As someone who had gone through harm OCD urges, I can say with confidence that they are among the most disturbing anxiety disorder manifestations you can have. Even though you can never act on them, I decided to find out why do they feel so real?
Why do harm OCD urges feel real? Harm OCD urges evoke strong emotional reactions of fear, shame, and guilt that capture your attention completely. However, what makes them even more personal and real is the fact that they go against your deeply held beliefs of what is right and what is wrong.
There are many types of harm urges a person can have. They can range from harming a stranger to harming yourself or your close ones.
Even though these urges may seem like a hard puzzle to solve, they're really basic once you get to know exactly what they are and how they work. In this article, I'll try to go in-depth on why they feel real and offer a solution that worked for me. Keep reading.
Scared to Think About, Ashamed to Talk About
The common problem with harm OCD urges is that they isolate the sufferer. Fear of being judged, misunderstood, criticized, or shamed prevents the sufferer from seeking help.
Urges become too scary to think about, let alone talk. As a result of repeated strong emotional reactions to urges, they turn into obsessions. Your brain registers that strong emotional reaction as something important or real and you become trapped in the OCD cycle.
To give you a general sense of what type of obsessions people have, here are some of the most common ones:
- Stabbing someone with a knife, skewer, scissors, or other objects.
- Bludgeoning someone with a bat.
- Sexually assaulting someone.
- Shoving someone off the sidewalk in front of a bus.
- Pushing someone in front of a train.
- Pushing someone down the stairs.
- Perhaps most distressing of all, being a child molester.
- And many obsessions related to harming oneself.
I have a confession to make - I had most of these obsessive thoughts. But you know what? Most people have them once in a while.
That’s right! These types of thoughts are not unique to OCD sufferers!
It’s not having these thoughts that make you think they’re real but your reaction towards them. Your reaction is also the exact reason why they become obsessive because your brain starts constantly reminding you of that “danger” to avoid.
Have you noticed, I started using the term ‘obsessive thoughts’ instead of ‘urges’? Let me explain why.
Urges or Obsessive Thoughts?
Let me make one thing clear – what you have is not an urge, it’s just an obsessive thought. It’s important to make this distinction because an urge implies something that you have a strong desire towards.
However, with OCD sufferers, “desire” is the exact opposite of what they wish to have, which is exactly why you fear to have these thoughts in the first place.
I know how hard it is to accept that these are not real urges because they certainly feel like ones.
One of the first obsessive thoughts during my anxiety disorder journey was jumping off the train platform. I live in NYC and some train station platforms are way up high, like this one:
In fact, this train station was the one I feared the most because it has gaps on both sides. It’s also elevated high above the ground, which makes it occasionally swing when the trains arrive.
My first “urge” to jump off came out of nowhere. And since I was already highly anxious back then, that mere thought frightened me instantly. The danger felt extremely real.
I held onto the station pillar trying to feel safer, which I learned later only made my obsessive thought stronger.
After the initial “urge” to jump off the station, I started avoiding going up the platform until the train arrived. This new behavior gave my obsessive thought even more validity while making me feel more trapped.
In other words, I developed a set of avoidance behaviors that sent a clear signal to my brain that this “urge” is a real threat.
Avoidance Coping – The Reason Why Harm OCD Urges Feel Real
So far I only gave you an example of self-harm, but I also had obsessive thoughts of violent character directed towards others. At first, I saw no connection between these harm “urges.”
The only similarity between them was that they both felt incredibly real and disturbing. Eventually, I came across the term ‘avoidance coping’ while reading some articles online and started researching it more.
Wikipedia gives a perfect definition of what is avoidance coping:
In psychology, avoidance/avoidant coping or escape coping is a maladaptive coping mechanism characterized by the effort to avoid dealing with a stressor. Coping refers to behaviors that attempt to protect oneself from psychological damage.
In other words, it’s not the physical harm that you’re trying to avoid but the mental and emotional damage that it causes you.
Hmmm… It kind of doesn’t make sense now, or does it? For example, as I was running away from the train platform, wasn’t I afraid of jumping off the height?
The answer is – NO. It wasn’t the fact of jumping that made me afraid, it was the combination of two factors:
- High level of anxiety and sensitization;
- Extreme reaction to a thought.
Add to that combination avoidance coping and you get a perfect formula for any obsessive disorder.
Let’s take another example: as I was sitting in the kitchen, I felt an “urge” to stab my roommate with the knife. Obviously, this was the last thing I wanted to do, so once again a combination of high anxiety and extreme reaction made me escape the situation and hide all the knives later on to avoid this type of situation.
The reason why avoidance coping makes harm OCD feels real is that you start validating that “urge” physically, mentally and emotionally. Put it simply, OCD has you under full control.
Now let’s talk about the way out of this hell.
The Way Out of Harm OCD
Now we know that harm OCD urges are formed as a result of two factors – high anxiety and extreme reaction. We also know that they’re maintained by one behavior – avoidance coping.
Here is the solution: the way out of OCD is to reduce avoidances, which will gradually reduce your anxiety level and lessen the severity of your reaction to a triggering thought.
The Wikipedia definition of the coping mechanism gives good general treatment advice as well:
Alternatives to avoidance coping include modifying or eliminating the conditions that gave rise to the problem and changing the perception of an experience in a way that neutralizes the problem.
Here is a step-by-step of what I did in my own example of jumping off the train platform:
- I set a goal to go to that station every single day;
- My goal for each day was to stay a little longer on the platform starting from 15 seconds;
- I tracked and measured my success.
In less than a month I was able to feel comfortable being on the platform until the train arrived.
As for hiding the knives while in the kitchen with my roommate, I purposefully left them exposed and made an effort to stay with the discomfort without escaping. I approached it methodically as well and measured the amount of time after each attempt.
As you can see it doesn’t take much to end disturbing harm OCD urges. The only things you need are desire, determination, and patience.
Can I ever act on my harm OCD urges? No, the fact that you are concerned about even having them means that you have no desire or motivation to act on them.
What if it comes true if I think about it? Thoughts don’t materialize. If you don’t believe me try to bend a spoon with your thoughts. It takes effort to make something happen and there could be no effort without desire and motivation, which we already addressed in the previous question.
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