Most folks would rather not admit it, but intrusive thoughts are a common part of life. They’re uncomfortable and can be quite disturbing at times. But, for most people, they’re fleeting and can be easily dismissed. This is not the case for anyone with a sub-type of obsessive-compulsive disorder (OCD) called harm OCD.

For them, unwanted thoughts about harming oneself or others are frequent and powerful. They are the obsessions in obsessive-compulsive disorder and can create a desire to perform compulsive rituals to ward them off. Compulsions may temporarily relieve anxiety, but they return as soon as the obsession does. The harm OCD cycle must be addressed.

What Causes Harm OCD?

As is the case with any type of OCD, no specific cause has been identified. Research continues, but, in the meantime, close observation has revealed some of the factors that could be associated with harm OCD, e.g.:

• Family history and learned behaviors 

• Preexisting mental health issues

• Brain chemistry

• Traumatic life events

Common Harm OCD Symptoms

Of course, there are intrusive thoughts and mental images of violence that trigger an intense fear that the person having such thoughts will carry them out. This includes a general dread that they will commit harmful acts by accident and remain unaware of them. Someone with harm OCD harbors a deep concern that they are violent people and just hiding their true nature. 

As mentioned above, obsessive thoughts of harm launch a cycle of compulsions in the name of reducing anxiety. Such rituals may involve:

• Self-interrogation with the intent to discover if they are truly capable of such horrific behavior

• Asking others for reassurance

• Hiding items that could be used to hurt themselves or others

• Avoiding exposure to news stories or violent content 

• A fixation on spiritual practices or items that they feel can prevent them from losing control 

• Engaging in dedicated research to learn more about people who have committed heinous crimes

• Fastidiously reviewing and replaying all their actions to make sure they did not contribute to the harm of anyone they encountered 

Needless to say, harm OCD can seriously hamper one’s daily functioning. Thus, they must get the help they need and deserve.

Harm OCD Treatment 

This is no “cure” for any form of OCD. However, proven treatment options are available. The most prominent is Exposure and Ritual Prevention (ERP). Working with an experienced therapist, the person with harm OCD agrees to be exposed to a trigger. The plan is to reduce the compulsive response to obsessive thoughts progressively. Here is a basic description of the process:

• The first step involves a short pause. When triggered to activate a ritual, the person commits to not take any action for a predetermined amount of time. This slowly builds confidence that they are not out of control.

• During the next exposure, you add to the delay by performing the compulsion in slow motion. You may still get the anxiety relief you seek, but again, you are reclaiming more control over the cycle.

• Typically, compulsive rituals will have several parts. Hence, the client will choose one component to omit. To review, they’ve resisted taking immediate action, slowed down the pace, and now altered the cycle by removing a step.

• By repeating and adding to the steps above, the person can reach a point where they can get triggered without responding. Yes, the intrusive thoughts arrive, but they no longer feel helpless in the face of them.

ERP can retrain the brain to recognize that there are big differences between thoughts and actions. Someone with harm OCD feels less trapped by the cycle and can function more healthily. 

Learn more about OCD Treatment.