What is Harm OCD?

As our understanding of obsessive-compulsive disorder (or OCD) deepens, mental health practitioners and researchers have managed to identify different subsets of this condition, with each one focusing on its own themes of obsessive concern. In addition to relationship OCD and religious OCD, a type called harm OCD was also discovered. Read on to find out what harm OCD is all about.

An OCD Primer

Obsessive-compulsive disorder is a mental health disorder defined by the appearance of either obsessive thoughts, compulsive actions, or both. As such, individuals facing OCD experience unwanted, adverse, and invasive thoughts on a subject that causes them great discomfort. To combat such topics, many develop repeated responses that are initially able to alleviate their obsessive thinking. Eventually, though, these actions lose their beneficial effect, and become part of a pattern of obsessive thought content and ritualistic reactions to it, with the individual now feeling compelled to carry them out.

At present, OCD has been found to develop in 2.3% of US adults, and in 1-2.3% of US children and adolescents. Globally, some 1.1-1.8% of individuals are believed to contend with OCD. The World Health Organization (WHO) ranks OCD among the top 20 causes of global disability.

Originally defined as an anxiety-based condition, OCD eventually branched out into its own category of OCD-related disorders.

These days, an ongoing debate is taking place over whether OCD is indeed centered on anxiety, or if its emotional driving force is distress. Anxiety is seen as a survival mechanism activating fear and vigilance of a potential threat even when one does not exist. Distress, on the other hand, is defined as an incessant, and highly unpleasant, nagging sensation. The debate between the two theories paints OCD as either stemming from a misguided, instinctual force looking to protect our physical health (for example, through cleanliness OCD), or as a thought pattern unable to process certain concerns (for example, the uncertainty of a budding romance that develops into relationship OCD).

In addition to the above question over its emotional center, OCD has been found to have a genetic base, with abnormal neural activity of the orbitofrontal cortex, anterior cingulate cortex, and striatum implicated in the appearance of OCD symptoms. Temperamental factors have also linked OCD to higher negative emotionality and behavioral inhibition during childhood. On an environmental level, experiencing childhood physical or sexual abuse, in addition to other stressful/traumatic events, have been shown to precede the appearance of this condition.

OCD has shown to respond to a number of treatments, with the FDA recognizing certain medications, forms of psychotherapy and medical treatments for their abilities to provide safe and effective OCD symptom alleviation:

• Selective Serotonin Reuptake Inhibitors: Called SSRIs for short, this anxiety and depression medication prolongs the activation period of the mood stabilizing neurotransmitter serotonin. Generally considered rather tolerable, certain patients nevertheless find SSRI side effects to be too adverse to continue, with their most common side effects being weight gain and sexual dysfunction.
• Cognitive Behavioral Therapy: This form of psychotherapy focuses on the thoughts, feelings, physical reactions and behaviors the patient has begun associating with their condition. By bringing them to light, discussing them within a therapeutic environment, over time the patient will hopefully be able to approach them with diminished fear, and gradually mitigate their response to the OCD-related emotional assault they had previously overwhelming.
• Deep Transcranial Magnetic Stimulation: Deep TMS™ is a medical device treatment that utilizes magnetic fields to safely regulate the neural activities of brain structures empirically proven to be associated with OCD symptoms. The treatment process does not necessitate the use of anesthesia and does not require a lengthy recuperation period. Due to its non-invasive nature, it does not cause any long-lasting or severe side effects, past a fleeting, localized headache. Deep TMS can also be incorporated into an existing OCD treatment regimen, as it can enhance the overall efficacy of treatments such as psychopharmacology.

Harm OCD

Harm OCD falls under one of the most common obsessions that can appear in OCD—taboo thinking. This OCD theme causes significant levels of anguish over the possibility of harming oneself (self-harm OCD), or someone else. Such thoughts can manifest due to frustration from a present situation (e.g., a long line at the bank), pent-up aggression felt toward an individual who has caused them pain, or the desire to rebel against the moral prohibitions society has put upon them.

Harm OCD obsessions are varied and can include many different fixations: among them are turning one’s car into oncoming traffic, harming one’s child or another individual dependent on their care, picking up a razor or knife and impulsively using to cut themselves or a loved one, poison another individual’s drink with a common household product, and many other examples of a sudden, violent behavior.

Patients with harm OCD may feel guilty over thoughts of purposely injuring others, or genuinely afraid of putting themselves in danger. They may also develop a serious sense of mistrusting their own self-control, due to concern that they will one day “slip” and carry out a gruesome act of violence.

The thoughts that materialize in harm OCD are upsetting, and leave the individual experiencing them scared of their own mind. However, thoughts of causing harm, even obsessive ones, do not necessarily reflect a desire to actually carry them out. In fact, the opposite may be true: an individual preoccupied with attacking someone else as part of their harm OCD will feel a great deal of agony over this. Their mind does not return to this subject because it causes them pleasure, but because they fear it will take place.

Preventing a patient’s harm OCD from occurring may be their most pressing concern, representing how important it is to them that it does not happen. The possible reasons behind their harm OCD are worth exploring in a safe setting, such as with a trusted mental health professional. But it is important to underscore the difference between one’s thoughts and their real-life actions, as individuals with this harm OCD attempt to achieve greater relief from a very disturbing condition.