What is Harm OCD?
There are around 2 million people in the United States who struggle with Obsessive-Compulsive Disorder. OCD can be divided into different subtypes, with each having different manifestations. Harm OCD is a subtype of Obsessive-Compulsive Disorder that is characterized by repeatedly having intrusive thoughts about causing harm to oneself or others. Someone struggling with this disorder does not intentionally think about inflicting harm. Instead, these thoughts pop into their heads without cause and can be extremely distressing.
People with Harm OCD do not intend to act on these harmful urges. They are completely contradictory to the person’s values and morals, which is why the thought of inflicting harm triggers an extreme amount of anxiety. Still, those struggling tend to take their thoughts as fact and can find themselves spiraling and having a deep distrust within themselves.
What Causes Harm OCD?
As with all types of OCD, Harm OCD most likely results from a number of causes. If a family member has OCD, there is a higher chance that you might develop it. Life experiences can also come into play. If someone has past trauma, it might trigger or worsen OCD symptoms. It might be the case in Harm OCD that someone witnessed a traumatic and violent event, which then turned into obsessive thoughts about harm.
This subtype of OCD is not caused by someone being an inherently violent person– these thoughts are in response to being scared of becoming one. Preoccupied with thoughts about harming, people with harm OCD engage in a pattern of trying to suppress these thoughts, which only acts to make them more prominent, creating a desperate cycle.
What Are the Symptoms of Harm OCD
Harm OCD, like all forms of OCD, is characterized by obsessions and/or compulsions. The obsessions are disturbing, intrusive thoughts, and compulsions are behaviors intended to neutralize the anxiety caused by the unwanted thoughts.
Obsessive Thoughts in Harm OCD
Obsessions in this disorder are highly intrusive thoughts. These thoughts are not intentional, but they pop into the mind without warning. As mentioned earlier, these thoughts do not reflect the person’s true desires. They are distressing for the sole reason that they conflict with the actual values of the individual. Here are some examples of obsessions in harm OCD:
You might be scared that you will become violent towards your child, and obsessive images flash in your mind of you slapping your child. This stems from the fear of hurting others, especially those close to you.
You may be making dinner for yourself and suddenly think about using the knife to cut yourself. This stems from the fear of intentionally hurting yourself.
You might be driving on a busy street and become flooded with worry that you will drive over pedestrians. This stems from the fear of causing accidental harm.
You see violent actions in the news and wonder to yourself if you unknowingly were behind those crimes.
You might have intrusive images come to mind of inflicting harm in graphic detail.
The discomfort brought on by these obsessions can result in a spiral of self-doubt and anxiety. To overcome the negative feelings, people with harm OCD might engage in compulsions to reduce the anxiety and eliminate the chance of causing any hurt.
Compulsions in Harm OCD
In Harm OCD, compulsions are behaviors or mental rituals that are performed to reduce anxiety or distract from obsessions. There are a few different types that are common with this form of OCD. Here are some examples of compulsions in harm OCD:
Physical compulsions: You might repeatedly check objects that you fear you might inflict harm with to ensure they are locked away. This can look like getting rid of all of your kitchen knives, or making them more difficult to access. Another example is backtracking in your car to verify that you didn't hit someone.
Mental compulsions: You might find yourself constantly reviewing past actions to verify that you didn't accidentally hurt someone. Similarly, you might repeatedly say phrases in your mind along the lines of "I will not hurt them," to protect against a false urge to hurt someone.
Seeking Reassurance: It is common to turn to loved ones in times of need, and people with Harm OCD do this as well. However, they seek reassurance from others that they didn't harm anyone, which over time, can strain relationships.
Avoidance Behaviors: Minor things in daily life can be extremely triggering. Unwanted violent thoughts can be brought on by virtually anything, so some people with harm OCD choose to isolate themselves to avoid doing harm to others. This can also mean isolating yourself from friends and family.
Living with Harm OCD
Life with Harm OCD can be a real challenge. Though a person suffering from it genuinely wishes to cause no harm, their intrusive thoughts and compulsive actions lead them and others to think differently. A person's constant anxiety and hyperawareness of their surroundings can become draining and interfere with daily functioning. Feeling guilty and ashamed of their own mind can lead some to isolate themselves from others, leaving them cut off from meaningful relationships.
Harm OCD often co-occurs with other mental health disorders, like anxiety and depression. Experiencing symptoms might be a clear sign that help from a mental health professional is necessary.
Treatment Options for Obsessive-Compulsive Disorder
If you or someone you know is experiencing symptoms of Harm OCD, seeking treatment from a mental health professional can be crucial in learning how to manage obsessions and compulsions and ultimately being free of the disease. While living with OCD can be tough, it is important to know that it is treatable with the correct interventions, and many people experience a full recovery after just a few months of OCD treatment.
Cognitive Behavioral Therapy for OCD
The best treatment for OCD is Cognitive Behavioral Therapy (CBT). CBT differs from regular talk therapy in that it is a strategic skills-based therapy that helps people learn to be free of their OCD symptoms. CBT techniques that target thoughts involve working with a trained specialist to identify unhelpful thinking patterns, like obsessive thoughts about violence. The behavioral component involves reversing unhelpful behavior patterns, like performing time-consuming compulsions.
Within CBT, many interventions can be employed to treat OCD, but some have been found in numerous clinical trials to be more effective than others.
Exposure With Response Prevention (ERP) for Harm OCD Symptoms
Exposure and response prevention (ERP) is the most research-backed OCD treatment, with the goal of this intervention being to learn to tolerate unpleasant thoughts while abstaining from compulsive behavior. The phrase "face your fear" encapsulates the gist of ERP. This intervention allows for gradual exposure to feared situations and increased confidence over time. With the therapist's help, clients create a hierarchy of feared situations, from least triggering to most triggering. Mastering one leads to the next, which ultimately leads to mastery of all of the feared situations. In Harm OCD, exposure serves to prove experientially that you can put yourself in a situation where you have thoughts about inflicting harm, and abstain from doing harm. ERP is a powerful method to reduce compulsions and to retrain unhelpful patterns of thinking.
ERP for Harm OCD might take the form of repeatedly saying the name of a sharp object, like a knife. This usually would bring on a compulsion, but in ERP, you learn to separate from that urge without acting on it. Next, you might look at a photo of the knife. After mastering that, you might then look at an actual knife in person and learn to tolerate the distressing thoughts it triggers until they fade away. The last step might be holding the knife in your hand and working through the emotions that arise.
It's common to feel intimidated by the idea of exposing yourself to triggers. However, when working alongside a trained OCD specialist, clients usually feel safe and empowered to do things they ordinarily don't have the courage to do by themselves.
Mindfulness as Treatment for Harm OCD
The goal of mindfulness is to cultivate awareness of your present experience, including intrusive and unwanted thoughts. Paying attention to the present moment without judgment allows you to practice accepting thoughts and urges without reacting. Mindfulness techniques can include breathing exercises and body scans, as well as observing thoughts and feelings mindfully and nonjudgmentally.
Cognitive Restructuring for Intrusive Thoughts
Cognitive restructuring can also be helpful in the treatment of OCD, as it helps to identify and challenge distorted patterns of thinking. Cognitive restructuring is one of a number of CBT exercises that help you to let go of intrusive thoughts. Alongside your therapist, through identifying and investigating automatic thoughts, you learn to replace negative thought patterns with a more grounded way of thinking. By identifying, challenging, and reframing a thought, urges to engage in associated compulsions simultaneously lessen and become easier to let go of.
Find a Therapist Specializing in OCD Today
Expert Treatment for Overcoming Harm OCD
At Cognitive Behavioral Therapy Los Angeles, our team of CBT experts specializes in the effective treatment of OCD. Each of our therapists holds a doctoral degree and brings extensive experience to their practice, with some teaching at the graduate level. We understand that living with OCD can feel overwhelming, but our evidence-based therapeutic methods offer a path forward. We are committed to providing the most advanced, scientifically-backed treatment options available in the field of psychological science.
Accessible Treatment for Harm OCD
We offer two locations for in-person therapy, making sure to serve both West Los Angeles and the East Side. We also offer virtual sessions online so you can receive high-quality care from the comfort of your own home.
Overcoming Harm OCD
Life Without OCD Can Start Today
If you or someone you know suffers from Harm OCD, we want to assure you that we are accepting new clients today. No one should have to constantly battle with themselves, and we want to help you free yourself from the shackles of OCD. Contact us today to schedule an initial appointment where you can meet one of our providers and take an important step toward being free from OCD.