Imagine you are sitting in your kitchen eating dinner with your parents. You lift your knife up to cut your steak and, suddenly, an image flashes in your mind of you violently stabbing and killing your parents. You put the knife down immediately, disgusted and ashamed that your brain could ever conjure up such a horrible idea. But the thought does not go away. You excuse yourself from the table, suddenly unsure of yourself and terrified you will lose control and kill.
Weeks pass. The thoughts do not leave your mind. No matter what you do to push them out, they come back with a vengeance. You are now completely convinced you are going to kill your parents. You lock yourself in your room and lay in bed for hours a day, afraid you will get up and do the unthinkable. The thoughts grow a life of their own, becoming even more horrifying and disgusting than the original thought.
You feel alone and trapped in your mind. You try to go to school, but when you talk to someone you are petrified that they know. They know you are a killer. They know you have done horrible things. They know you secretly want to cause harm. You have no one to talk to — terrified you will be arrested and thrown into prison for your thoughts, even though you have no desire to act on them.
For a large number of individuals around the world, this is a reality. Most of them do not know what they are suffering from. Most of them wait years to tell loved ones about their thoughts. Some of them never do. Even if they do tell, they are often feared by their family, friends and even their therapist who may not fully understand what is going on.
This is the harm subtype of obsessive-compulsive disorder. This is how it feels.
Harm OCD is characterized by unwanted thoughts of causing harm to self or others, according to Intrusive Thoughts, Inc. The thoughts tend to plague people who have no history of violent tendencies and who are otherwise caring and respectful. Sufferers often perform compulsions, whether physical or mental, to quell the debilitating anxiety. What they do not often realize is the compulsions provide only temporary relief and eventually make the power of the thoughts stronger.
In a world where violence is regularly available through mediums like graphic video games and news broadcasts, it is normal to occasionally wonder, “Who would do that? Would I ever do that?” For people with this type of OCD, it is nearly impossible to dismiss these “junk” thoughts and move on.
Why can normal people have these wacky thoughts and forget about them while those with OCD cannot? Current research suggests at least two major psychological processes are at play: the thought-action fusion and thought suppression.
The thought-action fusion is the incorrect belief that thinking about an action is equivalent to carrying it out. It represents a fundamental reason why OCD sufferers cannot rid themselves of the thoughts — they believe they have already committed an atrocious act and are bound to be incarcerated and hated. Thought-action fusions can often blur the difference between reality and what is occurring in the mind, making the disorder all the more confusing.
Thought suppression involves attempting to control or erase thoughts that an individual finds disturbing and unwanted. Individuals often try to get rid of their thoughts by performing compulsions or actively trying to think about something else. But doing so rarely works and instead signals the brain that the thoughts are of some importance.
There is a fundamental difference, however, between Harm OCD and an actual real desire to hurt yourself or other people. Those with Harm OCD find their thoughts ego-dystonic, meaning they do not align with the person’s morals, values and general character. Such is the reason why the thoughts stick around — the sufferer cannot say for certain whether they will act out on their fears. No one can.
Generally speaking, those with an actual desire to hurt themselves or others have a history of violence or aggression. It is not a matter of if they will act on their thoughts, but when. However, more research is needed in this field to truly distinguish the two, given that those who commit violent acts may suffer from an unrelated form of OCD as well as other co-morbid disorders.
Harm OCD remains one of the most isolating forms of an already debilitating disorder. Sufferers feel the need to attain certainty that they will not act on their thoughts. As with anything else in life, though, nothing is for certain. Through treatment, sufferers learn to expose themselves to their fear (for Harm OCD, this could be something like walking around the house with a knife) without performing compulsions such as avoidance or checking. This treatment method, called Exposure and Response Prevention (ERP) is the gold standard for OCD treatment.
By walking around the house with a knife and allowing whatever harm thoughts one may be suffering with to be there without performing compulsions, the individual often realizes their obsession is not that scary and is rather fueled by anxiety. By repeating these exposures, the brain no longer treats the thoughts as important, hence allowing them to pass.
Everyone has intrusive thoughts. Everyone has occasional moments where an image flashes in their mind of them hurting someone else or themselves. Those with OCD, however, cannot dismiss these thoughts, leading to a terrifying reality of constant uncertainty.
The mental health community has plenty to improve on when recognizing and treating these darker forms of OCD. By encouraging sufferers to speak out and clarifying what OCD really is in an age where it is constantly misrepresented in the media, we can demystify an already horrifying disorder and let sufferers know they are not alone.
You are not alone. You are not your thoughts.
Taylor Harton is the associate news editor for The Daily Campus. She can be reached by email at firstname.lastname@example.org.