Harm OCD: What is it?

by Journey’s Bridge Counseling

HARM OCD

Subtype of the Week: HARM OCD

OCD comes in many shapes and sizes. Journey's Bridge Counseling is on a mission to spread awareness about the many ways OCD shows up in people's lives.

What is Harm OCD?

Harm OCD is a subtype of Obsessive-Compulsive Disorder where individuals experience unwanted, intrusive thoughts, images, or urges related to harming themselves or others — even though the person does *not* want to act on them.

Obsessions:

Repeated, unwanted thoughts or mental images about causing harm — even though the person does *not* want to act on them.

Example: "What if I lose control and hurt someone I love? What if I grabbed that knife and did something terrible?"

Compulsions:

Behaviors or mental rituals performed to reduce the anxiety caused by these thoughts — such as mentally reviewing events to make sure no harm was caused, repeating phrases to "neutralize" the thought, or avoiding objects associated with harm.

Example: Repeating "I am not a dangerous person" over and over. Avoiding knives, scissors, or being alone with loved ones.

Quick Facts

➔  Harm OCD is ego-dystonic — meaning these thoughts go *against* the person's values and sense of self. The thoughts cause intense distress *because* the person finds them horrifying. That distress — and the desperate effort to make the thoughts stop — is what makes it OCD.

➔  Hit-and-run OCD is one of the most common forms of Harm OCD. People with hit-and-run OCD worry they may have struck a pedestrian or animal while driving, and will often retrace their route — sometimes multiple times — just to make sure they didn't hit anyone. The anxiety can become so severe that some individuals stop driving altogether (IOCDF, Penzel, 2015).

➔  Having intrusive thoughts about harm does not make someone dangerous. A large-scale Swedish cohort study of over 23,000 individuals with OCD found that the risks of serious transport accidents and driving-related criminal convictions in OCD are negligible — meaning people with these obsessions are not the dangerous individuals OCD tells them they are (Mataix-Cols et al., 2022).

OCD is treatable. Exposure and Response Prevention (ERP) is the gold-standard therapy for all subtypes of OCD — including Harm OCD.

Journey's Bridge Counseling | Houston, TX

Sources:

• International OCD Foundation. "Driven To Distraction: 'Hit And Run OCD.'" (Penzel, F., 2015). iocdf.org/expert-opinions/driven-to-distraction-hit-and-run-ocd/

• Mataix-Cols, D. et al. (2022). "Hit-and-run: a Swedish nationwide cohort study of serious transport accidents and convictions due to traffic offenses in obsessive–compulsive disorder." Social Psychiatry and Psychiatric Epidemiology. PMC: pmc.ncbi.nlm.nih.gov/articles/PMC9375758/

• NOCD. "Hit-and-Run OCD: Overview, Symptoms and Treatment Options." treatmyocd.com/blog/hit-and-run-ocd-overview-symptoms-treatment