OCD sufferers closing eyes with hands she has a Harm OCD attack

Harm OCD

A comprehensive guide to Harm OCD

Harm OCD is a specific type of Obsessive-Compulsive Disorder (OCD) where the sufferer has intrusive thoughts about harm coming either to themselves or other people. Harm OCD is one of the most common forms of the disorder along with Contamination OCD, Counting OCD and Checking OCD. This particular type of OCD can cause significant distress, since the sufferer will often perceive their intrusive thoughts as a real representation of something that might happen (or something that is happening) to themselves or the people around them.

People who have Harm OCD often describe it as having “the constant feeling of being on edge”. Some sufferers fear that they might at some point wish to deliberately kill someone, despite not having any previous tendencies towards violent behavior at all; or they might have unreasonable thoughts about potentially hurting themselves in the future, despite knowing they are not likely to do so.

Although Harm OCD is a subtype of OCD, there are various subtypes within Harm OCD itself, such as Postpartum OCD (also known as Postnatal OCD), Perinatal OCD and Hit and Run OCD.

First of all – there is nothing wrong with you

What you’re experiencing as someone with Harm OCD are thoughts that are not a true reflection of what is happening (or could happen) in real life; as real as these thoughts may seem, they are intrusive thoughts, which means you are not choosing to have them, therefore you are not in any way to blame for them.

OCD (which includes Harm OCD) is an anxiety disorder and all forms of anxiety are simply the brain’s natural response to what’s perceived as danger (regardless of whether that danger “really” exists or not), which goes off when one feels threatened, pressured, frightened or faced with a stressful situation.

Having Harm OCD does not make you a bad person

Despite what your Harm OCD might be telling you, having this form of OCD does not automatically make you a bad person or someone who genuinely wants to hurt anyone. It is important to remember this, as Harm OCD can make you feel like you are a “dangerous” individual, when in reality it is very likely that this is not even remotely the case.

Intrusive thoughts about harm might seem “real” to the sufferer, but they have nothing to do with one’s actual intentions or one’s character, because having intrusive thoughts is in no way a choice, therefore they cannot be used to judge anyone’s true nature.

What causes Harm OCD?

Harm OCD can be caused by several different factors (which are often combined) such as experiencing a traumatic event, having a family history of OCD or anxiety disorders, or being under a lot of stress.

Triggers for Harm OCD can vary from person to person and might include things like: seeing violence on the news or in films, being around knives or other (potential) weapons, seeing someone get hurt (e.g. a child), or experiencing a heightened level of anxiety or stress in general.

Examples of Harm OCD

  • Intrusive thoughts about harming animals
  • Recurring mental images of hurting your children (or someone else’s children)
  • Being worried about potentially committing a hit-and-run crime on a pedestrian (either accidentally or deliberately)
  • Fearing that you might at some point decide to become a serial killer (or other type of violent criminal)
  • A concern that you’ll go into a fit of rage and assault (or kill) someone you love
  • Fearing that you might poison a family member of friend
  • Worries about “losing it” and going on a violent rampage or running people over
  • Thinking you might have harmed someone in the past without realizing it at the time

How can Harm OCD be treated?

There are several ways in which Harm OCD can be successfully treated; the most common form of treatment is known as Cognitive Behavioral Therapy (CBT), which is a type of therapeutic intervention that has been proven to be effective for a number of different psychiatric disorders, including most forms of OCD. In one study, 75.8% of pediatric OCD patients were “much improved or very much improved” at the 3-month follow-up after an intensive set of CBT sessions.

The second-best option is probably ERP (exposure and response prevention) therapy, which helps significantly improve OCD symptoms in at least 50% of patients who complete the treatment.

Another option is a form of therapy known as Motivational Interviewing, which is also based on the principles of CBT and is designed to motivate and guide the patient to change. In one randomized/controlled trial, 71% of patients who completed the trial had their OCD symptoms go into remission (although the overall efficacy was really 52%, due to some patients dropping out of the trial before it could be finished).

Medication can also work, but it is considerably less likely to be effective in comparison to various forms of CBT; for example, in another clinical trial, the antidepressant sertraline (Zoloft) was used in OCD patients aged 7-17, and only 21.4% of them went into remission.

One form of psychotherapy that has limited evidence for it, yet has shown potential, is EMDR (Eye Movement Desensitization and Reprocessing). This form of therapy is primarily used for PTSD (Post-Traumatic Stress Disorder), yet can also be a promising treatment for treating OCD. One study proved that EMDR was more effective than the antidepressant Citalopram (Celexa) for decreasing symptoms of OCD.

What are some of the subcategories of Harm OCD?

How can Harm OCD affect someone’s life?

Harm OCD can have a significant impact on someone’s life; in clinical terms, for someone to have an OCD diagnosis, they must have time-consuming compulsions and obsessions that take up more than 1 hour of their time each day, are distressing and a hinderance to one’s work and/or social life.

A lot of people with this disorder may avoid social situations out of fear that they might act out their intrusive thoughts, or simply because they don’t want to deal with the anxiety that comes along with Harm OCD. Additionally, this disorder can lead to a great deal of guilt and shame, as the intrusive thoughts often feel very “morally wrong” or “evil” to the individual, making one think they’re responsible for these thoughts appearing in their head when that simply isn’t the case.

How can I help someone else who has Harm OCD?

You should be supportive and understanding, and let them know that you are there for them; however, it is important not to engage in enabling, reassuring or reinforcing their actual compulsions and OCD-related behaviors. It’s also important to guide them towards seeking professional help and evidence-based treatments, as these are the most demonstrably effective ways in which Harm OCD (as well as other forms of OCD) can be treated.

Have hope – Harm OCD can be (and very often is) overcome

Harm OCD is very treatable, and many people who receive evidence-based treatments see a significant decrease in their symptoms. Keep in mind to have hope for the future, be patient, and work towards getting the help that you need; remember – you are not alone! Make sure to also check out our forum where you can find more information and engage with other OCD-sufferers who are going through a similar experience! We even have a specific subcategory for Harm OCD!

Read more about Harm OCD – a few helpful resources

  • The International OCD Foundation’s (IOCDF) fact sheet on violent & sexual obsessions
  • Free eBook PDF on Harm OCD from the Light On Anxiety CBT Treatment Center (in Chicago, IL)
  • Free PDF resource on Perinatal OCD on the HSE’s (Ireland’s public healthcare system) website
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