Obsessive compulsive disorder - OCD treatment and therapy from NOCD

Are Homicidal Thoughts a Sign of OCD?

5 min read
Dr. Keara Valentine

If you’re having homicidal thoughts—thoughts about harming or killing another person—it’s understandable that you’d feel distressed, concerned, and confused. 

Some people have intrusive thoughts about harming or killing a loved one. Some may have unwanted urges about killing strangers. Others may have thoughts about killing someone in the public eye.

are homicidal thoughts a sign of OCD?

Whatever the nature of your thoughts, there are a couple of things to know before we go any further. A great majority of the time, intrusive thoughts about killing someone do not mean you’re an evil person who actually wants to do harm. And there is help available for what you’re experiencing. 

You’re not alone, and you may be dealing with a mental health challenge like obsessive-compulsive disorder (OCD), which is extremely common and highly treatable. 

Homicidal thoughts and OCD: the connection, explained

Homicidal thoughts are a common symptom in Harm OCD. While you might hear more about other types of OCD like an obsession with cleaning or organizing, Harm OCD is statistically the most commonly experienced type of OCD. It’s 66% more common than the contamination worries that you’ve probably seen portrayed in the media.

Harm OCD causes a person to fixate on thoughts of harming themselves or someone else. In truth, almost everyone has these kinds of passing thoughts from time to time.

With Harm OCD, however, these thoughts don’t pass as they do for people without OCD. Instead, you become extremely distressed and threatened by the fact that you have these thoughts. You may ask yourself repeatedly if you could act on your thoughts, maybe starting to worry about whether you’re a violent person at the core. Soon, the distress becomes so intense that you believe your only choice is to engage in compulsive behaviors and mental acts to escape the discomfort.

You depend on certain rituals

One of the key signs of Harm OCD is the need to perform certain self-imposed rituals to prevent something bad from happening. Examples include:

  • Reciting a list of evidence that someone is a safe or violent person
  • Methodically replacing each violent thought with a gentle one
  • Doing repeated actions with your body that “prevent” you from becoming violent

You avoid triggering situations

Many people with Harm OCD try to make their homicidal thoughts go away by avoiding certain situations, including those that trigger thoughts of killing and environments or situations that would make it easier to act on violent urges.

For example, you might feel like you have to remove all the knives, scissors and other sharp objects from your house in case you might use them to kill your partner. You might not be able to go near heavy traffic or subway trains for fear of pushing someone in the path of a vehicle. 

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You seek reassurance

Reassurance-seeking is a common compulsion among people with OCD. It’s not enough just to tell yourself, I won’t kill my wife; I love her. You have to get confirmation over and over again that you won’t act on your thoughts of killing. You might seek that reassurance from others, yourself, or the internet. Here are some examples: 

  • Repeatedly asking others to confirm that you’re not a violent person
  • Spending hours researching the backgrounds of serial killers to convince yourself that you’re not like them
  • Making lengthy mental lists of all the reasons why you don’t have it in you to kill

When you have OCD, you seek reassurance in ways like these all the time, but it never seems to be enough.

What if it’s not OCD?

It’s worth noting that many people with Harm OCD experience doubt that their thoughts are the workings of OCD. Many will look for alternative diagnoses or reject the diagnosis outright as their belief is that they are only having these homicidal thoughts because there is something more sinister at work. That said, of course OCD isn’t the only explanation for someone who has these thoughts. That’s why it’s important to be honest with your therapist about all your symptoms to help them assess properly why you may be having these thoughts. 

Research has shown that thoughts of homicide are more common in people with certain mental illnesses or disorders—and while OCD is one, it’s not the only one. Others include: 

  • Borderline personality disorder
  • Antisocial personality disorder
  • Schizoaffective disorder
  • Schizophrenia

People with these or other mental illnesses usually have other symptoms besides homicidal thoughts. If you have other mental health concerns, it’s important to talk with a professional about a diagnosis and potential treatment.

Seeking treatment for OCD

If you suspect that OCD might be causing your homicidal thoughts, exposure and response prevention (ERP) therapy might help. ERP therapy is the gold standard for OCD treatment. What happens during ERP? You work with a specially-trained therapist (this is much different from talk therapy) and go through exercises that teach your brain to tolerate your involuntary thoughts without feeling like you need to erase them using compulsions.

Effective, specialized OCD therapy is here

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In ERP therapy, a trained therapist will lead you through a series of distress-inducing scenarios. You’ll start with the least scary situation, like being in the same room as a drawer with a knife in it, and learn to tolerate the fear without compulsive behaviors. In time, you’ll work your way up to more triggering encounters.

ERP therapy has helped many people with Harm OCD to face and manage their homicidal thoughts. If you’re ready to take control, schedule a call with one of NOCD’s licensed and experienced therapists.

Dr. Keara Valentine

Dr. Keara Valentine specializes in cognitive behavioral therapy and other evidence-based treatments for anxiety disorders, obsessive-compulsive disorder (OCD), social anxiety, panic, and depression. She is also a Clinical Assistant Professor within the Department of Psychiatry and Behavioral Sciences at Stanford University, providing psychotherapy in the mood, anxiety, and OCD clinics and participating in research on novel OCD and Hoarding Disorder treatments.

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Taylor Newendorp

Taylor Newendorp

Network Clinical Training Director

I started as a therapist over 14 years ago, working in different mental health environments. Many people with OCD that weren't being treated for it crossed my path and weren't getting better. I decided that I wanted to help people with OCD, so I became an OCD therapist, and eventually, a clinical supervisor. I treated people using Exposure and Response Prevention (ERP) and saw people get better day in and day out. I continue to use ERP because nothing is more effective in treating OCD.

Madina Alam

Madina Alam

Director of Therapist Engagement

When I started treating OCD, I quickly realized how much this type of work means to me because I had to learn how to be okay with discomfort and uncertainty myself. I’ve been practicing as a licensed therapist since 2016. My graduate work is in mental health counseling, and I use Exposure and Response Prevention (ERP) therapy because it’s the gold standard of OCD treatment.

Andrew Moeller

Andrew Moeller

Licensed Therapy, LMHC

I've been a licensed counselor since 2013, having run my private practice with a steady influx of OCD cases for several years. Out of all the approaches to OCD treatment that I've used, I find Exposure and Response Prevention (ERP) therapy to be the most effective. ERP goes beyond other methods and tackles the problem head-on. By using ERP in our sessions, you can look forward to better days ahead.

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