A discussion of the treatment of Harm OCD using Cognitive Restructuring. Part three of a series.
In our previous installment of this series, we looked at Mindfulness for the treatment of Harm OCD, and how a change in perspective towards unwanted thoughts and feelings can lead to a change in compulsive behaviors. But as many sufferers well know, one’s response to intrusive harm thoughts is frequently automatic. Those with Harm OCD have conditioned themselves to respond to their harm thoughts in a certain way, and very little thinking may go into it.
Mindfulness encourages us not to waste time and energy attending to thoughts and feelings with urgency when those thoughts and feelings could be simply observed and allowed without response. This is not only difficult to do, but requires practice, training, and education that may not always be immediately practical early in treatment. If we must attend to the content of our thoughts directly, we should attempt to do so with as little mental ritual as possible. So we ask the question, “What is it that I am thinking about my thoughts that appears automatic, yet may be voluntary and may be pointing me in the wrong direction?
Cognitive Distortions Commonly Experienced in Harm OCD
The reason why a harm sufferer feels compelled to compulsively analyze, avoid, or otherwise over-respond to harm thoughts is because they are filtering these meaningless little ones and zeroes through distorted lenses that spit them out as unacceptable indictments. These lenses are called cognitive distortions. Here are some examples of common cognitive distortions experienced in Harm OCD:
All-or-Nothing Thinking (Black and White Thinking)
- Because I had a mental image involving a knife cutting my mother, I am a psychopath and a danger to society.
- If I have one thought of violence, I am a violent person.
- Because I had a thought that involved violence, I will do something horrible and be put away forever.
- If I go to a social event, I will snap and kill everyone there, so I must avoid that event to ensure their safety.
Discounting/Minimizing the Positive
- Though I have yet to even be in a fight, all of this madness has been stewing inside, and I will burst the moment I hold a knife and am near a loved one.
- Though I have had these thoughts for years and not acted on them, I am a ticking time bomb.
- I feel calm while having a violent thought, so I must be a sociopath.
- I feel anxious when I have these thoughts, so that must mean I am about to act on them.
- I feel guilty, so I must be a bad person for having harm thoughts.
- I had a bad thought about my mother dying and unless I complete this ritual, she will actually die.
- My violent thought must be neutralized or my loved one will get in an accident.
Should/Must Thinking (Perfectionism)
- I should only have pure thoughts.
- I must not experience anger.
- I should always feel comfortable around children.
- I can’t watch this movie because it has a fight scene in it.
- There are many different things in this kitchen, but especially knives, which are dangerous.
- I moved my hand in the direction of my child while having a harm thought, so I must have been very close to strangling her.
Cognitive Restructuring in the Treatment of Harm OCD
Understanding your cognitive distortions is an important part of fighting Harm OCD. Cognitive distortions are the language of OCD. By learning to recognize that language, you can learn to identify when you are about to be conned into doing a compulsion. Cognitive restructuring is a Cognitive Behavioral Therapy technique that involves identifying your OCD language, and then imagining what type of rational, objective, evidence-based thinking you could be engaging in without the OCD.
Objective thinking is not “positive thinking”. It is admitting what you don’t know and what magic powers you don’t have. Uncertainty can be habituated to. Nightmares cannot. Repeatedly telling your self that no bad thing will happen is compulsive. Sitting with the following is more effective – “I can’t predict the future, but based on my past experience with these thoughts, they tend not to result in me committing murder.”
Part of what makes Harm OCD so frustrating is the awareness that these unwanted thoughts make no sense, and that you feel helpless to do anything about them. It’s like you’re screaming, “This isn’t the truth!” but your mind is telling you in a low, booming, overpowering voice, “You know it is because you are evil”. But the fact that the rational voice is buried in there somewhere means we should be able to access it and cultivate it, without compulsions, so that its volume can compete on its own with the OCD thoughts.
The primary tool for strengthening this rational voice is called an Automatic Thought Record (ATR). There are different variations in the types of thought records that therapists may use, but they all focus on identifying three basic elements: triggering situations, automatic thoughts, and rational alternative thoughts. In treatment, it is important that you put in the work of writing these things in a disciplined format like a thought record. Acknowledging and admitting the content of these thoughts can be very challenging for some with Harm OCD, and writing some of these thoughts may be an exposure in itself. However, as discussed in the previous article on Mindfulness, the goal is treat them like thoughts, not threats, and writing them is a step in that direction.
We like to call this process “planting seeds” because every time you identify a distorted thought and challenge it with a more viable alternative, you are giving yourself an opportunity to use that thought later and help it grow. Freedom from OCD is not the eradication of unwanted thoughts – it is the equalizing of the volume of distorted thoughts and healthy ones. On equal footing, you can choose between the two, and the freedom to make that choice leads to the freedom from obsessions and compulsions.
Here are some starter examples of alternative thoughts:
- “I have lots of thoughts and these scary ones are just some of them. That doesn’t make them the most important ones.”
- “Just because I feel uncomfortable, doesn’t prove that I have done anything wrong or will do anything wrong. I feel lots of things.”
- “Yes, that is a knife and knives are used for cutting. But just because I am aware of this, doesn’t mean I am going to cut someone. Not everything I am aware of is about my OCD.”
- “Not all my thoughts have to go through some rigorous screening process for perfection. I can have an ugly thought like anyone else and not do anything about it.”
- “In my experience, thinking something does not necessarily result in it coming true. This is why I haven’t won the lottery, and this I why I don’t need to know for sure if these thoughts are going to result in bad things happening.”
- “This serial killer movie may make me very uncomfortable, but discomfort doesn’t have the power to destroy me and maybe there will be parts of the movie I even like. I won’t know until I see it and there’s no point in reviewing something I haven’t seen.”
Given enough time, Cognitive Restructuring can encourage your mind to gravitate toward a direction that allows you to resist compulsions rather than pushing you to ritualize. In other words, your automatic response could become healthy instead of distorted.
It is important to note that cognitive restructuring for OCD is not about proving that your fears are untrue – it is about weighing the evidence for and against the necessity of engaging in a compulsion. Those with Harm OCD should choose behaviors based on evidence, not just thoughts and feelings. If you are genuinely in danger, it makes sense to engage in an avoidant behavior. But you can make this decision based on evidence. If there is no powerful evidence that you or someone else is in danger, you may choose not to engage in avoidant behavior. This doesn’t guarantee that you are safe or that your fears are untrue. It doesn’t have to. Instead it affords you the freedom to tolerate uncertainty and keep your OCD from bullying you into always choosing to ritualize.
Cognitive restructuring is one powerful tool for combating OCD, but for many, relying on it too heavily can quickly become its own compulsion. A more powerful tool is a behavioral therapy technique called “Exposure with Response Prevention” (ERP). Using ERP, one learns to tolerate being exposed to what happens when they don’t try to shut their thoughts down, to the feeling of discomfort that remains, and to the fear of what might happen next while sitting in the present moment with their unwanted thoughts. ERP is probably the last thing you want to do, but it is the thing most likely to result in freedom from Harm OCD. The next installment in this series will aim to demystify ERP, and its role in treating Harm OCD.
To take our free confidential online test for Harm OCD, click here.
To read part one in our series on Harm OCD, click here.
To read part two in our series on Harm OCD, click here.
To read part four in our series on Harm OCD, click here.
•The OCD Center of Los Angeles is a private, outpatient clinic specializing in Cognitive-Behavioral Therapy (CBT) for the treatment of Obsessive-Compulsive Disorder (OCD) and related anxiety based conditions. In addition to individual therapy, the center offers six weekly therapy groups, as well as online therapy, telephone therapy, and intensive outpatient treatment. To contact the OCD Center of Los Angeles, click here.
Thank you for this article. I wasn’t familiar with the Automatic Thought Record, and I learned a lot. That being said, I must give ERP Therapy a huge plug, as it literally saved my son’s life. He suffered from harm obsessions and had gotten to the point where he could not even eat, and was totally isolating himself. That was four years ago. He has since graduated college and has a wonderful life ahead of him, with his OCD now classified as mild.
That is an awful photo accompanying this article. It looks like domestic violence rather then OCD behavior.
Thank you for your comment.
Many people with Harm OCD obsess about the possibility of harming their spouses and children. In fact, the fear of committing domestic violence is very common in Harm OCD.
For our previous article on Harm OCD, we used an image of a bloody knife, and someone also made a comment that the picture accompanying that article was problematic. But the nature of this condition is that sufferers fear committing violent actions, often against those people that they love the most.
Unwanted stabbing and strangling obsessions are common in Harm OCD, and these pictures, while disturbing, accurately reflect the nature of obsessions seen in this condition.
Thank you for reading our blog and for taking the time to comment. We always appreciate feedback. Take care.
Janet, thanks for your message. I agree that ERP is the most effective treatment tool for Harm OCD. Your son is proof of that! I hope you enjoy our next installment, which will discuss ERP for Harm OCD in detail.
This has been a great series to read. I suffer from OCD and had it pretty well under control for a couple years with initial therapy and meds. Unfortunately, about three weeks ago it reared its ugly head again and took me by surprise. It also manifested itself as Harm OCD. Everything you talk about here, such as the thoughts and mental responses one has with this affliction are 100% correct. It’s comforting to read the examples, identify with them and know that it’s not some seriously unhinged stuff going on.
I will be returning to my therapist for the first time since the last time my OCD flared up and I am hoping to discuss the CBT and ERP techniques. For what it’s worth, I’ve sort of been already forced into an ERP situation due to my work, having had to acknowledge my thoughts in the eye of the hurricane as it were. Sometimes I feel I might lose it but then I realize that I haven’t acted on my thoughts and dom’t want to, and I get through it, however exhaustedly. I am hoping that with therapy again I can be guided through the process and not just sort of flailing about. I have also been keeping a journal of thoughts, reactions, and thoughts on those two things so I can give my doctor a blueprint of how things have been progressing.
I know eventually I’ll be back to my balanced thought processes, as I’ve had this on and off since I was 12 (I’m 39 now and the psychologist I am going back to is the person who diagnosed me with OCD making so much previous confusion and fear completely clear for me for the first time in my life), and the thoughts eventually die out, but this time around I have made a concerted effort to educate myself more on the problem and be better prepared for the future. I look forward to future installments here.
Thanks for your comment, Jason. You articulate your experience well. I think if you commit to a structured CBT / ERP program with your therapist, you will get a taste of really defeating an obsession. This is far more powerful than waiting for an obsession to go away and will give you confidence to deal with future unwanted thoughts before they develop into obsessions.
Oh what a good read. The articles are so helpful, thank you!
Sadly I haven’t found a ocd therapist to guide and help me through this tough process. It’s difficult and yet painful knowing that not one therapist out here in the Island of Puerto Rico knows much about ocd and if they do very little which makes it very sad for me. Because when I mention what I go through they look at me like they are confused.
It has been very difficult to balance my harm ocd and my post traumatic stress disorder. I was diagnosed in NYC a few long years ago back when I was 30 by my therapist. I’m now 40 years old. But it all did started when I was 14. Father killed with a knife, mother depressed with anxiety, I was molested A saw a horrific movie about a girl who killed everyone. She was bullied and her parents wanted always a little girl so they dressed her up as a girl when in reality she was a boy who was shy and angry. I left that movie theater frightened and so traumatized, it was awful! My intrusive thoughts are about harming love ones who are near me. Thoughts I don’t want to have.
My mother was controlling and fearful all the time. It was not a happy home. I washed my mother checked her door 5 times to make sure it was locked. And when her kitchen knife fell on the floor by accident while she was cutting vegies she would hide knife in the refridg for safety. She said, so no one can harm us. She became depressed and full of anxiety after my father death. I was 7years old when this happened.
Anyways, I hope to that my new therapist is good for me. He knows a lot about EMDR. Can EMDR HELP OCD?
I APOLGIZE FOR THE LONG MESSAGE!
Strangely, my story is the same as Jason T’s story, above. OCD first hit me about 2 years ago and with a year’s worth of OCD-specific treatment and ongoing meds, I’ve been doing, what I would call, pretty well.
I’ve just recently had a spike of Harm OCD that got me searching for information on the topic and found this article. Similar to other folks that have posted, this series has been like you’re in my mind and it gives me comfort.
I’ll be eagerly anticipating the upcoming ERP for Harm-OCD article. I’ll be seeing my therapist in October for a 4 month check-up, or sooner if necessary.
Thanks for the great series!!!
Magaly, it sounds like you have been through quite a lot and PTSD is definitely coinciding with your ocd. It also sounds like your mother was dealing with ocd too. There is a foundation in Puerto Rico affiliated with the IOCDF that can hopefully help you access appropriate treatment. The only other option would be to travel out of state for an intensive program. I would think that part of your exposure therapy treatment might involve watching the movie you mentioned, but this should be done under the guidance of a good ocd therapist as we have to consider the role PTSD plays in all of this. There is some research indicating EMDR can be helpful for PTSD. It is not considered an effective treatment for ocd. For that you need cognitive behavioral therapy.
Jason A., glad the articles are helpful for you. Thanks for letting us rent some free space in your mind!
Wow. Just reading these articles has given me some comfort. I feel like I’ve had a mild form of OCD since I can remember. I would do certain things (like touch the wall, lift my feet when sitting, race myself) in order for bad things not to happen, as if I could control the situation or outcome by doing these things. I suffered from obsessive, bothersome thoughts when I was 12 about my sexual orientation but that went away quickly from what I can remember. I’m 22 now, and I still do and have always done the compulsive things I mentioned above but 2 months ago I started to get thoughts of what if I could hurt a child? And now I got one the other night about my boyfriend that has been bothering me. I confided in my mom about these thoughts because I thought I was going to go crazy. She told me that when I was 2 she battled thoughts of hurting me and suffered with them for over a year (my mom is the most loving, caring, kindest person ever). She doesn’t suffer from them anymore and hasn’t for years. I think she learned on her own how to accept the thoughts as just what you say here: thoughts. She also told me that they don’t really go away, they just lessen over time and you learn to accept them, which I understand because I know the relief that comes when you can look back at a thought and it doesn’t bother you anymore. It also gives me some relief to know that it’s genetic, my mom most likely has/had it, and that’s where I get it from. Sometimes the thoughts really give me anxiety (which I have never suffered from before this). My question, Jon, is that there is a class where I live that teaches mindfulness through meditation and yoga. Do you think this would benefit me? I think it’s time I accept that I have these thoughts, obviously they’re not going away, so maybe ERP would be beneficial for me along with the mindfulness class? I’m willing to do anything at this point.
Thank you for these articles. You lay OCD out in such a cut and dry manner. It makes it less scary.
Hi there, I’ve been reading a lot of the older posts on HOCD on this site and found them so helpful and interesting. I have actually read a lot on the matter since I typed the way I was feeling into google and found articles and websites like this one. When I was a young child I had a few experiences with a male friend, this never really affected me when i was young, I always had girlfriends and wanted girlfriends, but when I hit the puberty age I started having the gay fears and anxieties, I can remember spending nights in my bedroom thinking about the early child hood experiences in tears and feeling extreme shame and guilt. This is when the mental ruminating and mental unrest started, when it came on strong I couldn’t concentrate on anything and felt depressed constantly. It go stages where all I thought about was wanting to die. I then developed a negative self image because of the fears and gay anxieties, thinking that I looked gay and acted gay and that other people thought I looked gay. I had girlfriends during and after puberty and have always loved not just sexually but emotionally. To cut a very long story short I am now 23 and still suffer from these problems, I don’t have a job, I still live with my parents and avoid social gatherings with friends because if my low self esteem. Recentley it has got so bad that I went to my GP. I can’t take it anymore, I thought it might be low testosterone, Klinefelters Syndrome, absolutely everything. But none of those things explain the gay fears, I do not want to be gay nor do I want to participate in gay sex, this is what I don’t understand, I get really intrusive thoughts sometimes and then get all the extra anxious feelings that come with it. I lived with this so long now that I know how to deal with to an extent. It’s not all the time, sometimes I feel good for like a week, I have a healthy sex drive and feel good about myself and masculine then these feelings just take over again and I find myself in a mental hell, doubting and beating myself up, it feels like my mind is paying tricks on me and I can’t break free, sorry for the long post but it’s the first time I’ve been able to ask a professional about this, your thoughts would be great fully appreciated, thank you
I’m so glad I found this. I’ve been going through harm ocd for the past few months. Its excruciating. I’ve always had ocd and some obsessive thinking but this is awful. I have thoughts and fears of harming my kids. I can’t stand it. Its taken over my life. I think I need to go to a center but sadly they don’t take insurance and are self pay. Who can afford that? Its sad when you really want help you can’t get it. Do you have any?
Hi TD, your story is a common one and it’s no surprise you have a first-degree relative who struggled with ocd symptoms as well.
You asked, “is that there is a class where I live that teaches mindfulness through meditation and yoga.”
—I don’t know where you live. I am going to guess yes.
You ask, “Do you think this would benefit me? I think it’s time I accept that I have these thoughts, obviously they’re not going away, so maybe ERP would be beneficial for me along with the mindfulness class?”
—Cognitive Behavioral Therapy (CBT), including Exposure and Response Prevention (ERP) is the best form of treatment for OCD. The scientific community appears to agree with this assessment. I also believe that including mindfulness techniques alongside CBT increases its effectiveness, which again, the scientific community seems to agree with as well. So, yes.
James, it sounds pretty clear from your post that you have ocd and are not getting treatment for it. Isolating yourself only further sends the message to your brain that these intrusive thoughts are important and should be controlling your life. They’re not. They’re thoughts, not threats. But you need to get treatment to help you internalize this and put it into practice. If you want to email me your location, perhaps I can offer some suggestions.
Hi Ann, I agree it is unfortunate that access to appropriate mental health care is so limited and so expensive. If you are unable to find a cbt therapist in your insurance network, you might look into a self-help workbook, such as The OCD Workbook by Hyman/Pedrick or Freedom From Obsessive Compulsive Disorder by Jonathan Grayson. I would also recommend joining an online discussion board with treatment professionals in it that can offer advice, such as https://groups.yahoo.com/neo/groups/OCD-Support/info
I’m looking for a therapist in my area i have great anxiety i believe i suffer from harm ocd it started with would if i loose my mind and hurt myself as soon as i got past that about there weeks later after reading the Andrea Yates case i started having thoughts of would if i loose my mind and drowned my child would if i go to jail would if i start to hear voices and the list goes on in my head…..to the point where giving my child a bath sets of the harm thoughts causing more anxiety i love my child i live alone with her and would never want to harm her but the thoughts make me question every aspect of that i did have post partum anxiety the first nine months after she was born at that time i just had an over whelming fear about being responsible for another life and being afraid i could not do it everyone tells me I’m a great mother but the thoughts are driving me nuts i want a break from my brain the tools to heal and constant re assurance that I’m not loosing my mind and that i won’t and don’t want to act out these thoughts.
I am so glad i found this website! It really seems like you’ve been inside my head! I thought i was going crazy to the point of almost admitting myself somewhere! I had a thought of harming myself and its since magnified into me being scared to be alone and seems like i can never get that image out of my head. I have such a wonderful life going on that i don’t truly think i would ever hurt myself. For days the thought of if im left alone i will harm my self has been tormenting me! I have an appointment in a week with a therapist, hopefully they can help me with this! Thanks so much i can finally breathe a sigh of relief knowing im not going crazy!
Thank you for your response it is very appreciated, where can I get ur email address? Another thing I would like to say is when these fears and feelings happen it takes over my body and brain, like I convince myself that i must be gay or something but it makes me feel the lowest anyone could feel, that’s what I don’t get, people who are gay are happy and normal like everyone else, has the childhood experience messed with my head? Without sounding too explicit it is ruining my sex drive also when I get aroused from a girl or watching a nice girl I get thoughts again, not explicit thoughts but thoughts of friends, nothing sexual just like I can’t concentrate and my mind is throwing make friends at me to confuse me, I just don’t understand what is wrong with me. When I’m having a nice couple of days, I’m fine I feel free, then boom it hits me again.
“I am so glad i found this website! It really seems like you’ve been inside my head!” LOL, we get that a lot. Thank you for your comment, Jessica.
Assuming your therapist is trained in CBT and specializes in the treatment of OCD, you can expect to formulate a plan for confronting these self-harm fears and getting back in the driver’s seat of your mind. My guess is this will involve some forms of exposure to being alone and better tolerating the uncomfortable thoughts and feelings that come along with it.
Arr, thanks for sharing your story with us. The way your ocd presents itself is very common and certainly treatable with the right cbt therapist. The missing element here is that you are responding to these thoughts as if they were intrinsically abnormal to have, so your brain starts to throw them at you as if they are really important and must be attended to urgently. In treatment you would learn to respond to the thoughts in such a way that your brain had to recalculate their significance and ultimately stop burdening you with horrifying chatter.
You didn’t mention where you are located, but I would be happy to recommend resources that may be available to you. If you are in the state of California or are outside of the US, you could do skype therapy with one of us at the OCD Center of Los Angeles. You can visit our website for more info on online therapy for OCD at our center.
Hi James – You can read more about treatment for HOCD and gay obsessions on our website at at https://ocdla.com/sexual-orientation-hocd-gay-ocd-treatment-2-1970/. You have not mentioned what you are doing for treatment, so feel free to email us from the “contact us” page of our website at https://ocdla.com/ if you would like to get help with HOCD at our center.
Thank you for giving me hope just reading and educating my self on the subject helps I’m located in chico ca funds are low at the moment i only have medi-cal if you know of any one in my area please let me know and thanks again
I left a comment on part 2 of this series but I had another question. I have been trying to incorporate the mindfulness techniques into my harm OCD but I’m worried that I’ll start to feel neutral about ALL my thoughts that are “appropriate” to get anxious about. For example, before my OCD started I would think about future scenarios like my dog passing away (of natural causes) and I would get really sad. The sadness I felt would then cause me to love her even more and cherish the time we have together. When I think about it now however, I feel no sadness, only guilt and anxiety over the fact that I don’t have the sadness anymore. Is this pattern of thinking still my OCD and its just a different way it’s manifesting itself to me?
Vicki, the notion that there are certain thoughts that are “appropriate to get anxious about” is the primary weapon your ocd uses to trick you. If I watch a horror movie scene in which someone gets violently murdered, then I am also having thoughts about violent murder. Otherwise I would not understand the movie. Do I have a moral responsibility to be unhappy because these are the thoughts going through my head or can I just let those thoughts be there and not assume they say anything in particular about what actions I will take in the future?
You write “For example, before my OCD started I would think about future scenarios like my dog passing away (of natural causes) and I would get really sad. The sadness I felt would then cause me to love her even more and cherish the time we have together. ”
I find it hard to believe that forcing yourself to feel sad about some future hypothetical scenario is what drives you to love your pet. Maybe you just love them anyway. Sadness about losing love doesn’t “cause” love. Love happens because love happens.
When you refer to guilt and anxiety over not having what you think is the “right” emotional response, you are playing into the ocd. What you feel about what you feel is not an indicator of what you feel. The ocd is trying to get you to compulsively analyze the validity of your feelings, but what you end up with is securing the validity of your obsession with being a bad person. It’s a trap. Instead, I encourage you to accept whatever feelings you have when you have them as simply being the feelings you are having. If you enjoy them, then enjoy them. I you do not enjoy them, then accept that they are not enjoyable. All of the extra thinking about it is a mental behavior aimed at getting absolute certainty where there can be none.
Arr, I don’t know of anyone treating ocd in Chico specifically, but you might look at https://www.iocdf.org/ to see who is nearby.
I think suffer from pure O and it was manifested
10 years ago first time when I saw on TV police action against
pedophiles in Romania with very disturbing pictures and I could not
get that picture out of my head for months with thoughts like: why I
am thinking about that?….am I pedo? etc. I know that these thoughts
are nonsense and that I never had any need and thoughts about children
but it was very hard for me and I was very anxious. These thought
disappeared for 9 years(90%) without using medications and without ant
therapy and now they returned again after I read an article in the
daily paper.Also I got new thing as I watched tv show about Serial Killers( Dhamer,Gacy and Bundy) and after that I was vey anxious I am so scared to become one of them but I know that this is not possible but I cant get this thoughts out of my head. Am I monster etc.. Is it possible that OCD can disappear without any
therapy? Also I read book BRAIN LOCK and I am willing to start 4
steps method to win and to learn to live with my OCD problem is to
find a therapist here and is it possible that I can do it by myself?
And if yes can you forward me any steps and how to follow? I must say
that I am very successful in my job, that I have girlfriend that I
love and that we planing our life together but these thing is very
hard to ignore.
Hi Veki, sorry for the delayed response, this comment must have slipped past my radar.
It’s not unusual for harm ocd to come and go throughout life and be triggered by very specific things like the ones you mentioned. Schwartz’s 4-step method may be helpful, but there are some newer books that probably address your fears more directly. Imp of The Mind by Lee Baer and Freedom From Obsessive Compulsive Disorder by Jonathan Grayson are good ones.
Instead of “ignoring” the thoughts or trying to get them to go away, you will get better results from doing exposure to the thoughts and accepting them as thoughts. This may involve doing exposure to things that trigger you and resisting the urge to try to convince yourself that you are not what you fear.
My harm ocd has become horrible lately, unfortunately I researched psychopathy symptoms about not feeling remorse and liking the thoughts and now I feel as though I could carry out my thoughts or that I want too. I have also been getting horrible feelings, almost like false feelings that my dog and girlfriend that I love very much are “stupid or deserve to die” I get extreme anxiety over these thoughts to the point I break down and cry. I made a huge mistake of reading an article about dahmer who people had similar thoughts, now my mind is going crazy and I cannot stop thinking the same crap over and over along with intrusive feelings and urges, I just feel like I should be locked up, but I refuse to let my life spiral downward anymore any advice on what I should do?
Kyle, the urge to research psychopathy and try to prove you are not a horrible person is a compulsive attempt at self-reassurance. It is as common in Harm OCD as it is for people with sexual orientation obsessions to read “coming out” stories. Remember, ocd thrives on compulsions. It lives off of you seeking reassurance.
The increased presence of intrusive thoughts about people (or things) you care about is the ocd’s way of increasing the discomfort to get you to do more compulsions. Fear of liking the thoughts is pretty much as common as fearing that they mean something. When you try to prove that you hate the thoughts, the ocd comes back with, “How do you know for sure?” Since it is not possible to prove, you end up being triggered by your failure to get certainty.
I don’t think reading about Dahmer is the mistake – reading about Dahmer and trying to convince yourself that your thoughts aren’t like his is the mistake. My advice is to connect with an ocd specialist and start a structured program of Cognitive Behavioral Therapy (CBT) that includes Exposure and Response Prevention (ERP) strategies just like this. But for exposure to be effective, it must be done while concurrently resisting compulsions.
In the meantime, work on accepting that, however absurd the thoughts and feelings are moment to moment, they are still thoughts and feelings, not threats or facts. Instead of trying to prove their meaning or lack thereof, simply note them as happening, nothing more. But above all, get treatment for the Harm OCD from an OCD specialist before it comes up with some other mental twist to keep you seeking reassurance.
This is a very great article, my OCD has been flaring up alot lately and I am seeing a very good and understanding doc. I was also reading and I was getting the feeling of what if you would like it or something of that nature. keep in mind I have never had a violent past and only a couple anger issues but it feels like it has taken my personality and turned it completely around. I don’t really have mental pictures although when i read about people getting pictures I will sometimes throw one my way, but more verbal text. Its amazing that the thought can repeat in my head that I wanna kill somebody but yet I cant even say the word out loud. I do feel lost and confused and I don’t like thinking or cant think about my future. But hopefully all these techniques will help me out. I know the ERP hasn’t been anything but super unpleasant for me. Anyways great job!
I have a problem with OCD. I had/have such irrational things on my mind and I can get them out of my head. I had thoughts that I am pedophile, serial killer, maniac and now I developed a big fear of schizoprenia. I read forums about it and this thing is killing me.I surfed via web to see what are the symptoms,in which age you can develop it and I am scared that I will get hallucinations, that I will loose my mind.. I stared always to ask myself what if I develop symptoms of it, is this real world, what if I convince myself that I am posesed, that I am god etc…and then this makes mi very anxious because I know that this is stupid and irrational and that it is not normal to think on this way but it is hard
Thank you for your comments.
All of the obsessions you mention (pedophilia, murder, schizophrenia) are quite common in OCD. And like most people with OCD, you are having lots of “what if…” thoughts – what if I have hallucinations, what if I have symptoms, what if I lose my mind, what if I convince myself I am possessed, what I convince myself I am god, what if this is not the real world, etc.
The key is to realize that your brain loves to conjure up these kinds of thoughts, but that you don’t need to pay attention to them, or give them any weight whatsoever. They are just thoughts, no more meaningful or accurate than the thought “what if the sky isn’t really blue, but is actually polka dotted”.
Just because we have a thought doesn’t mean that thought is true, or accurate, or meaningful. Sometimes (frequently) we just have quirky thoughts that deserve no attention. And they certainly don’t warrant a behavioral response – checking the internet for reassurance that you are experiencing symptoms of schizophrenia will almost certainly backfire and lead to more obsessions.
I encourage you to accept that your brain cranks out lots of thoughts, many of which don’t require or deserve any attention or response. I also encourage you to read our follow-up article on Mindfulness for Harm OCD to help you with this.
thanks for this very good article. I have thought recent events in my life (death of a loved one, currently watching my father get sicker due to cancer, and almost losing my son in the woods in the back of my house) could have triggered stress that brought about PTSD or anxiety disorder. I have been extremely sad and cried 4 times today, about the thoughts I might harm someone. I don’t feel suicidal at all, but have guilt from these unusually strong thoughts. In life I just thought we all have these thoughts. I was worried it could manifest into action if it got stronger. Thanks for the information. I don’t think I could ever harm anyone, but this OCD is extremely convincing. I thought the best way to deal with it was making myself busy, or countering the bad thoughts with good thoughts; like a battle in my mind. It is exhaustive. I am off to see my doctor tomorrow hopefully. In the meantime, I will take the advice, and just try and rationalise the thoughts as just that..thoughts and not actions.
Thank you for your comments.
I’m sorry to hear that you are going through such a difficult series of events.
It’s worth noting that an increase in real-life stressors often leads to a spike in OCD and anxiety symptoms. You are experiencing some very real, very emotionally powerful events, and having an emotional reaction to those events is totally normal. Add to that that you have OCD, and you have a perfect recipe for increased obsessions and anxiety.
It sounds like you have a pretty good grasp of the importance of accepting thoughts as just thoughts. Be careful of countering “bad” thoughts with “good” thoughts, as this can very quickly become compulsive and counter-productive. The same goes for making yourself artificially busy. Staying busy is good so long as you are focused on actions that are actually important. But just getting busy with unimportant tasks in an effort to avoid feeling anxious will backfire.
Finally, I want to encourage you read our article on Thought-Action Fusion. It goes in-depth on the issue of confusing thoughts with actions, and how to best manage this problem.
i have had these thoughts for years, thank you for your website, it is reassuring. my concern is medication. i am not taking any right now, except for a natural one (SAM-e), there are so many issues, and new warnings about ssri’s and other medication that may increase violent thoughts or suicide. So now i am afraid if i take them, this will get worse, and then be out of control, being caused by the small chance of the medication warnings.
so i started taking SAM-e. hoping to help myself more naturally. i feel the thoughts are worse.not sure what to do. Do people with harm ocd need medication? is there a natural alternative?
Thank you for your comments.
The OCD Center is staffed by licensed and registered psychotherapists, but we are not medical doctors, so we cannot give advice on medications. That said, I can say that there have been numerous controlled, peer-reviewed research studies that have found certain SSRI medications to be very effective in the treatment of OCD.
Your fear of taking these medications is extremely common in those with OCD. Furthermore, it sounds like your concerns are actually part of your OCD in that you appear to be afraid that you will somehow lose control if you take the medications and “get worse”. But that is unlikely, and you report that you are getting worse anyway while not taking them. That seems to be pretty good evidence that the SAM-e is not helping you, so perhaps it is time to try medication.
As an alternative, natural, non-medication approach, I strongly recommend you try a course of Cognitive Behavioral Therapy (CBT) with a therapist who specializes in treating OCD. CBT has consistently been found to be the most effective approach to treating OCD, and has none of the side effects of medication. If you would like to discuss treatment options at the OCD Center, give us a call or drop us an email.
Hi, I have been dealing with these thoughts since the start of January, I have latched on to many themes, but this is the predominant one and I find it very scary. I’m worried I’ll hurt my family, even though I have no reason to do so, they’re very caring and I love them very much, but these thoughts make it feel like I don’t care for them when I know deep down I really do. My anxiety has been subsiding dramatically and there are times when I can put the thoughts to the back of my mind, but they often return with a sense of dread and a feeling of impending doom. It makes me feel like an awful and cold hearted person, it feels very real sometimes. I’m not able to get a CBT appointment until May, what would you reccomend I do until then? I’m tired of feeling this way.
It is the norm for obsessions, including harming thoughts, to come and go. Also, keep in mind that for many people with Harm OCD, the thoughts are focused on people who are the most important to them. That is what makes it so terrifying for many people – the idea that they would harm someone they love.
But it is important to remember that there is no evidence at all that you will harm anyone. It is critical to remember that these are just thoughts, not evidence of your secret evil character.
I have been dealing with Harm OCD for a little under three weeks now and it has been very tough. I was wondering if it is normal to feel emotionally detached or numb as a side effect of Harm OCD? In addition I have had horrible night sweats every night and a lack of appetite, I am worried because I feel like a robot.
Night sweats and a lack of appetite are common symptoms of anxiety, and OCD is just a specific manifestation of anxiety. Also, we have had many clients with Harm OCD report that they feel numb and detached. It seems to me that this would be a natural response to overwhelming feelings of discomfort – our bodies (and minds) just want bad feelings to stop, and numbing out is one way to do that.
It is also possible that you are over-attending to your feeing state, and coming to the (possibly false) conclusion that you are numb. We have seen many clients with Harm OCD who are afraid that their allegedly detached feelings are evidence that they are some sort of coldhearted monster who doesn’t care about these thoughts. But the opposite seems true – people with Harm OCD are overly concerned with these thoughts, not under-concerned.
I suffer from Pure O and was very good last month but week ago I had relapse worst than ever. My theme is that I am developing schiz paranoid type I am seeing my therapist who is the best for CBT in whole region and we were doing fine but I cant convince myself that this is just OCD.
Yesterday I was feeling very anxious about the dream that I had about schiz guy that I saw and when I came home paranoid thought pop on my mind….what if my wife wants to take me to.asaylum….after that I was so scared and even I know that thought is dumb I cant remove it out of my head and I feel so bad.I always say to myself this is the psychotic break an you are gone and after that answer is no you are not schizo and that spins like a record.My therapist told me that it is doubt illness…when you convince yourself that you are not schizo thoughts will go away but there is always doubt and it is hard to do it.Also he told me that if you are schizo you would not come to me and tell me that but I always have that thought that I am.Also he is eminent proffesional in Anxiety disorders with long enxperiance and was a teacher at Michigan University and he told me that if you have OCD it cant turn to psychosis and that I am immune on it but the thoughts are still here. Also I started obsessing about paranoid type when I find out that this is only type that I can develop at my age.I am 33 I have a great job wonderful wife and we plan a child.but I am so scared about the future and that I will loose everything
The fear of developing Schizophrenia is actually quite common in OCD. But if you try to convince your self that you do not have (and will not develop) Schizophrenia, then you are likely to make your OCD worse.
The goal with this type of OCD is the same as all types of OCD – to accept that your brain (and everyone else’s brain) produces all sorts of uncomfortable thoughts and feelings. For you, those thoughts focus on developing Schizophrenia. For others, the obsessions may be about harming people, being a pedophile, contracting a disease, or having a change in their sexual orientation. Truly, the list of potential obsessions is infinite.
In addition to accepting that your brain likes to make up weird thoughts like this, you also would benefit from making no effort whatsoever to eliminate them. In other words, accept the thoughts and do nothing about them. Just let them be there, without responding to them. I know this sounds counterintuitive, but it is the crucial step in learning to manage your OCD.
Finally, your behavioral goal should be to never let OCD thoughts have a say in what you do. If you and your wife want to have children, then you should have children. Do not let OCD change your mind. If you let OCD have power over your decisions, it will get stronger. Conversely, if you stand up to your OCD, you will get stronger.
hi , i have a story of sexual abuse in my childhood and i think that i developed kind of harm OCD ,with sexual themes , the first time it comes to me i was devastated by the flashbacks of my abuse but worse by the fear of harming my loved one , now after years , and research what i think now it s compulsive behavior , that finally i can put words of what i m feeling , harm OCD , i do not have access to a good professional in my country so i try by my self to find solution , the fact that my OCD have a background of abuse make them in my mind more scaring and credible , and even if i try to treat them as simple thoughts , another worry appears , how can i make a difference between a normal thought that belongs to me and another that have the right to exist but which belongs to my OCD , and seeking information is kind of compulsion , but if i did n t do that , i could n t have information that help me now , even in period when i lived what i thought a normal life cause i did not have any kind of worries or harm OCD , and i was living happy life , i discover now that i was doing a lot of compulsion thing and a lot of my acts was define by my inconsious fears , when i m in crisis my doubts are a lot and about a lot of subjects that never cross my mind in normal periods
i m wondering if having been abused in childhood make my harm OCD about sexual themes more credible and stressful and is there tools that i can use by my own to free my self and live a life which not defined by the abuse or my fears ,and searching information is good or bad thing if not what i have to do
Thank you for your comments.
It is not unusual for Harm OCD to have a sexual theme – rape, incest, pedophilia, etc. But trying to determine whether your thoughts are “simple” thoughts, “OCD” thoughts, or evidence that you actually want to hurt someone is a compulsion in itself, and will only worsen your OCD. I encourage you to let these thoughts exist, without trying to figure them out. As you noted, thoughts “have the right to exist”…but you don’t need to do anything about their existence.
Likewise, you need not try to figure out whether or not your history of childhood abuse is the cause of these thoughts. We have treated many people with Harm OCD who have had a history of childhood abuse. But we have also treated many with Harm OCD who do not have a history of abuse. Abuse doesn’t cause OCD. That said, a history of abuse can certainly flavor the themes about which one obsesses. It makes sense that a history of abuse could lead someone with OCD to obsess on thoughts related to abuse.
Finally, while seeking information may at first be a good thing, it can very quickly become a compulsion. From your comments, it appears that you are compulsively seeking reassurance about your thoughts – what are they, why am I having them, are they related to my history, etc. I encourage you to resist the urge to answer these questions. Just let them sit unanswered and get on with your day. This may seem almost impossible at first, but with effort and practice, you can learn to sit with these thoughts and the discomfort they cause. I also encourage you to seek out treatment with a therapist who specializes in Cognitive Behavioral Therapy (CBT) for OCD. Your thoughts are unwanted and distressing, but they are also very treatable. Take care.
I had harm OCD for many years and my main idea was that ‘what if I may have killed a child or weak person and forgotten about it’. In the end, I escaped from this idea around last 6 months.
Last week in the park, I was playing with my child and I looked at another child a little long then my obsessions suddenly started. Why I looked long? Am I pedophilia? I also escaped from this idea.
Now, I am asking myself that if I am a pedophilia maybe I could have killed a child in the past and that’s why I thought many years. Contradiction is that I have never read any article about pedophilia and investigated on the net so far.
Please share your comment with me. Harm OCD and pedophilia OCD symptoms can be seen together?
Thanks in advance for your reply.
Yes, Harm OCD and POCD can be (and frequently are) seen together. There is no significant difference between Harm OCD and POCD. Both center on some variant of the obsessional thought “What if I am a horrible person who did a horrible thing”.
thanks for your answer ; i read an article , another compulsive behavior , that 80% of abused people in childhood developed a PTSD with intrusive thoughts , flashbacks ,avoidance hyper arousal , which is explain by the existence of traumatic memories ,every time i have a crisis i have all this symptoms , and this is the 4 th time in my life i have it , between this crisis every thing is normal for years, and with the crisis comes what i can now put a name on it THE PURE OCD , also between crisis it disappear, this is why i thought that my OCD was related to the abuse, it seems that i have a PTSD and PURE OCD , what a chance
i ll try to put your words in practice , i will not seek for more information , i live in not developed country, there s no such specializes therapist , if i learn about CBT|ERP, can i try it by my self or it s not recommended
I have been struggling with Harm OCD for almost 4 years now. I was seeing a therapist who was trying to implement CBT and have me keep an ATR but I just could not allow myself to take a break from work to write down that I just had a random thought about hitting my co-worker over the head with a stapler. It sounds crazy to type that but that is not the worst thought I have ever had. I stopped seeing my therapist because I could no longer afford it and don’t have insurance. It takes a lot for me to open up about that to someone and I am not sure I would trust someone at a free or pro-bono therapy clinic in my area, although I have heard they exist. I have tried to get better at telling myself that when these thoughts come it is just a thought and let it pass without causing my such distress. Sometimes it works and sometimes there is a voice (not literally) in my head that is saying ‘these thoughts are not normal and you must be sick in the head to even think them’. It is that voice that makes me then obsess about the thoughts and the fact that I have them, thus making it worse. I have not been home to see my family in two years because I know I will have harmful thoughts about them and it is already making me feel anxious and I am 900 miles away. I have decided to go see them next week because I cant make any more excuses as to why I cant. The first thing I thought about after getting off the phone with my sister was harming my mother when I surprise her (as she does not know I am coming). Again, something that should be an exciting, joyous notion is turned extremely dark and catches my breath to even have such imagery about my mother of all people. This is the moment when I can not just say ‘Oh its a thought and nothing more. You aren’t crazy’. Because I know that people with normal brain chemistry and thought patterns do not have such thoughts regularly or at all. I am trying to build up my defenses and calm down as much as possible before I go see them. I really do want to have a great time and not be bothered with these thoughts but I know I will be. I am sure that notion is what is setting me up for failure here as opposed to telling myself ‘You wont have those thoughts so don’t worry..’ Its a vicious cycle that I wish would just end. I even tried medications during my stint in therapy and those made me worse. I just feel like a lost cause with this. Any effective techniques I could use to combat this would be greatly appreciated!
Sorry for the delay. Some posts get diverted to our spam file and I don’t find them for weeks!
The best suggestion I have is for you is to seek treatment with a therapist who specializes in treating OCD using Cognitive Behavioral Therapy (CBT). Unfortunately, it sounds like you were on that path but could no longer afford treatment. Therapists working at pro-bono clinics are unlikely to have any clue as to the appropriate treatment for Harm OCD. You may want to get certain books on OCD. For Harm OCD, I highly recommend The Imp of the Mind by Lee Baer.
Your thoughts don’t sound “crazy” – they sound like Harm OCD. You can’t control whether the thoughts cause you distress – you can only control how you respond behaviorally to them. On that note, I want to encourage you to not use avoidance as a method of trying to control your anxiety. It doesn’t work! You note that you have avoided visiting your family for two years due to your harming obsessions, and yet you still have the thoughts. That seems like ample proof that avoidance doesn’t work – it just kicks the can down the road.
Visit your family with the expectation that you will have unwanted thoughts. The real question is how will you respond when the thoughts arise. You can flee, or you can stay and spend time with people you love. Either way, you have the thoughts. I hope you choose to visit them.
I have been suffering with pure O since February. My Fear is that I may harm my family. I know that I would NEVER do that however I am still beyond scared. I am constantly questioning if I am feeling an urge to harm my family. I know that even if I felt an urge I would never do it but the thought that maybe im having an urge makes me physically ill. I don’t feel like I have had an urge to act on my thoughts but sometimes im not totally sure that the thought isn’t an urge. Im also scared that maybe I will develop an urge. Is it common to question if your having an urge to harm with OCD? Please know I have never in my life hurt anyone/anything…. I am terrified and just want to be happy again
Thank you for your comment.
These “urges” are what we call obsessions. Likewise, questioning what these urges mean and analyzing them are mental compulsions. The best thing to do with these types of urges is nothing. Don’t try to figure them out – just accept that your brain, like everybody else’s brain, comes up with lots of stuff, and that some of this stuff is weird, strange, unexpected, and unwanted. My best advice is that you seek treatment with a therapist who specializes in treating OCD with Cognitive Behavioral Therapy (CBT).
All the thoughts you posted on this part of the article did hit home for I thought about all the violent thoughts I’ve had and why I am calm a lot and don’t feel anxious. I have very little anxiety but I do notice when something starts to bother me I breathe in deep and my heart races.
I have a trouble not googling things. Anything about sociopaths and such sends me into a panic. I find myself reflecting back to criminal shows like CSI or Criminal minds and the way they describe the killers. (those shows for years though I’ve obsessed about every mental illness they describe)
I think about those who write horror and torture things and nothing is wrong with them…right? Those who watch things like Saw. I could never stand those and thought people were sick if you enjoyed that. I avoided things like gory movies or shows like the walking dead. Zombies I always hated. Never minded vampire or werewolf movies but zombies just freaked me out.
But suddenly I watch the walking dead and I’m loving it. I just figured it was because I grew up. I’ve always been a sensitive person and I mean majorly. I’d cry at everything. And even though I hated characters in shows like the walking dead two major characters I hated and wanted dead I still cried at their deaths because they were just so sad.
Now I can’t bring myself to cry or even laugh. I went to see my favourite comedian live and I’m barely laughing. I enjoyed the show but couldn’t laugh.
But here’s my major problem that I obsess about. I’m so apathetic toward things now. My grandmother went to the hospital for her low blood pressure and she felt really ill and just today my younger brother went to the hospital because he drank too much the night before. Everyone is freaking out BUT me. I’m not worried or sad.
I wonder why I’m like this. I obsess about it. I google to see if there are other people like that that aren’t sociopaths and such. Its like I joke about things like this because I don’t know how to react to it.
It’s like all I care about is me.
I’m calm about this yet I think about it constantly.
Your concern about being a sociopath sounds like Harm OCD to me. Keep in mind that sociopaths are highly unlikely to spend their time worrying about whether they are sociopaths, Googling things in an effort to figure out if they are sociopaths, or obsessing about why they aren’t having specific emotions that they think they “should” be having (all of which you report doing). Not freaking out may indicate something, but I doubt it indicates you are a sociopath.
As for liking horror films and such, if that is a sign of sociopathy, then we are deep trouble, because lots of people love those kinds of films. Just because you didn’t like them before but like them now doesn’t mean anything important – it just means your tastes have changed.
Hey I have been suffereng from severe ocd for the last couple years. I rarely leave the house and when I do I constantly check everywhere I was to make sure I didn’t do anything wrong. And when I do decide to try and go out, I start to feel really weird and lightheaded. And I begin to just feel off. Then that causes me to not remember everything. I feel like I have to remember every second of my day to be confident everything is okay. Could you please shed some light on this? Thanks.
Thanks for your comments.
The key to your question is when you say you want to “make sure I didn’t do anything wrong” and that “I feel like I have to remember every second of my day to be confident everything is okay”. Your checking and your attempts at remembering everything about both compulsive efforts to ensure that you haven’t inadvertently caused harm. But these compulsions never work for very long (if at all), and in the long run, they actually make your OCD worse.
If you want to effectively manage your OCD, you will ultimately need to abandon your compulsive efforts to ensure that things are OK and that you haven’t done something wrong or bad or harmful. You may also want to look at one of our articles that focuses on a mental compulsion called “memory hoarding“, which may have some resonance for your situation. You can read that article here.
Hi can ocd cause bizarre schizophrenic like thoughts? for example having a thought that my animal was chipped and was watching me. I know this is not true and irrational but cant seem to get over the fact that I have thoughts like this I know the symptoms of schizophrenia so maybe that’s why I have these thoughts
If having a thought that your animal is watching you is a sign of Schizophrenia, I am in big trouble, because I have had far weirder thoughts than that. Further, I am not sure what is so odd about an animal actually watching you? I suspect that animals watch people quite frequently. Perhaps I am misunderstanding you – when you say you had a thought that your animal was “chipped”, I think you mean that you had a thought that your dog was high. But again, I am not sure what is odd about your dog watching you, whether he was high or not.
By chipped I mean like microchip
Thank you for the clarification about the definition of “chipped”. That said, I stand by my earlier comments. The thought that your animal has a chip and is watching you is an odd thought, but people have lots of odd thoughts, and odd thoughts don’t necessarily mean you have Schizophrenia.
I would just like to add that I don’t believe in that thought but its like I’m always in doubt my brain always try’s to make me think the opposite of what I Really belief, I want to thank you for all of your responses this is the best website I’ve found
Thanks for your kind words.
Keep in mind that doubt is at the very core of OCD. Your experience of your brain trying to make you think the opposite of what you really believe is extraordinarily common in OCD, especially in the more “obsessional” subtypes such as Harm OCD and HOCD.
I have anxiety & OCD….about six years ago I started getting intrusive emotions/thoughts. On like three or four occasions, I would be telling a joke to a group of friends and when everyone would laugh, I would get like a feeling that one of the kids in the group (one of my best friends) didn’t have the right to laugh at my joke. It felt totally evil and not something I could relate to. It was totally irrational and bothered me that the thought/feeling came into my mind…I think I gave it too much room and dwelt on it, instead of letting it past. I’m still obsessing over this five years later (thank you OCD!)…is this just an offshoot of anxiety or is something else going on here? I think my subconscious was trying to blame the anxiety on him or something (even though it was no ones fault).
I had really really bad anxiety at the time when these intrusive emotions/thoughts were the worst. Can anyone relate? Of course my mind tries to twist this event into proof that I have X illness, etc…
Other OCD themes present at the moment is the fear of schizophrenia, harm-ocd, sexual-ocd, and hypochondria.
This sounds like OCD to me. And the fact that you have had numerous other manifestations of OCD supports that this is just one more way OCD likes to get in your head. The bottom line is that OCD can (and often does) latch onto just about anything.
I love your metaphor of giving the OCD “too much room”, and I think you are right on target. Five years spent obsessing about a friend’s laugh is five years too many, and I encourage you to seek out treatment with a therapist who specializes in treating OCD with Cognitive Behavioral Therapy (CBT).
Hi, I have been suffering with harm OCD for about 2 years now. It recently has gotten so bad that I don’t know how to cope. It seems like 50% of what I think about is horrible things I could do to people/animals/myself and it’s gotten to the point that I can’t even tell if it makes me feel bad anymore. I feel as if I am wore worried about how doing something like brutally murdering a child or torturing an animal would make ME feel as opposed to how much pain it would cause them. I’m starting to wonder that if I were to do something horrible in the minds of others to another living being if I would even experience any sort of empathy. Sometimes my anxiety gets so bad that I can actually feel as if I am about to harm someone; or I might find a knife and attempt to cause myself harm. I have never hurt anyone or myself in any serious (or even moderate) capacity but I feel as if it will happen eventually due to the persistence of these thoughts. I see animals and children and immediately think of terrible things, a feeling that has all but replaced all positive emotions I used to feel for those groups of beings. I’m scared that I just don’t care anymore, and have lost all true empathy.
Thanks for your comment.
It is extremely common for those with Harm OCD to be concerned that they lack empathy or that they are a sociopath who would not care about harming others. This is just one more obsession that is part of Harm OCD. But if these thoughts didn’t bother you, then you probably wouldn’t be posting a comment on this blog noting how concerned you are about not caring. In other words, writing here that you are concerned that you don’t care is evidence that you do care.
Also, there is not a shred of evidence to support your thesis that, due to the persistence of your unwanted harm thoughts, you are likely to eventually act out on them. As you note, you have never consciously hurt anyone, and have never acted on these thoughts. So the historical evidence strongly suggests you will not act on the thoughts.
There is no reason to continue suffering with these thoughts. I strongly encourage you to seek treatment with a therapist who specializes in Cognitive Behavioral Therapy (CBT) for OCD.
I have harm OCD and I am suffering from it.
My worry is that ”If I may have killed someone and forgotten about it” Is there a possibility to forget this kind of horrible thing?
Second worry is that ” If I may have killed someone to do myself harm like going to jail?”
Can a big fear cause to adverse effect on the brain like do the unwanted thing?
Thanks in advance.
I find it hard to believe that you or anyone would simply forget that they killed someone. Murder is not like misplacing your keys.
I encourage you to accept that your brain likes to come up with preposterous ideas like “what if I somehow forgot that I killed someone”, and to not take these thoughts seriously.
Thank you very much for your kind response 🙂
Glad to help.
6 months ago I developed a harm ocd towards the people I love the most. I was afraid that I had gone crazy and become sociopath… but then I found your article and all my symptoms inside it.
I tried your advice to stop suppressing the thoughts and allow them to exist inside my mind but start treating them as any other not important thought – a garbage And it actually worked. Anxiety was gone, but then ocd and anxiety found another way to harass me – thoughts simply mutated to something new even more upsetting – for example: “what if I become really crazy or paranoid (after I was listening some people talking about paranoia) and hurt people that I love the most because I’m gonna start thinking that they wanna do the same to me..” And anxiety came back although I am so much aware how stupid and irrational that all is. I guess now paranoid thoughts make me think I will become paranoid person.
So now I’m trying to treat those thoughts in the same way.
So I guess when I deal with one kind of OCD another worse will replace the first one?
I am happy to hear that you noticed an almost immediate reduction in anxiety when you stopped trying to suppress your unwanted thoughts, and instead accepted them as unimportant. That said, I am also not even remotely surprised that other thoughts popped up. After all you have OCD, and it is extremely common for OCD symptoms to mutate as one learns to how to more effectively respond to specific unwanted thoughts. That said, there is not a whole lot of difference between “what if I want to hurt the people I love most” and “what if I become really crazy or paranoid and hurt people that I love the most”. And yes, you can assume that other unwanted thoughts may sometimes appear.
The goal is to respond to all unwanted thoughts by accepting their presence, but without assuming they are important or meaningful. They are, after all, merely thoughts. I can assure you that everybody has unwanted thoughts. The only issue is how you respond to them.
Is it normal to feel like you’re missing something when you do stop fearing the OCD. I’ve been dealing with intrusive thoughts of a sexual nature for a little over a year now, and I went through CBT and it made a huge difference, and I met a guy and everything was good and I was happy. But as soon as he left the thoughts came back in full force and I ended up in the same place I was when the thoughts had first started, and yesterday I decided to stop fearing them and just let them be. Today the thoughts still occurred but I did not react to them, and now I feel like a) maybe these thoughts were always true but I know they are not so that can’t be it and b) I feel like something is missing and I need to be thinking about something. Now that I have stopped fearing the thoughts I feel like they are actually true, but I know they aren’t and because I feel nothing when I think of these thoughts I feel numb and just weird. Is this normal or whats happening with me now?
Everything you write sounds like you are experiencing a “back door spike”, a common phenomenon in OCD which is most easily described as being anxious about no longer being anxious. You can learn more about this aspect of OCD in this article about unwanted gay thoughts.
Hello, this is short history of my OCD:
– When I was young I counted the stairs, and afraid if I stop thinking about my breathing I’m gonna stop breathing. Those thoughts disappeared after some time.
-About 20 years I didn’t have any OCD thoughts.
-A while ago OCD hit me back in the worst form -harm OCD.
Fear of hurting my boyfriend who is someone I love the most in my life. I got bad anxiety feelings in my stomach – lost of appetite -lost 10 pounds in few days.
-Then I found texts about CBT and started practicing it -telling myself “it’s just a thought, nothing more”…
-Anxiety was gone!
But then I got a new problem – if I don’t afraid anymore what will stop me to do those bad things?
Then it came to my mind what if instead to accept that it’s normal to have bad thoughts I start thinking that bad thoughts itself are not actually bad and that is ok to hurt people?!
And after each “What if” that “what if” disappears and I just start having thoughts about doing it.
It’s like I’m fighting now with my OCD -OCD thoughts are telling me it’s ok to hurt, and I’m answering NO it isn’t! Confused because there’s no more anxiety.
I feel like running away to make sure that I can’t hurt anyone!
A few thoughts…
Everybody thinks their particular variation of OCD is the worst kind.
Your supposedly “new” thoughts about harming your boyfriend are nothing more than a slight variation on your previous thoughts. The bottom line is that you are still obsessing about harm, so there is not really any significant difference.
When you analyze the difference between old and new thoughts, you are doing a compulsion. A better approach is to accept that your OCD brain will continue to come up with thoughts that make you anxious, and to accept the thoughts without analyzing them in any way.
What stops you from actually harming people is your conscience. Your comments here clearly indicate that you have no real interest in harming people.
The key is to accept the presence of unwanted thoughts without doing compulsions (including mental compulsions like analyzing the thoughts).
Hello. Sorry for bad English, it’s not my native language. I’ve been suffering from harm OCD for years. And I managed to deal with it well through CBT.
But two days ago something extremely disturbing happened to me.
In the restaurant while my boyfriend and I had a dinner some irrational though came to my mind – what if this world isn’t real and if everything is my imagination. Or, what if my boyfriend is not real as well and I am actually sitting here alone like those crazy people from the movies and talking to myself. I am aware how ridiculous those thoughts are and how stupid they are because how would waitress talk to my boyfriend if he is only my imagination and million other stuff, but then brain tricks me with the question – what if you are imagining her talking to him as well.
These thoughts are so persistent and upsetting for some reason that I don’t know how to deal with them. it’s hard to accept these thoughts just as thoughts because they are somehow different – they are questioning everything – even the existence itself. Like OCD and anxiety finally found a winning combination to destroy me completely. I’m afraid that now I’m really sinking into craziness.
You are not crazy. In fact, these types thoughts are fairly common, and suggest you are experiencing a subtype of OCD sometimes described as Existential OCD. The treatment for this variant of OCD is the same as for Harm OCD – Cognitive Behavioral Therapy (CBT) with an emphasis on Exposure and Response Prevention (ERP). Additionally, we have found that mindfulness is quite helpful with Existential OCD.
You say these thoughts are hard to accept because they are somehow different. They may feel more important, but that doesn’t mean that they actually are more important. I would argue that these thoughts are just like any other weird thoughts that pop into the minds of humans. Strange and unexpected perhaps, but not particularly meaningful or important.
If you continue to struggle with accepting these thoughts, I encourage you to seek out treatment with a therapist who specializes in treating OCD.
Thank you so much for your answer.
It means a lot.
The thing is that I’m already going to a therapy because of previous harm OCD, but now it is paused for holidays and I am not so sure when will be possible to continue.
Also that initial idea “what if this world isn’t real” actually dissapeared and remained only the question “what if my boyfriend is not real and what if he is product of my imagination as a crazy person”.
And that though is extremely disturbing to me beacuse he is my life my biggest love.
I even started feeling weird talking to him in public places fearing what if I’m talking to myself.
Even previous harm OCD targeted him.
Although I know how ridiculous all this is. So irrational but yet so persistent and strong.
Constant doubts in everything.
Simply can’t stop thinking and analyzing.
I know you always say just accept the thought and don’t analize it – but that is the same like when you say don’t think about something, and then you think about it even more – it is somehow the same with analyzing – it sems like brain analyzing it when it knows it shouldn’t.
It’s very hard.
And no exact techniques and tricks how to do it….
You say you can’t stop thinking and analyzing, which is half right. It’s true that you can’t stop thinking (nobody can), but the analysis part is voluntary. Your goal us to truly accept doubt. If you accept it, there will be need to analyze it, because the goal of your analysis is to figure out if the the thought is “true” or “accurate”. By accepting doubt, you no longer need an answer to that impossible-to-answer question.
If you are unable to manage the acceptance of doubt, I encourage to seek treatment with a therapist specializing in Mindfulness Based CBT.
For some of us it is very hard to find a proper therapist – sometimes because of physical reasons (being relocated from Europe to some very small Caribbean island – like in my case). But that doesn’t mean that we don’t desperately need help or at least some advice.
I would really love to know so much how to truly accept doubts? Is there any technique to do that? I tried many times and still can’t.
I certainly understand that some people live in areas that have few local resources for the treatment of Harm OCD. I encourage you to pursue online therapy, which research has found to be every bit as effective as traditional face-to-face treatment.
I really need help, I have this and I’m to the point where I would rather kill myself. I never really hear stories of people getting better, all hear is to accept it and I”m sorry I’m not going to accept living with this for the rest of my life.
Part of the problem may be your definition of “getting better”. If you want some sort of magical “cure” whereby you never again have unwanted thoughts, you are out of luck. Simply put, everybody has unwanted thoughts, including all the people in the world who don’t have OCD. There is no “cure” for unwanted thoughts, but you don’t need a cure – you just need to learn how to more effectively respond to these thoughts.
Neither I no anyone else is suggesting that you accept being miserable, but rather that resistance to reality is not the answer, and that acceptance of reality (including the existence of unwanted thoughts) is. People with OCD get better quite frequently, but it is unlikely that your OCD will get better without taking active steps in response to it. I strongly encourage you to seek treatment with a therapist who specializes Cognitive Behavioral Therapy (CBT) for OCD, as that is your best option for learning how to better respond to these thoughts.
Finally, allow me to note that if you genuinely feel like killing yourself, you should take yourself to your local emergency room immediately.
I am a 26 year old woman, great life, great family/friends, and brought to my knees by what I believe in my gut is OCD. My obsessions stretch back to 11 years old and include: fear of getting schizophrenia, Type 2 Diabetes, or becoming a psychopath; fear of hurting my loved ones; and most recently, fear of killing myself. This obsession of ending my life has persisted for over a month now and I cried and has several anxiety attacks through my vacation this past week. I typically google the crap out of my obsessions – as I have done with this one.
I’m worried because my thoughts of “I could just jump off this balcony” or “I could drink that rubbing alcohol right now” have progressed to “You’ve already lived a great life – ending it would be beneficial for the planet.” I can’t overstate the level of distress this causes me, and unfortunately, that level of distress makes the remainder of my life feel unbearably long. I can’t take this much longer and need some help. My mind can’t help but argue with these scary thoughts but this arguing creates mental fatigue. Mindfulness meditation only amplifies the intensity of the panic. I need help soon. Any advice? Thank you!
All of the fears you mention are quite common in OCD, especially in Harm OCD. Likewise, all of the obsessive thoughts you mention are quite common. You could jump off the balcony right now – and so could anyone. For all I know, I will jump off the balcony tonight.
The problem is that you are assuming that having a thought is somehow indicative that you are planning to act on that thought, or that somehow the thought means something important. The existence of these thoughts doesn’t mean you will act on them – it simply means that you have had some unwanted thoughts. Thoughts are not the same as intent or action. They are just thoughts.
You say you need help and you want advice, so here it is – stop trying to out-think your OCD, and get yourself to a therapist who specializes in treating OCD with Cognitive Behavioral Therapy (CBT).
When I have harm thoughts I begin to get triggered and fearful and feel like “what if I’m a killer”, “suffocate my wife”, “what if im psycho”, and “am i crazy”.
all these thoughts do is weaken me and scare me. i panic and tell my wife my problems with the struggle and when i have them thoughts best thing that takes them is when i am hugged by my spouse my anxiety goes away. When i get these thoughts i then think of consequences and then i say “maybe i belong in jail” then i panic more. These thoughts feel unwated and i wish i can learn to get rid of them. They come then go away and when they come back they come stronger sometimes i ask “if i kill myself will i be at ease. I never attempted suicide but thought of it when i was young but i was fearful and scared.
The key for you rests in one sentence that you wrote:
“These thoughts feel unwated and i wish i can learn to get rid of them.”
Trying to get rid of thoughts will never succeed – your brain will come up with whatever it wants. A better solution is to accept thatchy exist. That doesn’t mean accepting that they are true or accurate – juts accepting that they exist, and then not taking them seriously. They are just thoughts, and your goal should be to accept their presence like any other unwanted experience, without reacting to them. to help you with this, I encourage you to read our article “Harm OCD Treatment: Mindfulness Based CBT“.
Hi, I have OCD for like ever and right now for almost five years I have had harm OCD or at least I hope. In the beginning it was the scariest thing and I was so unable to function, but now I have almost no anxiety.. Very rarely. If I do Google things about evil people I do get very nervous. I’ve resisted these thoughts since the beginning and always repeated to replace a bad thought with a good thought. Now I just undo things to act like they didn’t happen- that helps my anxiety now so my compulsions changed. But, I worry that maybe it’s not OCD and a result of depression because before I had this subtype of OCD I had depression and I worry if maybe I’m just angry or something. It almost feels like I’m starting not to care but I feel like I’m going to snap at any moment and that irritates me so much .. UGH please let me know if this is normal? Plus, I feel like I don’t feel guilty that often and that bothers me. Of course, I hate the feeling of guilt but I would like to feel more of it to reassure I’m a good person
OCD and depression commonly co-exist in people. There is no reason to attempt to ascertain whether your OCD comes from depression. Besides, you have had OCD since before you had depression, and it is quite common for OCD to morph into new sub-types.
Likewise, the fear that one does not feel anxious or upset or guilty enough is a common fear in those with OCD, especially those with the more “Pure Obsessional” types of OCD such as Harm OCD.
You are doing many compulsions which are guaranteed to backfire, specifically:
~ Googling things about evil people.
~ Resisting the thoughts.
~ Repeating to replace a bad thought with a good thought.
All of these things will only make your OCD worse. I encourage you to seek treatent with a treatment provider who specializes in OCD treatment.
Hello there, I have what I hope is Harm OCD that seems to express itself in one major way that worries me. When I get annoyed with someone for a second I get terrified that I want to hurt or kill them. It is hard to tell the difference between if it is genuine or not but I have not acted on it at all and I have never been a violent person until this bout with harm OCD that started like 6 months ago. Now it seems like I get annoyed with people for very small reasons all the time and I am very worried that I am going to get so annoyed that I will snap and hurt people. Does this sound like Harm OCD? I am just worried that this is something else.
Everything you write sounds like textbook Harm OCD. These types of thoughts are not particularly unusual. I would hazard to guess that most people experience thoughts about harming someone during the course of their life. After all, we all experience negative events that are annoying or frustrating or just downright horrible.
You have six months experience of having these thoughts without hurting anyone. That seems to be pretty good evidence that you are unlikely to suddenly “snap” and become a killer.
I am 41 year old mother of 5. I had my 5th baby two and half years ago ( the other babies are all grown up). i am so afraid to be left alone with my girl. i am so afraid that the thoughts are going to make me do something that i don’t want to do. i will not be left alone with her. i have tried and the thoughts get really bad when i am alone. I can’t seem to find any help in this city, i don’t understand what i need to do to fix this Harm ocd or at least thats what i think it is. it started out of the blue when i was 6 months pregnant with her. i have never hurt a fly in my life and know i live in fear. please help me makes sense of what my mind is doing to me…
It is quite common for people with Harm OCD to experience unwanted thoughts about hurting people they love. That is what makes Harm OCD so horrifying to people suffering with this condition – that these thoughts are often focused on the very people that mean the most to them.
It is also worth noting that, for many women with Harm OCD, symptoms either start or increase during pregnancy, or shortly after giving birth. I encourage you to read the Perinatal / Postpartum OCD page of our website at https://ocdla.com/postpartum-ocd/
I suggest that you seek treatment with a therapist who specializes in treating OCD with Cognitive Behavioral Therapy (CBT), as this approach has consistently been found by researchers to be the most effective treatment for all variants of OCD.
Hi I have recurrent thoughts that X-rays my son had as a child will give him cancer. They cause great distress because I believe they are true.
What you describe sure sounds like Harm OCD. People often think that Harm OCD only includes obsessions of purposely and violently causing harm, but that is not true. Harm OCD can include obsessions of involuntarily causing harm as well, and your situation sounds like a perfect example of this.
Hi, I;m 19 years old and this article helped me a lot, I have struggled with OCD my whole life, I was diagnosed about 4 years ago with OCD, GAD, and depression and was prescribed Prozac. Unfortunately, I stopped taking it 3 times because I thought I was okay, but this time my OCD has come back stronger than ever, I have worried about harming people before but it feels worse this time. Currently, my main obsession is I’m worried that I stabbed someone, the thought is so specific and real its like I want someone to check for me and make sure no one was harmed. I spend every minute of the day replaying my actions from the day when I think I stabbed someone. I have made lists, but I think because I have thought the same thought so many times replaying my actions doesn’t really help to calm my anxiety anymore. I went back to my psychiatrist about a week ago and he put me back on Prozac, so I hope it still works, because I can’t live like this, where I feel sick to my stomach everyday, it prevents me from even “going through the motions.” Somedays I feel really hopeless because I live in constant fear. I just want to be happy and normal again.
A few thoughts…
1) Mentally replying your actions sounds like reassurance seeking. This will ALWAYS backfire.
2) Ditto for making lists.
3) While meds may be helpful, virtually all OCD experts agree that the key to effective treatment for OCD is a type of Cognitive Behavioral Therapy (CBT) called Exposure and Response Prevention (ERP).
4) If you had actually stabbed someone, you would likely remember doing so with great clarity. In other words, you wouldn’t be full of doubt about whether you stabbed someone. The issue here is not stabbing, but OCD.
Hi my name is joe I never really knew what OCD was I never knew what harm OCD was. I overcame it when I was a freshman in HS but now I’m in college and it’s hit me hard and idk why. I first had it with knives I overcame that and now it’s with guns. I’m scared because all I have to do is pull a trigger and I could end my life or my loved ones and it terrifies me. I think about killing my family a lot now because of it and I swear it makes me sick I’m such a nice person and I love everyone and I would never do that to anyone. My dad keeps a loaded pistol in his closet and because I know this it gives me OCD so bad I know that all I have to do is go in there turn it off safety and shoot everyone I love and that I could do that if I wanted like if he kept it in a case with with a lock I would feel so much better but it hurts I feel like I think about it so much that I’m actually about to do it like there’s something in me just saying hey do it right now just do it and it hurts especially at night when there’s no one awake. Idk what to tell myself in my head to over come this I feel if I just let the thoughts come I’m actually going to do it.
Thinking about things does not automatically lead to doing those things. We all have lots of thoughts that don’t lead to specific actions.
People with Harm OCD are extremely unlikely to act on their thoughts. In my 20+ years of specializing in the treatment of OCD, I have treated well over 100 people with Harm OCD, and not one of them has ever acted on their obsessions. In fact, they are horrified by their thoughts. This horror is at the very core of Harm OCD.
You note that you all you would need to do to kill your entire family would be to go and get the gun and kill them. Well, that is true for lots of people – anyone who lives in a house where there is a loaded gun could do this. And anyone who lives in a house with sharp knives could also murder their entire family. And oh yeah, anyone who lives in a house with pillows could suffocate their whole family. And one more thing, anyone who lives in a house with rope or electrical cords could strangle everyone in their family. In other words, having the implements needed to kill is not enough, and having the thought present in your mind is not enough. To purposely kill people, you would need to have the intent, and it is clear that you do not have the intent to kill anyone. In fact you are horrified by the very thought of it.
I encourage you to seek treatment with a therapist who specializes in treating Harm OCD.
Thank you for responding that helps a lot. It’s just sometimes when I think of going in there and grabbing the gun it doesn’t phase me and then other times it really bothers me. I’ve read and I’ve tried doing the things it says in the article but I get confused on what I should actually do or tell myself when I get these thoughts. It’s like I don’t have these thoughts outside my house even if I’m in a house where I know there’s a gun. It’s only when I walk into my house that I get these thoughts. I made myself like this because I told myself what if next time you come home from college and you have those same feelings and that stuck with me so next I came home I remembered that and I couldn’t shake the thoughts like I usually can and now it’s like that every time I come home I rememeber what I told myself and the thoughts of killing my family is back in my head. Most likely I will go seek help from someone, but I’ve overcome this before and that’s why I’m trying to do but every time I walk into my house I get drilled by those thoughts
You can’t “shake the thoughts” because you have OCD. As noted in my reply to your prior comment, I strongly encourage you to seek treatment with a therapist who specializes in treating OCD. Trying to manage this on your own is unlikely to provide you with relief.