Recently, I was on the phone with a good friend of mine who is a Psychiatric ARNP and we were discussing relationships when she reminded me of the term FOG, something she was introduced to when attending an event featuring Dr. Anita Phillips.

In clinical practice, it’s not uncommon to encounter individuals who feel emotionally trapped in relationships where fear, obligation, and guilt—collectively known as FOG, heavily influence their decision-making. I’ve seen this dynamic surface time and time again, both in the lives of my clients and, if I’m honest, sometimes in my own.

The term FOG was introduced by Susan Forward and Donna Frazier in their work on emotional blackmail. It describes the psychological pressure people often experience when involved with individuals who may have features of a personality disorder, or who simply engage in manipulative behavior patterns. Understanding this concept is essential when working with clients navigating boundary-setting, relational conflict, or recovery from emotional abuse.

Defining FOG: Fear, Obligation, and Guilt

• Fear is an adaptive survival response. It’s what prepares us to react quickly to threats. However, chronic fear, particularly fear rooted in emotional manipulation, can lead to long-term stress, anxiety, and difficulty making sound decisions.
• Obligation is closely tied to our need for social belonging. Our natural desire to contribute to our community or maintain relationships can become a vulnerability when leveraged by someone seeking control.
• Guilt is a normal emotional response to harming or disappointing others. But in the context of manipulation, guilt is often triggered when an individual resists complying with unreasonable demands. This can make even healthy boundary-setting feel selfish or wrong.

Clinical Examples of FOG Dynamics

FOG often shows up in relational patterns that may not seem immediately concerning but carry significant emotional weight:

• A partner threatening self-harm if the relationship ends.
• A parent shaming adult children for not participating in family events.
• A child or adolescent using emotionally charged language (“you’ve ruined my life”) to pressure caregivers.
• Colleagues misrepresenting group consensus to influence decisions.

These scenarios may initially appear like typical relational conflict but can signal chronic patterns of emotional coercion when sustained over time.

The Emotional Impact

Clients who live in persistent FOG environments often present with feelings of hopelessness, helplessness, and powerlessness. Over time, these feelings can contribute to symptoms consistent with learned helplessness, a state where the individual believes that no action will improve their situation. This can lead to withdrawal, diminished self-efficacy, and difficulty trusting their own perceptions.

From my perspective as both a clinician and a human being, I can attest that navigating FOG is profoundly challenging. Even those with strong self-awareness can struggle to distinguish between legitimate relational responsibility and manipulation-induced obligation. The who reason my friend mentioned FOG was to point out to me some of the reasons I stayed in a toxic relationship way to long. I did it out of fear (of leaving), obligation (feeling responsible for that persons happiness) and guilt (over a past transgression).

How to Step Out of the FOG

1. Name It.
   Awareness is power. When you can identify Fear, Obligation, or Guilt at play, you start to reclaim control.
2. Use the Internal Pause.
   Before responding, take a breath and ask:
   “Is this choice coming from a place of love or fear?”
3. Challenge the Narrative.
   Ask yourself:
   “What would I say to a friend in this situation?”
   That lens can help you cut through distorted beliefs.
4. Set Boundaries with Clarity, Not Shame.
   Saying no doesn’t make you cold. Taking care of yourself isn’t betrayal—it’s self-respect.
5. Get Support.
   Whether it’s a therapist, a support group, or trusted friend, healing from FOG often requires safe, validating spaces where you’re not being gaslit or guilt-tripped.

Clinical Recommendations: What Helps

When working with clients (and even in personal reflection), several approaches can support FOG recovery:

• Psychoeducation: Learning about personality disorders and emotional manipulation can empower individuals to understand the patterns they’re experiencing. I personally had to read a book on borderline personality disorders in order to get out of a toxic relationship with a former girlfriend.
• Boundary Work: Clients often benefit from structured boundary-setting exercises that help them regain a sense of control without falling into emotional reactivity.
• Support Systems: Encouraging clients to build networks outside of the manipulative relationship provides a necessary reality check and emotional grounding.
• Cognitive Techniques: Teaching clients to pause and apply rational, logical thinking to emotional decisions can help them break the cycle of fear-based responses.
• Values-Based Decision Making: Guiding clients to align their actions with their core values, rather than reactive emotions, can help them move toward healthier relational patterns.
• Safety Planning: In cases of emotional abuse or high-stakes manipulation, helping clients develop clear safety plans, including the removal of themselves and dependents from harmful environments, is critical.

Final Thoughts

FOG can cloud judgment, erode confidence, and trap individuals in unhealthy relational loops. A a clinicians, it’s my role to help illuminate the pathways out through education, validation, and skill-building.

I’ve seen first-hand how challenging it can be to untangle fear, obligation, and guilt from genuine connection and responsibility. But I’ve also seen people, including myself, find their way out of the fog with support, patience, and compassionate guidance.

If you find yourself walking this path, know that clarity is possible. The fog does lift.