Ever had irrational, intrusive thoughts about harming someone you love? You don’t have to suffer the shame those thoughts bring. Harm OCD is an obsession without a compulsion and you CAN find help.
Editor’s note: The following piece was submitted by an anonymous author. While many of us envision repeated hand washing, or perhaps Monk’s compulsion to have everything orderly when we hear the words ‘OCD,’ that isn’t the only kind of Obsessive-Compulsive Disorder. Many people with Harm OCD suffer because they don’t realize help exists.
It first happened six months after I turned eighteen, as I walked to the chapel at my university for a required assembly. Palm fronds swished against a clear sky and a light wind brushed my face. I yearned to stay in my dorm room and read rather than attend a required assembly with two thousand sweaty students.
The next thought sliced into my mind out of nowhere.
What if I stabbed a family member?
My feet stopped moving.
I did not just think that, I thought, I would never do that. People surged past me, chattering about upcoming exams, the greasy cafeteria food, lack of sleep. I made myself start walking again, but my mind sank deep into thought.
How do you know you would never do that?
Because I love my family, I thought. Because I hate violence. I can’t even watch scary movies without a pillow over my face.
But does that mean you’ll never hover outside your brother’s door with the knife from the kitchen and—
—sneak over to his bed and—
A gruesome image followed. I swore at myself to stop, to banish the image from my mind. By then I had come to the steps before the chapel. I climbed them slowly, my fingers clutching the metal rail.
You see, said my mind, you can imagine it. That means you might do it. Mightn’t you?
No, I wouldn’t. I could never do that because I love my family, I love my brother. Please, that’s enough.
How can you be sure you won’t hurt them?
I dropped into a wooden pew and tried to answer that question for the next hour but I failed.
Thoughts From Nowhere Haunt Me
For the rest of that week, my throat ached in the place where my mind told me I might draw a knife across a loved one’s neck. During work one evening, I called my mom, and I sobbed to her that something was wrong.
“Explain it, Sweetie,” she said, but I didn’t dare. She would have no choice but to report me to the police or commit me to an insane asylum.
Sane people did not have these thoughts.
So my mom offered all she could: prayer.
But I had already begged God to take the thoughts and images away from me, and he had not answered.
I almost didn’t want to go home for the summer, for fear I would fulfill the horrors my mind now paraded in front of me every day. My life laid out before me: One day I would snap under the weight of the thoughts. I would lose control and do the terrible thing. Then I would die in jail, a criminal who had never wanted to commit a crime.
The thoughts slammed me into a place of crushing self-hatred. But then I knew—and this thought made me feel only slightly better—that before I let myself hurt anyone, I would kill myself.
Those Thoughts Continue to Torment Me
I tried to distract myself with my summer job and spending time with my family. If I kept close to my family, they could restrain me should I show signs of snapping. They would keep each other safe. One warm summer evening, we watched a movie that started to show my nightmare. A kid with a knife, entering his family’s house with a chilling look on his face. I left the room, slipped into the bathroom, and sat on the toilet lid, my face cradled in trembly hands.
After half an hour, I edged back into the living room. I wanted to ask if the boy had done it if he had done the unthinkable. But I didn’t, because if he had, might that not mean I could, too? It was better not to know.
Another year of college flew past, and then another summer. I tiptoed through life, avoiding situations that could cause me to hurt someone else. I stayed away from knives, from guns, from balconies.
Each day I judged myself a murderer for the images that seared my mind, and one day in church as I sang a song about God’s love, I felt God had ditched me. I wanted nothing more than to meet him and ask him what was wrong with me. If I could just talk to him in person, I could ask him to heal me. Just then another horrible thought burned my mind and nearly pushed me to my knees.
I closed my mouth. The song swelled toward the ceiling. Clouds loomed over the stained-glass windows, shuttering all the light.
My biggest enemy, my snatcher of joy, lived within my own bones and smiled my smile, and not even God could squelch it.
A Ray of Hope
Somehow, I successfully completed the third year of college. During my senior year of college, I decided to look for help for another problem I’d faced for years. After some online research, I ordered a book called The Anxiety and Phobia Workbook by Edmund J. Bourne. I decided to read from the beginning, and the book covers many types of anxiety disorders. I read disinterestedly about obsessive-compulsive disorder until I read this line:
“Obsessions may occur by themselves, without necessarily being accompanied by compulsions. In fact, about 20 percent of the people who suffer from obsessive-compulsive disorder only have obsessions, and these often center around fears of causing harm to a loved one.”Bourne, 21
I re-read that lifesaving line.
Eagerly I read on, and found this:
“It is very important to realize that as bizarre as obsessive-compulsive behavior may sound, it has nothing to do with ‘being crazy.’ You always recognize the irrationality and senselessness of your thoughts and behavior, and you are very frustrated (as well as depressed) about your inability to control them.”Bourne, 21
Yes, that’s me, I thought.
On the next page, I got a morsel of information on how to help myself: cognitive therapy.
“Fearful, superstitious, or guilty thoughts associated with obsessions are identified, challenged, and replaced. For example, the idea ‘If I have a thought of doing harm to my child, I might act on it’ is replaced with ‘The thought of doing harm is just ‘random noise’ caused by the OCD. It has no significance. Just having the thought doesn’t mean I’ll do it.”Bourne, 22
Reverently, I closed the book. I was not psychotic, I was not evil, I was not a murderer. Instead, I probably suffered from some form of obsessive-compulsive disorder.
Harm OCD IS a Thing
I researched books specifically for OCD and found a well-rated one called The Mindfulness Workbook for OCD: A Guide to Overcoming Obsessions and Compulsions Using Mindfulness and Cognitive Behavioral Therapy by John Hershfield and Tom Corboy. In this book, I found the answer to the type of OCD from which I suffered: Harm OCD, which centers around the fear of hurting loved ones.
I spent hours reading about why the brain begins the thought processes it does. The book told me most people have fleeting thoughts of What if I hurt someone I love? The difference between those people and people who suffer from Harm OCD is most people recognize such thoughts for what they are: meaningless thoughts, not threats.
Their brains do not seize on the thoughts and launch into relentless cycles of questioning, fearing, and judging.
These two books started hoisting me out of the pool of darkness that I had swum in for three years. I still struggled with intrusive thoughts, but I fought the OCD with techniques I learned in the books I read. When I got brave enough to search Harm OCD on the Internet, I found out while the information on it is relatively new, hundreds of people have it—probably thousands.
Few people seek treatment because they fear the same things I feared—their family members will think them psychotic and evil, and doctors and counselors will commit them to psychiatric hospitals or jail.
And sadly, sometimes the reaction to this mental illness is negative, but I have been lucky. In the past year I have told my mom, husband, and a handful of other family members and friends about my struggle with this illness, and each of them has emanated understanding.
Hard Work and Hope
Intrusive thoughts still plague me from time to time, and on some days I can deal with them better than others. But I’m determined to beat OCD. Each morning I make three requests of God, and one of them is that he help me conquer the OCD soon so that I can live the way I once did and worry about the things normal people worry about.
Because of my experience with OCD, I try to stay alert to clues that someone might be suffering from a mental illness they don’t understand, and while I pray that God comforts them, I also pray that he will lead them to the right tools to help them start to heal, as he did for me.
Monk isn’t the Only One with OCD
While many of us laugh over the television character Monk’s obsession with straightening things, we probably know little about those who suffer from obsessive-compulsive disorder. I’ve even casually told picky friends to ‘Stop being so OCD.’ Looking back, I feel horrified by my choice of words. What if one of them actually suffered from some form of OCD?
As the anonymous author of this piece pointed out, most people with Harm OCD don’t seek help because they fear reactions from therapists or family members. But help exists. You don’t have to live with those intrusive thoughts that bring so much guilt and shame.
A psychiatrist or psychiatric nurse can do both cognitive-behavioral therapy and prescribe medications if your situation requires medication. You’ll want to interview the person you choose and find out if they have treated anyone with Harm OCD before. Strangely enough, not all psychiatrists have a familiarity with the condition. You don’t want to feel shamed by someone who looks aghast when you explain you imagine hurting a family member.
Questions to ask in your interview include these:
1. Tell me about your professional background.
You want to make sure the psychiatrist has the proper credentials and certifications. In the case of a therapist, you want to make sure the therapist has a license from the state, and not just an online course or a pastoral endorsement from a church.
2. What treatment approach do you use?
You want someone who starts with cognitive-behavioral therapy. If they have other approaches that bring more to the table, even better.
3. What types of patients do you enjoy working with?
This open-ended question gives you time to consider how interacting with the psychiatrist or therapist feels for you. Do you feel understood? Does the interaction seem authentic? Does the psychiatrist or therapist seem like an expert?
4. How many patients have you treated with Harm OCD?
If they say none, ask if they can refer you to a colleague who has treated patients with Harm OCD. Remember, it may prove difficult to find someone who has treated people with Harm OCD because many people never seek help due to fear of reprisals. Or, if you feel like the psychiatrist or therapist might be a good fit, ask them what they can tell you about the condition to gauge whether or not they are willing to learn.
Remember, psychiatrists and therapists have the tools in the boxes to help anyone, how they handle their tools is important. Do they react with horror, disbelief, or dismissal? Or do they react with curiosity, compassion, and competency?
5. How will I know treatment is working?
A therapist or psychiatrist should seek to help you function on your own. This isn’t a lifetime commitment (although it will take time and hard work).
6. Tell me about your fees, payment system, and what I can expect from a session with you.
You want to know if they accept your insurance, how often they bill, and whether or not they have a sliding scale for those without insurance. The billing question is important. I know about a psychiatrist who only billed when she remembered. Every four or five months, she’d bill for dozens of sessions. Spread out monthly, the co-pays were manageable. Lumped together as she did, the patient struggled to pay them.
7. Are you a person of faith?
Counselors and psychiatrists don’t have to share your religion to help you. On the other hand, if you prefer working with someone who shares your faith, go ahead and ask. While trained to remain neutral about religion (they should neither mock it nor push it), you may find it comforting to know your therapist or psychiatrist would be willing to share ways you can invite God into your healing process.
Maybe you don’t suffer from Harm OCD, but want to know how to react if someone confides in you. Above all, react with compassion. Ask how you can help. Reassure them they are not alone. Offer to help them find a psychiatrist or therapist, direct them to a book, share this article with them, and most of all, don’t freak out. Be the safe harbor a hurting friend or loved one needs.