilt and sorry in others, attempting to get others to take responsibility for the manipulators action. Escape the realistic obligations, responsibilities, and duties in life. Dishonestly making friends, work colleagues or family members to do or act in a way which they might not have chosen as their own. Make people believe what the manipulator wants them to Lying to staff and or family Attempting to get their way in every interaction which is possible. Displaying dependency or extra assistance when not required Manipulators try to present reality the way they want you to see it Involve inappropriate people in their lifes problems often making the situation worse Try to get others to take and make decisions for them, top avoid the distress an then the ability to blame others for their own faults Manipulation is a set of behaviors whose goal is to:
Get

you what you want from others even when the others are not willing initially to give it to you. Make it seem to others that they have come up with an idea or offer of help on their own when in reality you have worked on them to promote this idea or need for help for your own benefit. Dishonestly get people to do or act in a way which they might not have freely chosen on their own. "Con'' people to believe what you want them to believe as true. Get "your way'' in almost every interaction you have with people, places, or things. Present reality the way you want others to see it rather than the way it "really is.'' Hide behind a "mask'' and let people see you in an acceptable way when in reality you are actually feeling or acting in an ``unacceptable'' way for these people. Maintain control and power over others even though they think they have the control and power.

 Make

other people feel sorry for you even though it would be better for them to make you accept your personal responsibility for your own actions. Get away with not having to do the things necessary to meet your obligations, responsibilities, and duties in life. Involve everyone in your life's problems so that you do not have to face the problems alone. Keep everything the same so that the "status quo'' is not affected or changed. Make others feel guilty or responsible for actions or thoughts which are yours alone. Get others to feel like they are responsible for your welfare so that you do not have to make a decision or take responsibility for anything that goes wrong in your life.

Interventions Identify splitting behaviours and communicate this with the treating team Consistency, discuss all angles of care with the whole team at every handover Comprehensive documentation, minimise the number of staff involved with the patient Be clear, direct and when setting limits on behaviour, enforce limits but also reward and praise positive behaviour Ask patients to be more direct and succinct, develop a behavioural agreement with the patient and staff

Authors Smith J & Brunero S (2008)

Ref: Anderson (1999) Responding to Difficult Patients Amer J Nurs (99).