Harm OCD: Can I trust myself?

Patrick Carey

January 24, 2019

Amy is just hanging out on a Saturday afternoon, trying to entertain her toddler. She’s full of love for this three-year-old. But today, like every other day she can remember, brings a horrible moment. She suddenly thinks about how she could just kill her child if she wanted to.

Amy is launched into a spiral of extreme doubt and anxiety: “Would I ever do that? How could I think such a thing? Do I care about my child at all? What kind of person am I?” As she tries to prove to herself that she wouldn’t hurt her toddler, Amy’s distress only increases. No attempt to answer these questions feels good enough, and Amy starts to feel panic coming on as she fails to fully convince herself that she’ll never lose control and become a murderer.

It may come as a surprise, but it’s very common for people to have disturbing and even graphic thoughts about hurting or killing a loved one, friend, coworker, acquaintance, or stranger. Parents like Amy can experience these thoughts even though they'd do anything to protect their children. Most people, most of the time, brush them off as strange, unexpected, or unpleasant, without seeing them as especially meaningful or feeling like they need to make them go away.

Sometimes, though, the thoughts feel catastrophic and uncontrollable. They seem to signal an urgent need to make sure something bad won’t happen now or in the future. Some people even question whether they’ve already harmed someone and don’t know about it or simply can’t remember. Those who think and feel this way, and end up relying on repetitive behaviors for temporary relief, might be displaying symptoms of obsessive-compulsive disorder, or OCD.

The primary symptoms of OCD are obsessions and compulsions. Obsessions are unwanted or intrusive thoughts, images, or urges. Compulsions are repetitive behaviors performed to provide temporary relief from the anxiety those obsessions generate. These symptoms disrupt daily life and cause significant distress.

We can look at statistics about how rare acts of violence are or read reassuring articles all day long (seeking reassurance and doing research are common compulsions), but they’ll never be good enough to convince us for more than a few moments that there is no risk of us doing harm. In fact, with OCD, these behaviors usually just cause more anxiety in the long run.

So what does help people with Harm OCD?

The intrusive, unwanted thoughts that people with Harm OCD experience are understandably terrifying and isolating. They seem like signs that our lives will be stuck forever—or, worse, that we're bound to do something terrible. But, although Harm OCD seems uniquely terrible, it's just another form of obsessive-compulsive disorder. And OCD is highly treatable with exposure and response prevention (ERP) therapy.

Conducted by a licensed OCD therapist, ERP is the most reliable way to significantly decrease the amount of distress caused by OCD. Trying to fight our thoughts directly is a losing battle, so ERP works by helping people resist their compulsions (like staying inside to eliminate the possibility that we'll lose control). This, in turn, gradually teaches us that we can tolerate even our most violent thoughts—we don't need to do anything about them after all.

Although this might sound simple, it involves careful planning and constant adjustment; so ERP is most effective when practiced with a therapist who has received specialized training. An OCD-trained therapist knows what to anticipate when you describe your thoughts and behaviors, and how to build your personalized treatment program. Their expertise is in teaching you how to manage your OCD and make positive changes in all areas of your life—not just your relationship.

This is the same training all of our NOCD Therapists receive. The goal of NOCD is to reduce your OCD symptoms within just a few weeks of live one-on-one video therapy. You'll be welcomed into our supportive peer community, with 24/7 access to personalized self-management tools built by people who have been through severe OCD and successfully recovered using ERP. 

Schedule a phone call with a member of the NOCD clinical team to learn more about how a licensed OCD therapist can help you get better. This consultation is free and doesn't take very long—and it could be one of the most important calls you ever make.


If you believe you have genuine intent to harm yourself or someone else, please seek immediate help by calling 911 or heading to an emergency room.

Please note that this post is an exploration of a common question from our community members. It is not intended to diagnose. 

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