Taboo OCD Themes: Harm-OCD, Sexual Intrusions

The phrase “Harm OCD” refers to a vast array of OCD presentations that involve unwanted, intrusive thoughts, images, and/or “urges”*** that are of a violent nature. Often sufferers will experience these internal events and become extremely distressed at the possibility that they might mean that they are dangerous, deviant, amoral, or perhaps even evil. Depending on the specific content of the thoughts, they will then engage in patterns of compulsive behavior and avoidance to try and get rid of the thoughts or to prevent the feared outcomes from happening (or both). 

Consider, for example, the case of a young father who is playing with his child and has the random thought, “What if I physically harm my child?” He then becomes highly distressed, wondering “What kind of person has a thought like that?” He even begins to worry that he is a danger to his family, and in turn gradually reduces the amount of time he is around them for fear that he might “lose control” and hurt someone. In turn, engages in compulsive rituals (mentally “checking” his emotions to make sure he is not about to lose his temper, researching online about parents who “snap” and harm their kids to make sure he does not share characteristics with them) and patterns of avoidance (disengaging from physical play with his child, avoiding handling potentially dangerous objects) to ensure that his family stays safe. As the OCD cycle grows, his intrusions become more and more graphically violent, further confirming his fears that he is truly a dangerous person.

Other common themes of Harm OCD:

• Hit and Run Fears - Intrusive worries that one has inadvertently hit someone with their vehicle while driving and somehow forgotten or not realized. Compulsions may include re-tracing one’s route over and over, checking the local news for traffic accident reports, and avoidance of driving altogether. 

• Accidental Harm / Forgottten Harm  - Fears of accidentally causing harm (physical, emotional, or psychological) to someone. Intrusions may also take the form of worries that one has already committed the harmful act unknowingly. (link to false memory OCD). Compulsions include mentally reviewing events and checking to make sure no harm has occurred. 

• Postpartum/Perinatal Harm - A form of Harm OCD that typically affects new mothers, wherein the sufferer experiences unwanted, intrusive thoughts specifically about harming one’s baby. These thoughts may also be sexual in nature (i.e. “What if I touch(ed) my baby inappropriately while changing their diaper?)