Obsessive compulsive disorder - OCD treatment and therapy from NOCD
What is OCDOCD SubtypesFears about harming a sibling

Fears about harming a sibling

5 min read
Serena Bednarczyk, LPC

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What is sibling harm OCD

Sibling Harm OCD involves fears about causing harm or violence to siblings or being uncharacteristically aggressive towards them. This can include thinking of intense violent acts, such as severely hurting or killing them, as well as minor harmful acts, such as doing harm to their car or clothes, which would impact them negatively. It could also involve emotionally or psychologically harming them. Harm OCD related to harming siblings can occur at any age. 

People experiencing this subtype do not want to be experiencing these thoughts, so they can cause great distress and anxiety. These thoughts are intrusive in nature and are ego-dystonic, meaning that they go against the person’s beliefs, identity, and values. People experiencing sibling harm themes in OCD will experience intrusive thoughts, images, or urges, known as obsessions; feel shame, guilt, or distress as a result; then respond by engaging in compulsions. 

A compulsion is any behavior to try to reduce the anxiety that comes from obsessions. It may cause some temporary relief from the distress, but it doesn’t help in the long term when the thoughts occur again. Exposure and response prevention (ERP) therapy is a helpful treatment for this. 

Sibling Harm OCD – Common obsessions

  • What if I harm my sibling?
  • What if I kill my sibling?
  • What if I am playing with my sibling and unintentionally cause them harm?
  • Images of killing, stabbing, hurting the sibling in any form
  • What if I told my sibling’s secret and got them into trouble with school, job, family?
  • Do these thoughts mean I hate my sibling?

Common triggers

People with Harm OCD related to harming siblings may be triggered by any situations involving their sibling, such as doing a dangerous activity together, cooking, playing, talking, or speaking about personal topics. People with OCD often compulsively avoid any situations that they fear may trigger their obsessive thoughts and anxiety.

Potential scenarios involving sibling harm OCD

A person is cooking with their sibling, and an intrusive thought occurs when using a knife to cut. The person receives a sudden image about using the knife to stab or hurt their sibling. They love their sibling, and they cannot let go of the impression that their fleeting intrusive thought means that they are at risk of harming their sibling.

A person is wrestling with their sibling. The intrusive thought occurs about their capability to break the sibling’s arm. Even though they didn’t hurt their sibling, and had no intention of doing their sibling any harm, they can’t bear the idea of continuing to wrestle, and become convinced that they pose a risk to their sibling’s safety.

A person is speaking about a sensitive, personal subject with their sibling. The thought occurs that they could write down information about their sibling and use it to harm their sibling’s friendship. They are disgusted by this thought, and spend days attempting to forget the information their sibling shared or convince themselves that they imagined it.

How can I tell if it’s OCD and not stress, anxiety, hatred, jealousy, or something else?

Identifying the typical signs of the OCD cycle (intrusive thought, anxiety, compulsion, repeat) can be helpful in order to differentiate Harm OCD related to harming siblings from other possibilities. Other illnesses or symptoms such as anxiety, jealousy, stress, etc. would not follow the cyclical pattern that characterizes OCD. 

Additionally, obsessions from OCD come to mind when someone doesn’t want them to, and can even happen for no reason. Another sign is that thoughts or urges from OCD are often especially aggressive and completely out of character. This is because intrusive thoughts are ego-dystonic, which means that they do not align with someone’s values, beliefs, or identity.

Common compulsions

When people with OCD sibling harm fears experience intrusive thoughts, images, feelings, or urges that cause distress, they may feel incredible guilt and shame, and start to be fearful of themselves and what they are capable of. Because of this, they might start to avoid being around their sibling, distract themselves when a thought occurs, or utilize mental review or checking in order to resolve worries about a previous situation.

Compulsions performed mentally or physically by people with sibling harm OCD include:

  • Avoidance of siblings
  • Distraction from intrusive thoughts
  • Rumination on thoughts, actions, and intentions
  • Mental review of past experiences with siblings
  • Mental checking of thoughts and memory
  • Self-punishment for thoughts perceived as dangerous or bad
  • Reassurance-seeking from the sibling or others to receive certainty that the sibling was never harmed
  • Researching similar scenarios online

How to treat fear of harming a sibling

Harm OCD related to harming siblings can be debilitating for people who struggle with it, but it is highly treatable. By doing exposure and response prevention (ERP) therapy with an OCD specialist, there is hope.

The goal of ERP is to retrain and educate the brain that intrusive thoughts from OCD don’t have any real meaning. There is no Thought-Action Fusion, meaning that unwanted thoughts do not cause actions to happen. Once a person with fears about harming their sibling can accept that their thoughts do not actually make it likely that they will cause harm, even when they stop engaging in compulsions and safety-seeking behaviors, their thoughts will cause less and less distress. As a result, they can start to feel better and enjoy a healthy relationship with their siblings. 

If you’re struggling with OCD, you can schedule a free 15-minute call today with the NOCD care team to learn how a licensed therapist can help. At NOCD, all therapists specialize in OCD and receive ERP-specific training. ERP is most effective when the therapist conducting the treatment has experience with OCD and training in ERP.

We look forward to working with you.

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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.

Gary Vandalfsen

Gary Vandalfsen

Licensed Therapist, Psychologist

I’ve been practicing as a licensed therapist for over twenty five years. My main area of focus is OCD with specialized training in Exposure and Response Prevention therapy. I use ERP to treat people with all types of OCD themes, including aggressive, taboo, and a range of other unique types.

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.

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