Harm OCD Test & Symptoms

Uninvited and intrusive thoughts about harming other people, loved ones, or strangers.

When most people think of OCD, they imagine someone who is a “germophobe” or who repeatedly checks that doors are locked and that stove is indeed turned off. While many people with OCD do have a compulsion to clean or check things (they don’t necessarily enjoy it, though!), there are several other ways that OCD manifests itself in different people. One of the most surprising and common ways is regarding themes of harm.

What is Harm OCD?

One of the most troubling manifestations of OCD is experiencing intrusive thoughts of harming others – otherwise known as Harm OCD. Most OCD sufferers experience intrusive thoughts as a symptom of their condition, but Harm OCD takes the form of incredibly distressing intrusive thoughts harming others and engages in compulsions that are enacted as a means to ensure this has not or will not happen.

While everyone might have the odd fleeting thought about punching someone who has been rude to us or pushing someone in front of a bus, for the Harm OCD sufferer, these thoughts are repeated and are accompanied by a fear that they might act on that thought. This, in turn, can turn into an intense preoccupation with preventing that situation from happening. Rather than treating the thoughts as a weird, fleeting, brain malfunction that is easily dismissed, the Harm OCD sufferer might see them as a sign they will act on the thought. This is when Harm OCD starts radically affecting their lives.


    Signs of Harm OCD

    If you think you may have Harm OCD, you may find that you are asking yourself ‘what-if’ questions (what-if questions are a common feature of all forms of OCD) related to whether you could harm someone, or have done so in the past. These might include questions such as:

    • What if I harm or kill my child or another vulnerable loved one?
    • What if I am deep down a violent person and will act out in future?
    • What if I act on a violent impulse and hurt someone (push someone in front of a train, for example)?
    • What if I harm or kill myself?

    OCD, in itself, is defined by the presence of an obsession and/or compulsions. Harm OCD is characterised by obsessions that may be considered ‘off-limits’, such as hurting someone vulnerable or someone clearly undeserving of harm, like an innocent bystander, for example. These might include any of the following;

    • Your child/newborn baby. You may have visions of dropping a baby out of the window or down the stairs, for example, and worry that you will act on it.
    • A vulnerable elderly or disabled relative. You might have thoughts of hurting someone you are caring for who is not able to defend themselves.
    • A pedestrian (if you are driving). You may worry that you will hit someone and then drive off unaware that you have done so. Or that you will have a fit of rage and deliberately plough into some pedestrians.
    • A random person in the street. You may be concerned that you will have a sudden compulsion to hurt someone you do not know in an unprovoked attack.

    Common Compulsions of Harm OCD

    In addition to having these thoughts, people who experience Harm OCD will react to their intrusive thoughts by engaging in rituals (compulsions) that help relieve their anxiety about the thoughts. These compulsive behaviours can be divided into three primary categories: avoidance, mental rituals, and the seeking of reassurance.

    Avoidance could include avoiding certain people or locations (such as balconies in high buildings or station platforms). It might also involve avoiding being around particular objects, especially items such as knives or medication that could cause harm. It might also include avoiding watching violent films or disturbing images on the news for fear that it might induce thoughts of causing similar harm to others.

    Mental rituals are a common feature of all forms of OCD, and Harm OCD is no exception. Mental rituals that a person may engage in could include;

    • Obsessively praying that no harm will occur to anyone
    • Superstitious rituals that the person believes will counteract any evil thoughts they may be having
    • Repeatedly playing out scenarios of troubling situations and thinking how they might handle them
    • Trying to replace ‘bad’ thoughts with good ones

    Sufferers of Harm OCD may also try to seek reassurance about their thoughts by repeatedly checking that no harm has come to someone (repeatedly calling or texting them to see if they are OK, for example) or obsessively researching online about violent thoughts and whether people who have them go on to act on them.

    What should you do if you think you have Harm OCD?

    If any of the signs of Harm OCD resonate with you and you think you may have Harm OCD, one of the first steps you can take is to take a Harm OCD test. A simple online test might help to put your thoughts in perspective and reassure you that there is nothing shameful about having these thoughts (although that is easy to say if you are not the one having the thoughts!).

    There are various methods of treatment for Harm OCD that may go some way to alleviating the stress and worry caused by having such thoughts.


    Treatment for Harm OCD

    The gold-standard treatment for sufferers of Harm OCD is ERP (Exposure and Response Prevention Therapy). This is a form of CBT whereby the patient engages in exercises that gradually expose them to their fears in a planned and strategic way.Research demonstrates that this is the most effective way of treating Harm OCD and is successful in more than two-thirds of cases.

    CBT that incorporates mindfulness is also considered to be an effective way of treating Harm OCD in the latter stages of treatment. This treatment aims to change how you see and react to your thoughts, so you take them less seriously. Mindfulness will help you feel more relaxed and able to cope when the thoughts arise.

    Some see medication as a last resort, but for others it is an effective way to manage their symptoms when combined with appropriate psychotherapy and behavior change. Medication (most commonly SSRIs) can be used in conjunction with other treatments and is most effective when combined with ERP.

    If you think you may have Harm OCD, the best course of action is to see your physician or a therapist who will assess your symptoms and advise you on the best course of action to help you.