Is ERP Therapy Best for Harm OCD?

By NOCD Staff
Reviewed By Keara Valentine
4 min read
is erp the best for harm ocd

If you have obsessive-compulsive disorder (OCD), it might seem difficult to imagine a life free of your obsessive fears and compulsive behaviors. For someone with Harm OCD, it might feel downright impossible.

Harm OCD is categorized by intrusive thoughts of harming others, even if there’s no prior history of violence. The intrusive and unwanted thoughts, or obsessions,  can start to convince someone they may actually act violently — no matter how irrational that might seem. Over time, someone with harm OCD may start to question their character and wonder what kind of person they really are, impounding the stress their OCD is already causing them.

Furthermore, someone with harm OCD may not seek treatment as quickly as someone with a different OCD subtype. Because the thoughts of someone with Harm OCD are centered on things that are potentially dangerous to others and heavily stigmatized, they may fear that even a licensed professional will judge them.

But while harm OCD may seem impossible to treat due to the intensity of symptoms, this isn’t the case. It still follows the obsessive-compulsive cycle, meaning that it can be treated just as effectively as any other subtype of OCD. And a qualified mental health professional with expertise in OCD, will never judge you for your OCD, no matter what thoughts it’s causing you to have.

What is OCD?

Obsessive-compulsive disorder is a mental health disorder categorized by a cycle of obsessive thoughts and ritualistic behaviors — or compulsions — to alleviate the distress caused by the obsessions.

If you have OCD, you may be able to recognize that your fears and the actions you take to quell them are irrational. Nonetheless, the disorder has you feeling convinced that something terrible will happen if you don’t enact your compulsions.

There are over 18 different subtypes of OCD. In almost all of them, the obsessive-compulsive cycle exists, with the difference lying in what the obsessions are centered on. For example, someone with relationship OCD (ROCD) will have seemingly never-ending thoughts about their romantic relationships, such as, “Does my partner want to be with me? Do they even find me attractive still?” Meanwhile, someone with contamination OCD will experience excessive fears around getting sick or being contaminated with germs.

For someone with any type of OCD, they feel an intense urge to engage in compulsions and reduce uncertainty. Even if it doesn’t feel rational, the compulsions feel like the only way to stop the unwanted thoughts and to prevent something bad from happening. Compulsions may look like seeking reassurance, tapping to a certain number, performing mental rituals and more. 

What is Harm OCD?

For Harm OCD, the OCD cycle of having obsessive thoughts or fears and feeling the urge to enact compulsions in order to ease the anxiety around those obsessions is present. In this case, the obsessions center on worrying about harming another person. These thoughts appear seemingly out of nowhere and may be triggered by things such as being around a certain person or holding items such as a kitchen knife.

These thoughts can be terrifying to have, and someone with Harm OCD may feel as if they will act on them. In order to stop the fears and to ensure no harm will be done, they might engage in a number of different compulsions. This may include avoiding the people they feel they may harm or any potentially dangerous objects, as well as seeking reassurance from trusted loved ones that they will not actually harm anyone.

As these obsessions continue, someone with Harm OCD might put off seeking treatment as they may feel their thoughts reflect their character — even if they have no prior history of violence. In fact, the uncertainty that someone might engage in a violent or destructive action is what keeps people stuck in endless cycles of compulsions. If you have Harm OCD, it is important to recognize that you are not crazy. Having intrusive thoughts is a common part of the human experience (yes, even violent ones) and you are probably no more likely to harm someone than the rest of us. 

How does ERP therapy work?

While the specific subject matter of your OCD obsessions might contribute to feelings of shame, it is still a subtype that can be treated easily and effectively. The most highly recommended treatment option for harm OCD is a form of cognitive behavioral therapy (CBT) called exposure and response prevention (ERP) therapy.

If you begin ERP, your therapist will work with you to expose yourself to the various things that trigger your obsessions and challenge your fear of uncertainty. In a safe and controlled environment, you can begin to work through your fears and learn ways to put a stop to your compulsions. 

Understandably, it can seem scary to face your fears, but your therapist will be alongside you every step of the way and you’ll soon be able to handle the discomfort. Over time, you will learn to not turn to your compulsions to alleviate the distress your obsessions cause, and instead be able to allow your thoughts to come and go.  This is why ERP therapy is considered the gold-standard treatment for OCD.


If you’re ready to seek treatment for your Harm OCD, you can schedule a free call with the NOCD clinical team to get started. Our team will match you with a licensed therapist with experience in using ERP to treat OCD. Over time, ERP can help you experience life without allowing fear of uncertainty to take over and without feeling controlled by your OCD.

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NOCD Staff
WRITTEN BYNOCD Staff
Keara Valentine
REVIEWED BYKeara Valentine