When Is It OCD?

It’s important to distinguish between OCD about maliciously hurting others and a truly high risk for causing harm. A person who is actually dangerous may have a history of assault and will feel a desire to hurt others. The person may try to resist those urges because of the likely consequences, but not because the idea of acting on the thoughts or urges is incredibly unsettling.People with MOCD usually say hurting someone else is the last thing they would want to do. Even thinking about the possibility is upsetting. To actually commit such a heinous act would be the worst thing imaginable. And yet the thoughts come back, over and over.

But How Do You Know for Sure You’re Not a Terrible Person?

I’m fully aware that trying to distinguish between these two categories, important as it is, will almost certainly feed the doubt in those who have this form of OCD. After all, how do I know I don’t want to hurt someone? And what if I don’t want to right now but then have a sudden urge that I act on without thinking? Or what if I just “lose it” and snap? What if I’ve been pretending all along to be “normal”?In fact, the quest to be 100% certain I won’t do what I’m afraid of is a big part of what makes it OCD. When it comes right down to it, it’s hard to be completely sure of anything. This uncertainty—or rather, the effort to eliminate uncertainty—is what fuels OCD. When we aim for certainty, OCD always holds the trump card. As we’ll discuss later on, beating OCD means refusing to play its game.

Myths About Malevolence OCD

As if having MOCD weren’t enough, there are unhelpful beliefs about it that compound the difficulty. The primary myth is that having this condition means that “deep down” the person really wants to do the thing s/he is afraid of. In fact, obsessions about harm used to be called “Aggressive” obsessions in the mental health community based on an old-fashioned understanding of the condition.In a related way, the general public often misunderstands MOCD, too. Most of the time when someone says she’s afraid of hurting people, we take these concerns seriously, especially in the current environment where we’re told, “See Something, Say Something.” If we don’t probe a little deeper we’ll miss the crucial point that the person doesn’t want or plan to act on the fears.I would trust an individual with MOCD to stand behind me on a train platform as a train arrives, to hold a knife near me, or to be around my kids. In reality, a person with MOCD is probably the last person who would hurt anyone.Which raises the question, if I don’t want to do these things, why do I think about them all the time?

Why Do I Have These Thoughts?

Often in MOCD a person will ask, “But if I don’t want to do it, why am I thinking about it so often? What kind of person does that?” As we’ll see is, the answer is: someone who doesn’t want to do anything wrong.Our brains are great at imagining things th...

Common Fears in Malevolence OCD

Obsessions about hurting others can take different forms. Stabbing someone with a knife is a common one, probably because knives are so readily available and the idea is so grisly. Others include:Again, the individual with OCD does not want to do these terrible things and is not at a greater risk than the average person for doing them. Nevertheless they might worry that they’ll change in some fundamental way, becoming a cold, callous, sadistic human being, even a “monster.”It’s important to mention that another form of Harm-related OCD can also be directed toward oneself: What if I commit suicide? What if I impulsively jump from a bridge? I don’t focus on this topic here because it’s nuanced enough that it deserves being addressed separately.

Common Compulsions in Malevolence OCD

The compulsions (or “rituals”) in MOCD are intended to prevent what the person is afraid of. They’ll generally involve trying to prevent the thoughts, trying to prevent the feared actions, and trying to make sure I’m not a bad person.One of the most ...

Consequences of Malevolence OCD

The real harm, of course, happens to the individual who has Malevolence OCD, and the fallout can be devastating. An aunt might avoid being around her nieces and nephews for years out of fear that she’s a child molester—and may avoid having kids of her own for the same reason. A man might never go out with friends because he’s afraid of assaulting one of them. Students might not go to class where they worry they’ll attack the professor.And of course the emotional toll can be severe. Imagine if you lived every day worried—maybe even convinced—that you were terribly dangerous or depraved. It’s common for OCD to lead to depression as a result of these self-condemning beliefs as well as the withdrawal from enjoyable activities and relationships. Tragically in some cases the person may even resort to suicide.

Treating Malevolence OCD

Thankfully there is highly effective treatment for MOCD in the form of exposure and response prevention, or ERP, a type of cognitive behavioral therapy. I’ve covered the basics of ERP elsewhere (see this post on my Psychology Today blog); here I’ll di...

Where to Find Help

I’ve had many requests for more information about how to find help for Malevolence OCD. The International OCD Foundation is an excellent starting place; check out their website.There are also several excellent books on OCD and effective treatment. Here are ...