What Is Harm OCD? Fear of Hurting Others
Reading Time: 6 minutesEven if you’re not a violent person, you’ve likely experienced violent thoughts. But knowing you’d never act on them, you quickly forgot about them and moved on. However, some people with obsessive-compulsive disorder (OCD) are plagued by thoughts of hurting others or themselves. This manifestation of the disorder is known as harm OCD.
To cope with harm OCD, people may engage in specific compulsions to ward off these distressing thoughts. The frequency of these thoughts and the rituals they use to cope with them can make day-to-day life unbearable. However, effective treatment reduces the distressing obsessions and compulsions associated with harm OCD.
Key Takeaways
- Harm OCD is a type of obsessive-compulsive disorder that causes an individual to fear hurting oneself or others.
- Some of the causes of harm OCD include genetics, brain chemistry, prior trauma, and perfectionism.
- Having harm OCD is not associated with committing violent acts—only with the fear of it.
- Evidence-based treatments can help reduce the negative effects of OCD symptoms on a person’s life.
What Is Harm OCD?
Harm OCD is a type of obsessive-compulsive disorder involving a fear of hurting others. Having violent thoughts is common: In fact, 85 percent of people admit to having thoughts of harming people. But people with harm OCD assign meaning to these thoughts. They genuinely fear they could lose control at any moment and commit violent acts against themselves or others.
Because they feel they can’t trust themselves, they engage in ritualistic compulsive behaviors to reduce the anxiety and shame their harm obsessions ignite. These physical and/or mental compulsions may ease their distress for a short time. But then the intrusive thoughts arise again, and the vicious cycle of fear and compulsions continues.
How Many People Have Harm OCD?
It’s unclear, in part because individuals are unlikely to disclose the disorder. While people can develop OCD subtypes at any age, OCD generally appears between the ages of 8 and 12, or in late adolescence/young adulthood. In fact, 19 is the average age when OCD symptoms appear.
Harm OCD Symptoms
Harm OCD symptoms fall into two categories: aggressive obsessions and compulsive behaviors.
Aggressive Obsessions
The first category of symptoms is aggressive obsessions. These center around obsessive and intrusive thoughts of causing harm. Harm OCD obsessions often manifest as “what if” thoughts, such as, What if I …
- Lose control and strangle my girlfriend?
- Push my mother off the balcony?
- Drive my car through the intersection and hit that pedestrian?
- Open the exit door on the airplane?
People with harm OCD also wonder if they should tell the police about their thoughts. And they may fear that something terrible is wrong with them—or that they are evil for thinking this way.
Harm obsessions can also manifest as disturbing images. People may visualize themselves acting violently toward others. Sufferers may also have physical sensations, like sweating or stomach cramps, while worrying about intentionally or even accidentally hurting someone.
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Compulsive Behaviors
The second category of harm OCD symptoms includes repetitive mental or physical behaviors. The person performs these rituals repeatedly to reduce stress and ease anxiety. Some examples include:
- Seeking reassurance that you aren’t a violent or evil person
- Checking yourself and others to make sure you haven’t caused harm
- Constantly praying that you won’t control and hurt someone
- Hiding sharp objects so you’re not tempted to commit a violent act
- Avoiding places where you fear causing harm, like window ledges, train platforms, balconies, isolated areas, or places that sell weapons
- Staying away from people you could more easily hurt, like children and the elderly
- Not watching violent movies, TV shows, or the news so you don’t get ideas
- Neutralizing your “bad” thoughts with “good” ones
- Researching violent crime to determine whether you have things in common with the offenders
- Conducting superstitious rituals to counteract the potential harm of your violent thoughts
What Causes a Fear of Hurting Others?
Harm OCD is a subset of obsessive-compulsive disorder. Like other mental health conditions, OCD doesn’t have one single cause. Different factors increase the likelihood of developing OCD and therefore, harm OCD.
Genetics is one factor. One study identified four genes in individuals who suffer from OCD that were absent in those who didn’t suffer from the condition. Additionally, another factor is brain chemistry and structure. Brain imaging studies show that the amygdala, the brain’s integration center for emotions and emotional behavior, may affect the development of OCD.
Research has also linked past trauma (like physical or sexual abuse, or other types of trauma) to the development of OCD. In addition, a low tolerance for uncertainty—correlated with trauma—can be a factor. And having a perfectionistic personality can further increase the likelihood of developing OCD. Moreover, OCD in young adults frequently occurs with other related disorders, such as anxiety, depression, ADHD, and bipolar disorder.
Does Fear of Harming Others Result in Violent Acts?
People with harm OCD are not more likely to commit violent acts. Rather, they experience agony for even entertaining violent thoughts. This contributes to the shame felt by people with OCD.
Harm OCD sufferers don’t act on their morbid thoughts, because these thoughts are what’s called ego-dystonic. That means their thoughts are inconsistent with their ego, personality, and core beliefs. The disturbing mental images they wrestle with don’t reflect their true intentions. In fact, being overcome with guilt, anxiety, and shame about your violent thoughts means you’re not the kind of person who would act on them.
Will Harm OCD Ever Go Away? Overcoming Harm OCD
If harm OCD is left untreated, living with it can become intolerable. Hence, most experts recommend medication for treating OCD. However, research shows that medication is most effective when combined with therapy. Here are some therapies that are effective in treating OCD, including harm OCD.
Exposure and Response Prevention (ERP) Therapy
Exposure and Response Prevention (ERP) therapy is the first-choice treatment for harm OCD and other forms of OCD. A type of Cognitive Behavioral Therapy, ERP interrupts the cycle of OCD obsessions and compulsions. The point of ERP is to confront and tolerate anxiety and fear, without using compulsive rituals to reduce distress.
First, therapists expose patients to triggering objects, images, emotional states, or environments that spark their violent thoughts. Hence, harm OCD patients practice resisting the urge to complete a ritual. And they realize they haven’t harmed anyone as a result. Therefore, they build self-confidence and distress tolerance. Over time, they begin to accept that their thoughts are just thoughts, and they’re not at risk of acting on them.
Know the Facts
In one study, ERP treatment, alone or in combination with medication, reduced symptoms to a minimal level for 50 percent of patients.
Acceptance and Commitment Therapy (ACT)
A type of mindfulness-based psychotherapy, Acceptance and Commitment Therapy helps people sit with their OCD thoughts and feelings rather than avoiding or denying them. ACT therapists encourage patients to stay focused on the present moment through mindful breathing.
As they breathe, they’re guided to notice and accept the transient nature of their thoughts and feelings. Over time, people with harm OCD realize it’s not necessary to control what they’re thinking and feeling. Instead, they begin changing the way they perceive and react to their thoughts and feelings. Techniques may include self-compassion meditations, loving-kindness phrases, and other approaches for releasing obsessive thinking patterns.
Attachment-Based Family Therapy (ABFT)
Attachment-Based Family Therapy (ABFT) is an empirically validated modality designed to heal early childhood attachment ruptures in the parent-child bond. These ruptures can prevent young adults from feeling a sense of safety and acceptance.
At Newport Institute, we often include ABFT in young adult OCD treatment plans. The goal is to heal rifts in the family system so that young adults feel safe reaching out to parents for support when they’re struggling with OCD symptoms.
Transcranial Magnetic Stimulation (TMS)
Transcranial Magnetic Stimulation is a non-invasive, FDA-approved treatment. It involves precise neuron stimulation using repetitive electromagnetic fields. The goal is to create electrical changes in the regions of the brain associated with OCD symptoms.
During TMS treatment, an electromagnetic coil is placed on the scalp near the forehead. Short magnetic pulses are painlessly directed into an area of the brain that controls moods. These pulses trigger changes in the brain that can reduce OCD symptoms. Neither anesthesia nor a lengthy recuperation is necessary.
Treatment for Harm OCD at Newport Institute
Harm OCD and other forms of OCD are unlikely to go away without treatment. At Newport Institute, we use gold standard OCD treatments like ERP, as part of an integrated approach to care. Our multidisciplinary team includes psychiatrists, nurse practitioners, family therapists, individual counselors, equine therapists, art therapists, music therapists, adventure therapists, registered dietitians, and more.
Our specialized OCD treatment for young adults incorporates evidence-based therapeutic modalities, medication management, and life skills training. Each young person’s individually tailored treatment plan includes clinical, somatic (body-based), and experiential therapies. Many of these modalities activate the relaxation response, or parasympathetic nervous system, reducing harm OCD thoughts and the anxiety they produce.
To learn more about our industry-leading young adult treatment and schedule a free mental health assessment, contact us today.
Frequently Asked Questions
Can OCD cause thoughts of harming others?
What is the phobia of hurting others called?
What are some harm OCD symptoms?
How is harm OCD in young adults typically treated?
