Harmful and Aggressive Thoughts in OCD

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Harming and Aggressive thoughts in OCD

Obsessive Compulsive Disorder is typically identifiable in individuals who experience repetitive unwanted and intrusive thoughts (otherwise known as obsessions), that are commonly (but not always) followed by a series of compulsive behaviours, performed in an attempt to alleviate their associated anxiety and distress. Contrary to popular belief, there are many different ways in which Obsessive Compulsive Disorder (OCD) can present itself OTHER than the stereotypical representations most commonly portrayed in the media (e.g. “As good as it get’s wirth Jack Nicholson”). Harm oriented OCD is one of the various subsets of OCD, whereby an individual’s obsessive thoughts involve the irrational fear that they may accidently or intentionally harm themselves or others in some way. In an attempt to decrease the likelihood of their fears from coming true, many individuals with harm oriented OCD will engage in various compulsive precautionary and avoidant behaviours associated with causing harm (or potentially causing harm) either in themselves or others. Notably, an individual’s fears of harming are ego-dystonic: meaning they are contradictory to their withstanding values and moral belief system. Interestingly, at the OCD Clinic this is the most common presentation.

 

 

 

What are the symptoms?

Some of the most common themes associated with harm oriented OCD include

Obsessive thoughts surrounding the fear of:

• Accidently or purposely causing harm to loved ones such as family or friends
• Losing control and acting upon violent thoughts
• Committing suicide
• Using objects that could potentially harm oneself or others (eg: knives, cutlery, automobiles)
• Accidently leaving various household appliances on or unattended, therefore being responsible for causing significant harm or death to others (eg: running tap, gas stove, oven).
• Not being able to refrain from an impulse to hurt someone when placed in particular circumstances (eg: pushing someone in front of traffic, throwing a knife at someone when cutting food, being unable to pull foot away from accelerator of car).
• Being responsible for poisoning or causing illness in themselves or another by not following stringent hygiene measures
• Subconsciously committing violent acts (without recollection)

Compulsions typically associated with excessive checking, avoidance, reassurance seeking, and mental ritualistic behaviours, including:

• Constantly examining internal and external bodily cues that may indicate that they have harmed themselves or another
• Scanning the vital signs of others to make sure that they have not been hurt by them
• Excessive checking to see if appliances have been turned off “just in-case”
• Making sure any objects deemed dangerous or potentially cause harm are out of reach or hidden (eg: knives, scissors, razors)
• Avoiding places or people that could increase the likelihood that they could cause harm (eg: pedestrian crossings, balconies, small children).
• Constantly researching sociopathy or psychopathy to determine the resemblance between their irrational thoughts and behaviours of harming
• Asking others to recall their behavioural actions to confirm that they have not committed a violent act
• Mentally retracing the memories of their precise behaviours to re-assure themselves that they have not committed a violent act without knowing or remembering
• Avoiding watching or reading headline news stories for the fear that they may have caused a reported injury or murder

 

 

 

 

What causes it?

Just like other forms of OCD, there is not one, but many contributing factors that may influence the manifestation of harm oriented OCD – including one’s previous life experiences, their genetic predisposition and exposure to their environment.

Dr Emily O’Leary often states that OCD is like a missile effect so whatever is most important to you that is where the OCD will go. Family is usually the most important and cherish thing so naturally, the OCD thoughts are about harming family members. If your car was the most important that is where it would go. The fact that you are obsessing about harm coming to your family means that you love your family very much.

 

How can it be treated?

Like other forms of OCD, the most successful treatment for harm oriented OCD is Cognitive Behavioural Therapy (CBT) practised under the guidance and ongoing support from a specialising psychologist. The main components of CBT involve identifying the individual’s irrational thought patterns that have become second nature to them, and gradually challenging these cognitions with GRADUAL exposure therapy (otherwise known as Exposure and Response Prevention – ERP).
Here is a short clip explaining how the exposure component of CBT is applied during psychological treatment of harm oriented OCD: 

 

 

What is your experience?

• Clinical Director of Anxiety House and OCD Clinic since 2010
• Ten years’ experience with clients with OCD and anxiety
• Clinical supervisor and STAP trained
• Worked in public and private sectors for many years
• Worked in acute inpatient and outpatients units
• Regular speaker on radio and social media
• Researcher and presenter at international conferences

 

Sophie Lucas is our Anxiety House blogger and is studying Bachelor of Communications at UQ. Sophie is passionate about anxiety recovery and loves to write about research and provide EDUCATION about anxiety. Sophie and Director Dr Emily O’Leary carefully think about each topic and try and provide the most up to date information. We have a number of scheduled blogs coming up, but we really want to hear your IDEAS! What topics would YOU like to know more about?

If you have any comments or queries feel free to contact us at blog@anxietyhouse.com.au

 

Sources

http://www.ocdla.com/blog/harm-ocd-treatment-mindfulness-1560

http://www.ocdtypes.com/harm-ocd.php

http://www.ocdla.com/blog/harm-ocd-1-1488

 

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