A Bit About Harm OCD

This is particularly disturbing OCD subtype as the person has thoughts, feelings and even urges of violence to themselves or others. They can be quite intense, and they often feel like they are on the verge of doing the violent act. They feel absolutely terrified much of the time. Many of them feel like killers and develop a personality that says they are a killer of some sort.

I’ve done therapy with a guy who was convinced he was a serial killer. Of course he’d never hurt a soul and he never would, but I could not convince him of that. The obsessions were powerful, continuous, and 24-7. They were so persistent and tenacious that he had given up all hope of resisting them. They had also become quite strong in that the illness was actually telling him or ordering him to commit the violence.

He had suffered from this for 15 years in the time I met him. Of course, he had never come close to committing any violent act in that time. This is a case of a good person who is being mentally tortured every waking hour.

I spoke to another woman, a young schoolteacher, who had thoughts of killing her students all day. She was shaking like a leaf, as she put it.

A young man, a multimillionaire, has been more or less housebound with Harm OCD for 4 years. I talked to him on the phone for 1 1/2 hours and helped him more than the best and most expensive therapists in his country had in a long time. He was spending $1,500/week on therapy and not getting much better.

I told him he was fine and told him to put a knife into his pocket and go out shopping. Of course he could pull out the knife at any time and start carving up passerby, but he didn’t. He told me that I had gotten him out of the house for the first time in 4 years (an exaggeration).

The avoidance with this type of OCD is particularly severe. They start to avoid all human contact for fear of the violent thoughts, urges, etc. It’s also very disturbing for laypeople, and most laypeople think they are dangerous.

Curiously, these people either never or almost never (I’m not sure if there have been cases or not, but I’ve never heard of one) act on these strong violent feelings that may wrack them every waking hour or even minute. Something is preventing them from doing it. Fact is, they really don’t want to hurt anyone, and they are trying not to do it all the time. Furthermore, acting on the thoughts would violate their morals.

I’ve heard that a person with violent obsessions is actually the least likely person to ever commit any violent act. This does not seem clear to the general population, and I’ve talked to people with this condition who tell me that others are terrified of them, people often say that they are killers, criminals, etc.

This is clearly a most bizarre illness! The person least likely to commit any act of violence is wracked by violent thoughts, feelings and impulses day and night that they will never act on in a million years.

How can we make sense of this? We can’t, except maybe to consider that the best people have the worst thoughts. The least impulsive person (a person with Harm OCD is a very non-impulsive person) is wracked by terrible impulses through the day. The illness targets the persons least likely to do something and convinces them that they are most likely to do something.

It doesn’t make sense until you understand human nature. The best people feel the most guilt. The worst people feel the least guilt.

Obsessionals feel incredible guilt, yet they never do anything aggressive.

Antisocials commit tremendous aggression, yet they feel no guilt at all.

Here we go beyond psychology and into the realm of religion. Priests and ministers have always understood such things, going back hundreds of years. The best people do the least harm because they feel the most guilt. The guilt keeps them from doing bad things. The worst people do the most harm because they feel no guilt at all. The lack of guilt is what causes the bad behavior.

The worse the behavior = the less the guilt.

The better the behavior = the more the guilt.

It’s so paradoxical, but if you have any sense of human behavior, of course it all adds up. And a priest understand this intuitively. He’s nodding his head before you are done explaining it to him.

We wonder what the mindset is of the person who commits violent acts. Let us say the sociopath. For example, let us look at the serial killer.

This person typically has violent fantasies a good part of time. It’s how they like to pass the time. The crucial factor here is that the violent thoughts are not resisted and attempts are not made to stop them. This person enjoys thinking violent things, thinks them all day long to his heart’s content, and never tries once to stop them or resist them.

When he kills people, he’s simply doing what he likes to do. He feels no guilt and is incurable, since you can’t put a conscience into someone who lacks one, and anyway, he’s having fun. He doesn’t want to change. He doesn’t want to get better. He’s already fine. He’s in hog heaven, killing away, doing what he loves. Why give it up?