Understanding Harm OCD: Why You Are Not Your Thoughts
Understanding Harm OCD: Why You Are Not Your Thoughts
If you’ve been following the news lately, you might have seen some heavy stories about postpartum mental health and intrusive thoughts, like the heartbreaking case of Lindsey Clancy’s children. These headlines can be incredibly triggering, especially if you’re living with Obsessive-Compulsive Disorder (OCD), particularly the "Harm" subtype. It’s a lot to process, and if these reports have left you feeling anxious or alone, I want you to take a deep breath. You’re not alone.
What exactly is Harm OCD?
Harm OCD isn’t about who you are; it’s about persistent, unwanted "brain noise." It involves intrusive thoughts or graphic images of causing harm to yourself or the people you love most.
These intrusive thoughts, or obsessions, are typically followed by compulsions, repetitive behaviors or mental rituals performed to manage the resulting anxiety. This might manifest as avoiding specific objects, such as knives, or situations, like being around children. It can also involve mental compulsions, where one might try to "cancel out" the intrusive thoughts with more pleasant ones or force themselves to constantly distract their mind.
“Another common but often misunderstood version is Pedophilia-themed OCD (pOCD), which brings up distressing thoughts and may even make one questioned “am I a pedophile?””
In the clinical world, we call these thoughts ego-dystonic (American Psychiatric Association, 2013). The reason these thoughts cause so much distress is precisely because they are the opposite of your true desires and beliefs. Your horror at the thought is actually proof of your character. It’s like the whole “don’t think about the white bear”, when you tell someone to not think about something, it makes it very hard for them to not think about it.
Cutting through the confusion: OCD vs. Postpartum Psychosis
When tragic stories hit the media, it’s easy to get these two very different experiences mixed up. However, they are clinically worlds apart.
Think of OCD as an overactive "what if" machine. It’s driven by obsessions and compulsions, but importantly, people with Harm OCD stay firmly grounded in reality. They are terrified by the thoughts and don’t have real intentions behind these thoughts.
Postpartum Psychosis is a rare medical emergency where a person actually loses touch with reality, often experiencing delusions or hallucinations (Meltzer-Brody et al., 2018).
While intrusive thoughts are a very common part of the human experience, postpartum psychosis is incredibly rare, affecting about 1 to 2 per 1,000 births (Meltzer-Brody et al., 2018). Most people having these scary thoughts are at zero risk of acting on them. However, because psychosis needs immediate medical help, any big change in how someone is perceiving reality should be checked out by a a mental health professional right away.
Media reports tend to focus on the shock factor, which can make it feel like these rare emergencies are more common than they are, leading us to confuse a non-violent (though scary) thought with a rare clinical crisis.
You don't have to go through this alone
If you’re struggling with thoughts that feel dark, "taboo," or just plain wrong, please know that you don't have to sweep it under the rug until it finds its way back into your life just to get through the day. That heavy distress you’re feeling is just a sign that your mind is looking for some relief and a bit of guidance.
I really encourage you to reach out to a psychologist or psychiatrist who specialises in OCD. We have some incredible, evidence-based tools like Cognitive Behavioural Therapy (CBT) and Exposure and Response Prevention (ERP) that are life-changing for managing these symptoms and helping you get back to living your life in line with your actual values (Williams & Choy, 2013).
If you or someone you know is in crisis, here are some crisis contacts:
Lifeline: 13 11 14 (24/7 support)
1300 MH CALL: 1300 642 255 (24/7 mental health crisis support for Queenslanders)
Suicide Callback Service: 1300 659 467 (24/7 counseling)
Beyond Blue: 1300 22 4636 (24/7 support)
Kids Helpline: 1800 55 1800 (24/7 support for young people)
If you are in immediate danger or a medical emergency, please call 000 immediately.
References
American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders (5th ed.). Arlington, VA: Author.
Meltzer-Brody, S., Howard, L. M., Bergink, V., Vigod, S., Jones, I., Munk-Olsen, T., ... & Honig, A. (2018). Postpartum psychiatric disorders. Nature Reviews Disease Primers, 4(1), 1-19.
Williams, M. T., & Choy, Y. (2013). Obsessive-compulsive disorder. In S. G. Hofmann (Ed.), Cognitive behavioral therapy for adults (pp. 118-132). New York, NY: Cambridge University Press.