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Written by:Minkyung Chung, MS, LMHC

Published On: July 26, 2022

Medically reviewed by: Bisma Anwar, MA, MSc, LMHC

Reviewed On: July 26, 2022

Updated On: July 17, 2023


Harm obsessive-compulsive disorder (OCD) is a type of OCD that causes repetitive thoughts and urges to hurt yourself or others. Here, we’re discussing what harm OCD is, common obsessions and compulsions associated with it, what’s thought to cause it, and available treatment options. Many people are surprised to learn how common this frightening, but often very treatable condition is. Keep reading to learn more. 

What is Harm OCD?

Harm OCD is a subclass of obsessive-compulsive disorder (OCD) that causes disturbing, undesirable thoughts, fears, mental pictures, or urges regarding causing harm to yourself or others.

Thoughts about hurting anyone should always be taken seriously, which is part of what makes some of the symptoms of harm OCD so alarming.

People with this challenging mental health condition live with unwanted, intrusive thoughts, which they often view as indications of a desire for violence. That belief can exacerbate and fuel anxiety symptoms, which in turn can drive them to engage in compulsive behaviors in an effort to try making their disturbing, intrusive thoughts go away.

Symptoms of Harm OCD

What is harm OCD? People with harm OCD typically experience obsessions and compulsions in one of two ways. They either:

  • Have repetitive worry about hurting somebody else, or themselves, accidentally
  • Believe they may snap and hurt someone else or themselves impulsively


Let’s look at some examples of typical obsessions and compulsions associated with harm OCD.


There are unlimited possible obsessive scenarios for people living with harm OCD:

  • You might be in the kitchen, slicing vegetables, and have a sudden urge to stab someone standing next to you. This would understandably make you wonder, “Why did I just think that? Am I crazy? What if I actually had just stabbed them?”
  • Or perhaps, you’re standing on the sidewalk having a casual conversation with a friend, and suddenly, you think about pushing them (or yourself) in front of a passing car. Internally, you would probably ask yourself, “What’s wrong with me? Why did I just think about pushing them? Do I need to see a doctor or a psychologist?”
  • It could also be that you’re excessively infatuated with the possibility of overmedicating. You might worry, “What if I take too many of these pills and kill myself? What if I take the wrong dosage accidentally? What if this medication causes my liver to fail?”
  • Maybe you’re watching a movie with your partner on the living room couch and you feel a sudden urge to reach over and choke them. You would likely think, “I can’t bear the thought of this! Why did I have a sudden urge to choke my partner? This is not how I want to feel! They’re such a good person.”



Like obsessions, compulsions can come in a wide variety of possible behaviors that might result from the obsessive harm OCD thoughts you have.

  • People with harm OCD may seek reassurance from friends, loved ones, teachers, religious leaders, or others. You might constantly ask things like, “Do you believe that I’m the kind of person who could harm someone else? Please tell me that you don’t believe that I’m a risk to my own health and safety.”
  • Sometimes, harm OCD can cause you to repeatedly relive past experiences in an attempt to prove to yourself that you’re not going to harm anyone else. You may remind yourself, “I haven’t ever hurt anybody. Why am I so worried about hurting somebody?” You also might continuously search your mind for memories of times you were kind to others so you can block out any violent feelings and urges.
  • Another compulsion common with harm obsessive-compulsive disorder is engaging in mental rituals to reduce your obsessive thoughts and urges. For example, you might tap on your left elbow seven times whenever you think about hurting somebody else or yourself. You might constantly tell yourself, “I just tapped my elbow seven times, which ensures that I am not going to hurt anyone.”


It’s also not uncommon for someone living with harm OCD to try and replace intrusive thoughts with positive ones in a desperate attempt to negate unwanted morbid obsessions. If you think about hitting someone with a baseball bat, you might force yourself to think about spending time together in a pleasant atmosphere instead.

Then, some people with harm OCD experience avoidance compulsions. Here, you might intentionally stay away from people or situations you believe could potentially trigger a violent urge. Maybe you avoid going to a specific restaurant because the last time you were there you had an urge to throw hot coffee in a server’s face.

Is Harm OCD Normal?

It’s not that uncommon to occasionally have an intrusive thought about hurting yourself or someone else. However, these are typically fleeting feelings that generally only last a second or two. People with harm OCD, though, have repetitive, long-lasting episodes of violent thinking, often mixed with compulsive reactions in hopes of easing a nervous mind. Of course, most people don’t want to hurt themself or anybody else, but harm OCD can make the fear of it happening so real that it can begin to interfere with daily functioning.

For example, someone without harm OCD might have a quick thought about slipping and falling down the stairs, breaking their neck. Their next thought would be something like, “Whoa! I wouldn’t want to do that! I better grab this handrail a little tighter.” Then, they’d likely forget all about it and go on with their day.

A person with harm OCD might have the same thought about falling down the steps but react entirely differently. Instead of letting the violent thought casually pass, they may instead feel the need to go to great lengths to completely avoid the steps altogether, both immediately and far into the future. This could even mean something as drastic as finding a new place to live or taking 20 extra minutes to get to a regular spot because they need to find a different route that gets them there.

“Most people have thoughts about harming someone or themselves occasionally, but they are often fleeting and aren’t disruptive to daily functioning. Individuals struggling with harm OCD focus on harm, of themselves or others, in more intense and obsessive manners. So it’s as if the fleeting and unobtrusive thoughts are magnified and unrelenting. Online therapy and medication can help decrease symptoms.”

Licensed Mental Health Counselor (LMHC), MS Minkyung Chung

Causes of Harm OCD

Experts believe that OCD affects an estimated 2-3% of the adult population in the United States. A slightly larger percentage of women are affected than men. While we’re unsure exactly what causes OCD, we do know that OCD typically begins in either childhood, adolescence, or early adulthood. The typical age that OCD symptoms most often become apparent is 19.

Family history

According to the National Institute for Mental Health (NIMH), obsessive disorder has a genetic connection and runs in families. However, there are other likely culprits, including environmental factors, past trauma, and other causal factors to consider.

Comorbidity of mental disorders

Research discovered that when it comes to OCD, more than two-thirds of patients have comorbid disorders. This means they have OCD along with one or more other mental health conditions. Anxiety disorders, depression, schizophrenia, trichotillomania, eating disorders, and other comorbidities may contribute to OCD. More research is still needed so we can learn more.


Researchers at the University of Alberta collected evidence for post-traumatic OCD. They realized that traumatic past events often have a significant overlap with OCD. Their findings support the recommendation that trauma should be considered during OCD treatment.

“It’s unclear what causes traditional or harm OCD, but researchers continue to study the topic. Some triggers and causes that have been identified are family history, comorbidity of mental health disorders, and trauma.”

Licensed Mental Health Counselor (LMHC), MS Minkyung Chung

What Triggers Harm OCD?

There are several types of triggers that can be problematic for someone with harm OCD. These include:

  • Environmental triggers from an external environment
  • Emotional triggers like anxiety, fear, or anger
  • Interactions with others


In general, there’s no limitation to what can trigger the symptoms of harm OCD, or any type of OCD for that matter. Outside of prescription OCD medications, controlling the symptoms of OCD depends on the ability to expect, recognize, and proactively manage triggers as they arise.

Treatment for Harm OCD

Obsessive-compulsive disorder (OCD) is a chronic and distressing mental health condition generally that won’t go away on its own. Additionally, it’s associated with a high risk of suicidal thoughts and behavior or death by suicide.

This is why getting a correct OCD diagnosis and finding effective, prompt OCD treatment is so essential. A treatment plan is imperative for the long-term health and safety of anyone living with OCD. It’s also important for the people in that person’s life.

“Treating harm OCD is not dissimilar to treating traditional OCD. Cognitive-behavioral therapy is often the go-to technique in treating individuals with different forms of OCD. Some specific subsets of CBT that are commonly employed are exposure and response therapy and mindfulness-based CBT.”

Licensed Mental Health Counselor (LMHC), MS Minkyung Chung

Deep brain stimulation

According to researchers at the University Hospital in Rome, there are add-on stimulation techniques used to treat OCD that can potentially be very effective for people dealing with a very severe case of OCD.

Particularly if they’ve been unresponsive to other forms of treatment such as behavioral therapy for OCD or medication. There’s evidence that deep brain stimulation (DBS), for example, and transcranial magnetic stimulation (TMS) can be helpful. There’s less research and evidence about the efficacy of transcranial direct current stimulation (tDCS), vagus nerve stimulation, and electroconvulsive therapy for OCD, although future research might prove them to be effective.

If you’re living with the symptoms of harm OCD, don’t try to manage them on your own. Reach out to friends, loved ones, and most importantly, a therapist or other mental health professional who specializes in obsessive-compulsive disorder. A licensed online therapist at Talkspace can help you understand the nuances of OCD. Together, you’ll develop a customized treatment plan designed to significantly reduce the frequency and intensity of your obsession or compulsion.

OCD is a common and treatable mental health condition. Don’t wait any longer to reach out for the support you need to live a happier, healthier, and safer life. Reach out to Talkspace today for support.

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Minkyung Chung, MS, LMHC

Minkyung Chung has over 10 years of experience and specializes in multicultural issues, specifically issues unique to the Asian American population. She enjoys working within the Asian American community to help reduce the stigma associated with seeking mental health services and normalize the process of it. Her passion for this topic has led her to focus her research efforts in examining how to help the Asian American community.

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