What Is Harm OCD?

Studies show that the vast majority of us occasionally have unwanted violent thoughts about injuring ourselves or others. For example, we might briefly fantasize about harm befalling the guy who just cut us off in traffic and then scared us even more when he immediately slammed on his brakes to avoid other cars. Although we don’t like to acknowledge them, about 85 percent of people do experience some type of random harmful thoughts, but they are fleeting and don’t disturb our normal lives.

For people who have obsessive compulsive disorder (OCD), however, having unwanted thoughts about hurting someone may not be able to be dismissed so easily. In fact, these thoughts can become frequent enough to become intrusive, taking over the person’s life. When this happens, the individual is dealing with Harm OCD.

Defining Harm OCD

Harm OCD is a subset of classic obsessive compulsive disorder (OCD). The condition is characterized by having aggressive, intrusive thoughts of doing violence to someone, as well as the responses the person uses to cope with these thoughts.

OCD makes the individual feel that they can’t trust their own mind. Wherein someone without OCD could have a violent thought and recognize that it is simply a thought, a person with OCD who has the Harm OCD subset worries that just having the thought is somehow meaningful. As a result, they want full assurance that they won’t act on the thought.

Having these intrusive thoughts leads to engaging in compulsions and rituals to decrease the anxiety the person feels about the thought. Once they complete the ritual, they feel less anxious, but then the intrusive thought comes again, setting up endless cycles of doubt and fear.

Harm OCD Symptoms

Those who suffer from Harm OCD may:

  • Have aggressive thoughts or see images in their minds of violence and worry that this means they will carry them out.
  • Fixate on the idea that they could inadvertently be responsible for causing harm and not realize it (for example, they may worry about running someone over by accident, and then leaving the scene because they were unaware of what they had done).
  • Be terrified that they will hurt someone (or themselves) on impulse – whether intentionally or not.
  • Worry they are hiding their true nature from themselves and others and that they are really a vicious, aggressive person who will act out someday because they will lose control.

In response to their intrusive thoughts, people who experience Harm OCD engage in compulsions and rituals to help relieve their anxiety. These may include such actions as:

  • Hiding dangerous objects (kitchen knives, poisonous chemicals, medications, ropes, razor blades, and the like) so they aren’t tempted to use them to hurt someone.
  • Reviewing their every action to see if they could have, or did, cause harm
  • Avoiding watching the news or such things as violent movies, television shows or videos, so as to keep from triggering violent ideas.
  • Spending excessive amounts of time online, researching violent crimes and ideology in an effort to know whether they have things in common with the offenders.
  • Compulsive praying or carrying and using spiritual items so that they won’t lose control.
  • Asking others if they think the person with Harm OCD could hurt others.
  • They may also endlessly question themselves in an effort to answer, once and for all, if they are capable of injuring anyone (including themselves).

Treatment for Harm OCD

As with classic OCD, Exposure and Ritual Prevention (ERP) is the treatment for any OCD subset, like Harm OCD.

The first part of the therapy – exposure – happens when the individual allows themselves (with the help of their therapist) to encounter the triggering object, image, or environment that begins their cycle of intrusive thoughts. The idea is to confront what they fear, but to refrain from using their compensating compulsions (ritual prevention).

By resisting the urge to complete a ritual after the exposure and then finding that they do not act on the violent thought, the person builds self-confidence and begins to retrain their brain. This leads to learning to trust that their thoughts are simply thoughts. Over time, consistently avoiding the use of compulsions while remaining nonviolent helps break the cycle of doubt.

For the best chance of overcoming Harm OCD, find a therapist who specializes in treating classic OCD. Trying to get past intrusive thoughts on your own can keep you stuck because it can be difficult to stop “testing” yourself to see how you are reacting – which is a ritual that could reinforce your false beliefs.

Have Further Questions?

If you are concerned about your violent thoughts or worried that you may harm yourself or someone else, seek help from the OCD-trained therapists at The Center for Treatment of Anxiety and Mood Disorders in Delray Beach, Florida. For more information, contact us or call us today at 561-496-1094.

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  2. Luke

    Can you please tell me if this sounds like Harm OCD?

    I have emailed a couple priests about this topic:

    I suffer from intrusive thoughts related to mental illness. I am taking medication and being seen by a psychiatrist. I am not a danger to myself or others. I have no intention on acting on these thoughts.

    But my question to the priests is do I need to bring them to confession, and if so, how specific to I need to be?

    For instance, I have had about 20 thoughts of shooting my priest. A priest that I love and am grateful for. Someone I have no ill feelings about. The thoughts of shooting him are intrusive thoughts I would never act on. Please look up “Harm OCD” as I believe that accurately describes my situation. Sometimes when I think about the thought, I do briefly smile and delight in the thought, but again, it is just for a second, it is outside of anything I can consent to. It is beyond my will, it is not something I have control over, the delight in the thought or the thought itself are both intrusive in nature. I do not dwell in the delight, but turn from it was quickly as I turn from the intrusive thought. I am afraid that bringing these thoughts to confession only makes the thoughts more frequent. But I am also afraid that if I don’t confess them, then I won’t be truly absolved.

    So when I go to my priest, do I need to tell him I had 20 intrusive thoughts about shooting a priest, more specifically, do I need to tell him I had 20 intrusive thoughts about specifically shooting him, and smiling a couple times about the thought, but again, I have resisted these thoughts, they have to do with the nature of my mental illness. Or can I be more vague and just say “I had 20 intrusive thoughts about shooting someone” and I don’t need to specifically address whether it was a bishop or a priest or the person I am confessing to.

    I also had a few thoughts of shooting my Bishop, whom I love, and would never harm. Do I need to tell me priest, “I had 20 thoughts of shooting you and four thoughts of shooting my bishop and I smiled a few times”?

    I don’t want to under confess, or over confess. I have a hard time understanding how specific I need to be in confession or if I need to confess these at all. It’s also difficult because it starts with one intrusive thought of shooting my priest, then the other 19 thoughts come about because I am worried about confessing the 1st thought.

    Thank you,


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