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Understanding Harm OCD

How do you know if you really want to hurt people or if it's just harm OCD?

Source: Pexels

Are you anxious because you are having thoughts about hurting other people?

These thoughts are a lot more common than you think. While it can be confusing and scary to have thoughts like this, they don't mean you are a bad person. If you're anxious about this, you may have a form of obsessive-compulsive disorder (OCD) called "harm OCD." It is common and treatable.

If you have this fear, you are probably worried that it's not harm OCD and that there might really be something wrong with you. Let me explain how to tell the difference between harm OCD and an actual desire to hurt other people.

OCD can take many forms, and harm OCD is one of the more common ones. Harm OCD is characterized by:

  • Fear of thoughts that you will cause harm to others (either accidentally or purposely)
  • Excessive worry and mental analysis about these thoughts
  • Compulsive behaviors to avoid the risk of causing harm to others (e.g. avoiding knives, driving, being around kids)

Harm OCD sufferers have thoughts pop into their heads about various ways they could potentially hurt other people. They then feel very anxious and intensely guilty about the fact that they are having these thoughts. They also worry that the thoughts might mean they are actually capable of doing these things and could slip up and do something horrible at any moment.

The type of harm the person fears can be pretty much anything. Most commonly it is fear of physically harming others. For instance, it is common for people with harm OCD to have thoughts about stabbing someone with a knife, running people over with their car, or going on a shooting spree. For others, the thoughts are more sexually related and they worry about touching a child inappropriately or groping another person.

The thoughts are what we call "ego-dystonic," meaning they are unwanted and inconsistent with how the person views themselves. They worry that the thoughts mean that they are a terrible person who might actually want to do horrible things like killing people.

The distinguishing factor, however, between OCD thoughts of hurting other people and thoughts of hurting other people that we would actually be concerned about is the guilt and anxiety: people with OCD feel absolutely awful about the fact that they have these thoughts and are trying hard not to think about these things (which of course makes them think the thoughts more).

People who actually end up doing horrible things to people are not overwhelmed with anxiety when they have these thoughts. On the contrary, the thoughts are often pleasurable and they may purposely fantasize about hurting people.

This is good news because if you are struggling with thoughts like this and are reading this article, it means I can say this quite confidently:

The very fact that you are reading this article means you have harm OCD and proves you are not a murderer, child molester, rapist, or whatever you're afraid you are.

People who actually want to do those things aren't scared of the thoughts. They don't research the problem online and they don't look up articles about harm OCD. If you are worried about this, that in and of itself disqualifies you from being the monster you think you are.

It also makes you so inhibited around any risk of hurting another person that I can say with confidence that you are never going to do it. I can't tell you how many times I've had clients tell me that they are different and that their thoughts are so crazy and feel so real that they really might hurt somebody. And guess what: None of them ever have.

Source: Photo credit: Pexels

Keep in mind, however, that me telling you all this is not going to convince you. That's just not how OCD works. You might find this article reassures you for a moment, but your brain will come back and say to you:

  • "Sure, but how do you know?"
  • "Maybe you're different, maybe this stuff is true for most people but your thoughts mean you really do want to hurt people."
  • "It feels like you actually like the thoughts sometimes, so that means it's not just harm OCD, you really do want to hurt people."

OCD is nicknamed "the doubting disease" for a reason. It makes you question everything. You are not going to find the answer you want in any article online. Your mind will have what it thinks are valid reasons to poke holes in my logic here. And the truth is that I indeed can't tell you for certain that I'm right about you personally.

You are never going to convince your mind with 100% certainty that you are not a murderer-in-waiting. But that's okay, you don't have to.

Harm OCD is very treatable with Exposure and Response Prevention (ERP), the gold standard treatment for OCD. The thing to do is not to try to convince yourself that this is just harm OCD.

The thing to do is to stop treating these thoughts as if they are dangerous. Accept the thoughts, accept the uncertainty, and move on with your day in spite of it. There is nothing to figure out here about the thoughts or about yourself and you are never going to figure it out in a way that satisfies your mind. Leave it alone, let the thoughts happen, and move on with whatever else you're doing with your day.

That's the basic idea, and in my next post, I will go over more details about ERP for harm OCD and what to do if you have harm OCD.

To find a therapist, please visit the Psychology Today Therapy Directory.

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