Summary
Intrusive thoughts of harming oneself or others can be distressing and lead to questions of your own morals and values, but it's important to remember that these thoughts don't define you. Understanding and distancing yourself from your thoughts and seeking treatment can help you take your life back from OCD.
Obsessive compulsive disorder (OCD) presents unique challenges, particularly when you find yourself grappling with intrusive thoughts of impulsively harming yourself and others. These thoughts can be deeply unsettling and may lead you to question your sense of self and mortal integrity.
Despite the private nature of this struggle, know that you’re not alone. A substantial portion of those with OCD contend with similar concerns. In fact, research highlights that obsessive thoughts about harm are reported by many individuals diagnosed with the disorder—in fact nearly a quarter, according to one nationally representative study (Ruscio, Stein, Chiu & Kessler, 2010).
At our anxiety and OCD center in Philadelphia, we understand the heavy burden these thoughts can carry—the profound sense of shame, the fear of being misperceived or judged. In our work with adults and children with OCD, we’ve seen that it’s not uncommon for individuals to internalize these experiences, questioning their core values and worth.
In this post, we want to share a little bit about this subtype of OCD and the meaning behind these intrusive thoughts, equip you with practical strategies to manage them, and introduce evidence-based treatment options for OCD available to you.
Demystifying Harm-Related OCD
Prevalent but misunderstood OCD subtype
While popular discussions often paint OCD as an obsession with cleanliness and order, the reality is more complex, as explained in our recent post about common OCD stereotypes and misconceptions. Harm-related intrusive thoughts and behaviors represent a prevalent and deeply misunderstood subtype of OCD. These thoughts can include distressing ideas or mental images of violence, aggression, sexual violence, and other taboo subjects. In our clinical work, we’ve guided many through the process of understanding and managing these intrusive thoughts that starkly contrast with their inherent values.
These thoughts may center around the people you cherish most—family members, partners, friends, yourself, or even pets—which can make the thoughts even more distressing. Many of the patients we have worked with also fear they might harm people who are weaker than them, such as children or older adults.
Moreover, some individuals worry about inadvertently causing harm through negligence, such as forgetting to check appliances, locks, or stoves. These fears, while different in nature, are equally rooted in OCD’s characteristic blend of doubt and hyper-responsibility.
Common responses to intrusive thoughts of harm
The response to these fears among people we’ve worked at with at our anxiety and OCD center can vary significantly. Some may avoid triggers (whether sharp objects, high places, driving, feeling anger, or being alone with the people they fear harming), follow certain routines, engage in excessive safety checks, or seek reassurance to cope with their fears. Others perform mental rituals—like reciting mantras or prayers or mentally reviewing their actions and intentions—to mitigate anxiety and ensure they’re not responsible for committing harm.
Initially intended as protective measures that seem responsible, these responses can evolve into compulsions, consuming time and eroding quality of life.
Real Life Stories of Harm-Related OCD
To give you a clearer picture of what harm related OCD may look like, consider the experiences of Bill and Anne.
Bill’s protective paternal fear
For Bill, a resident of Fairmont, fatherhood brought an unexpected twist in battle with OCD. His son’s arrival should have been all joy, yet it was overshadowed by a barrage of intrusive thoughts that he might harm his son, which seemed to ambush him when he was most vulnerable, like when he was alone with his son or in the quiet of the bathroom. Bill felt tormented, not understanding the origin of these fears, feeling immense guilt as if he were failing as a parent for even harboring such thoughts. Despite his profound love for his son, he felt himself hesitant to hold his child and felt compelled to affirm his love in his mind, “I really love this baby,” a mantra against the relentless tide of OCD.
Anne’s self-harm concerns
Anne’s relocation to Rittenhouse Square brought the promise of new beginnings and the simple joys of culinary exploration. But as she stood in her cooking class, the knives weren’t just tools for dicing vegetables—they became triggers for violent thoughts that clashed with the happiness of her new life. Anne’s rational self knew she had no desire for self-harm, yet the intensity and confusion nature of her intrusive thoughts drove her to an endless search for answers online, leaving her even more confused and entangled in her fears.
Understanding Self-Judgment in OCD
You might empathize with Bill or think, “Anne wouldn’t actually do that,” yet find you’re much harder on yourself. It’s a common pattern in OCD to judge our own thoughts more critically. Reflect on this: your intrusive thoughts, much like Bill’s or Anne’s, are not indictments of your character. They’re symptoms of OCD, calling for compassion towards yourself, just as you would show to others.
Addressing Your Concerns About Violent or Aggressive Intrusive Thoughts
Do violent or aggressive thoughts disturb you? Do they seem utterly out of line with who you are and the life you envision? It’s common to feel troubled by such thoughts, especially if you worry they might reflect your true nature.
Many of the people we see at our anxiety and OCD Center share this concern, fearing that these persistent, unwanted thoughts could mean they’re dangerous or that they’re fundamentally flawed and immoral. It’s vital to understand that these intrusive thoughts are a symptom of OCD and not a true reflection of your character or moral compass.
Here’s a closer look at why these thoughts aren’t the markers of your true self but rather, misleading echoes of anxiety:
- Commonality: Intrusive thoughts are much more common than you might think. Many people have fleeting thoughts of harm, although typically less frequently and with less intensity than people with OCD do.
- Incongruent intent: Intrusive thoughts of harm do not reflect a wish but instead represent fears—fears that are distressing precisely because they’re so so contrary to who you are.
- Control and Future Actions: Persistent thoughts don’t signal that you’re losing control or will in the future. They’re unwelcome intrusions, not forewarnings.
- Non-dangerousness: Despite the alarming content, frequent intrusive thoughts don’t signal a wish or a likelihood of acting dangerously, but instead represent fears—fears that are distressing precisely because they’re so so contrary to who you are. In reality, individuals with harm-related OCD very rarely harm others. And suicidal attempts, when they occur, are almost always a deliberate means to escape severe distress, rather than impulsive, uncontrolled actions (Palombini et al., 2020).
- Relevance to Self: Intrusive thoughts don’t define your true self. They are often the exact opposite of who you are and who you strive to be. Whether they manifest as fears of becoming someone you don’t want to be (Aardema et al, 2018) or as doubts about how well you’re doing at being the kind of person you’d like to be, like being a good person, partner, or parent (Doron et al., 2012), they reflect insecurity rather than reality.
Remember, intrusive thoughts are not a reflection of your desires and intentions or a forecast of your future actions. Instead, they reflect your fears, concerns, and insecurities. Being able to separate yourself, and your values and morals from your intrusive OCD thoughts is important and may begin to alleviate self-blame and stigma, and help you to seek support and treatment.
Six Ways to Distance Yourself from Your OCD Thoughts
The strategies outlined below are derived from evidence-based treatments for OCD, including Exposure and Response Prevention, Cognitive Behavioral Therapy tailored to OCD, and Acceptance and Commitment Therapy, offering practical steps toward managing intrusive thoughts.
- Label intrusive OCD thoughts: Recognize that intrusive OCD thoughts differ from your usual thought patterns. They may appear similar but are more intense and revolve around distressing themes like harm. Labeling a thought as an “intrusion” or ‘OCD’ and as a representation of something you fear can help you recognize that these thoughts don’t say anything about your character or intentions.
- Cease neutralizing rituals and compulsions: It’s natural to want to counteract unsettling thoughts with certain rituals, but we know that these actually perpetuate the cycle of fear and keep you caught up with the distressing thoughts. Working to gradually stop behaviors like precautionary actions, checking behaviors, avoidance, reassurance seeking, and mental actions can be challenging but is a proven step towards long-term wellness.
- Face feared triggers through exposure: Confronting the feared triggers, situations, and emotions directly can be a powerful method to reduce the power intrusive thoughts have over you. This form of exposure therapy involves gradually, and with professional guidance, facing the thoughts, situations, and objects you might be avoiding due to fear. It’s a practice grounded in the principle that avoiding fears can increase them, while facing them can diminish their control over your life. OCD and anxiety specialists are trained to support you through this process, ensuring it’s done safely and effectively, making it an essential component of managing OCD.
- Embrace Your Values: Reminding yourself of what truly matters to you can act as an anchor, helping differentiate between intrusive thoughts and your genuine self. Documenting your values can be a simple yet powerful tool in this process.
- Recognize misinterpretations: As mentioned earlier, having scary thoughts about harming yourself or others doesn’t mean you’re ‘crazy,’ losing control, or are a bad person. Believing these things can make you more tangled in those thoughts and feelings. The key is not to fight the ‘what if’ thoughts but to learn not to get absorbed by them. Cognitive behavioral treatments with OCD specialists can help you learn to view these thoughts as mere fears or doubts, not realities, helping you detach from them more easily.
Engage in Cognitive Defusion: Defusion strategies involve looking at your thoughts rather than from your thoughts. You can separate yourself from your OCD thoughts by recognizing them as mental events, rather than the truth. Imagine your thoughts as leaves floating down a stream. Instead grabbing the leaf out of the water to hold onto it or trying to speed up the stream to make the leaf go away, observe it traveling down the stream.
Remember, recognizing your harm related intrusive thoughts as simply thoughts, rather than as a reflection of your moral integrity or intentions, is a cornerstone of recovery and of OCD therapy and treatment.
Find more information about these and other strategies under our OCD and anxiety resources page for further guidance.
We recognize that taking these steps on your own can often be difficult, particularly when thoughts feel so scary and shameful. If this is the case for you, know that support is available. Our dedicated specialists in OCD and anxiety are here to help you through this journey.
Effective Treatment for OCD About Harm
Understanding the struggles of living with harm-related OCD and knowing what these intrusive thoughts do and do not mean are an important first step. The good news is effective treatments for this form of OCD exist. Treatment can significantly reduce the intensity of the thoughts and fears and their hold over you, allowing you live a life in line with your values. Approaches like Exposure and Response Prevention, Cognitive Behavioral Therapy for OCD, and Inference Based Cognitive Behavioral Therapy, and Acceptance and Commitment Therapy with Exposures can be very effective for treating harm-related OCD.
Are you ready to take the next step toward healing? Reach out to us to learn more about starting your treatment journey.
Conclusion: You Aren’t Your Harm Related Intrusive Thoughts
Living with harm related OCD can feel like a direct shot at your morals and values, yet it’s crucial to realize that this condition doesn’t define you. You are so much more than the intrusive thoughts that visit your mind.
By learning to separate your identity from these thoughts, affirming what you hold dear, and seeking expert guidance, you can gain control over your life again.
By learning to distance yourself from your thoughts, distinguishing OCD fears from your values, and seeking treatment, you can gain control over your life – just as Bill, Anne, and many other adults and children with anxiety and OCD have done through working with our specialists.
Through treatment, Bill was able to fulfill all his responsibilities as a parent and enjoy time with his child. The thoughts still pop in sometime, but the intensity of them has been turned down and they cause him less distress. Anne began Exposure and Response Prevention (ERP for OCD) and has confronted her fears so that they no longer control her. In her last week of therapy, her exposure was to use a steak knife in her cooking class. She learned to manage her OCD and is able to continue pursuing her passion for cooking.
Join the Conversation and Expand Your Support Network
For more insights on OCD and to explore various therapy options, we invite you to connect with us and become a part of our social media community. Follow our updates on Facebook, Twitter, Instagram, and LinkedIn, and explore additional OCD resources in our other OCD blog posts.
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This blog was brought to you by Allie Bond MA and Daniel Chazin PhD ABPP
