Most individuals will experience intrusive thoughts that are aggressive or violent in nature on occasion; however, these are normally fleeting and easily dismissed. Harm OCD, a subtype of Obsessive Compulsive Disorder, involves experiencing frequent unwanted or intrusive thoughts or mental images of a violent nature. These thoughts can be directed at one’s self or others (i.e. experiencing thoughts of harming yourself or harming loved ones, or even strangers).
While many people experience such types of thoughts, people with Harm OCD have trouble dismissing them. They can come to attach meaning to these intrusive thoughts, making them even more distressing. Often, in order to try to neutralize the anxiety brought upon by these uncontrollable thoughts, compulsions are utilized. These can present themselves as actions such as avoiding the use of sharp objects (e.g. knives, razors, etc.), obsessively reviewing past actions to try to decide whether they might have caused harm, or avoiding violent imagery such as that which appears in the news or in fictional media depictions of violence.
As with any subtype of OCD, people with Harm OCD should remind themselves that they are not their thoughts. Experiencing thoughts related to violence or harm does not say anything about the person or their character. To be more concise, experiencing Harm OCD and the intrusive thoughts that come with it does not make someone bad or harmful. However, seeking treatment such as ERP (Exposure Response Prevention) can help sufferers learn to manage the thoughts caused by Harm OCD by retraining the brain to differentiate intrusive thoughts from real danger. ERP can help Harm OCD sufferers learn to avoid compulsions and subsequently prove to the brain over and over again that the intrusive thoughts have no real power and are ultimately just that— thoughts.
Below is a personal account from Mollie, one of our blog writers, who has suffered from Harm OCD:
“Grab that knife and stab him right now!”
“What if you vacuumed water out of your fish tank? Would the fish get sucked up and die?”
“Could I break my own leg?”
“I wonder if your dog would die if you pushed him down the stairs.”
“How much blood would pour out if you cut off the cashier’s fingers with those scissors?”
Almost everybody has had those types of unwanted violent or aggressive thoughts; it is a natural part of being a human who has a brain. Although they may be of a distressing nature, these types of thoughts typically don’t interrupt somebody’s daily living.
Unfortunately, as somebody who lives with Harm OCD, when these intrusive thoughts of harming somebody else or myself pop into my brain, they become “sticky,” and I have a difficult time pushing them out of my mind. I see an image, feel a sensation, or get an urge to commit a heinous, violent act, and my reaction is to try and alleviate that anxiety and distress.
Some common compulsions that I engage in when I have intrusive thoughts surrounding harming a stranger, a loved one, or myself are: avoidance (I will leave the room, store, or stop spending time with that person/animal), reassurance-seeking (I will ask the people I trust to tell me – for the millionth time, it seems – that I would never hurt somebody), and mental compulsions such as reviewing past events and checking my feelings/thoughts towards the individual.
Through ERP (Exposure and Response Prevention) therapy, I have learned that the thoughts themselves are not the problem and are not something that I am in control of — remember, everybody has these thoughts from time to time — but that I am absolutely responsible for the reaction to those thoughts.
Samantha Cartwright & Mollie Albanese
Co-Authors
