About Obsessive-Compulsive Disorder

Aggressive and Violent Obsessions in OCD

People with OCD often worry that they will cause harm by impulsively hurting someone just because they can. People with these thoughts typically have no history of violence, nor do they act on their urges or impulses. However, people with OCD often appraise their thoughts as dangerous and overly important, so when a random thought involving harm enters the person's mind, the OCD sufferer begins to worry. They often believe that having such a thought is as bad as performing the action, thus they devote a large amount of their mental effort to attempts to suppress the thoughts. Conversely, this only serves to increase anxiety and perpetuate symptoms. Below are some common fears.

Common types of aggressive and violent obsessions:

• Harming others impulsively
• Violent and horrific mental images
• Doing something shocking or embarrassing

Harming others impulsively

One of the most upsetting types of aggressive obsessions concern worries that a person may cause harm to others impulsively. For example, the person may fear that they will punch a friend, when they are not angry, but just because they can. They may be concerned that they might push an elderly person into subway tracks or push a child into oncoming traffic. Another common fear is that the person might use stab a loved one while using a kitchen knife. The focal point of these worries is usually loved ones, but can be strangers or pets. Sometimes the person is not worried about harming others, but worries about harming him or herself, which is not to be confused with suicidal ideation as people with these types of fears will do anything to avoid causing the harm they worry about.

A person without OCD might be standing behind a loved one at say the Grand Canyon, and randomly get a thought of pushing the loved one over the edge. They would never do it or have a desire to do it, so they might just chuckle inwardly and think what a silly thought. Or they might even shiver for a second with discomfort. But, most people would realize this was just a random thought that jumped into their head and had no significance. We all have weird thoughts from time to time. A person with harming obsessions would probably latch onto this thought and do compulsion after compulsion in response to make the worry go away. Also, if a person is afraid of thinking something, then they are more likely to think it. So, if you're always worrying about accidentally harming someone, or harming someone because you're worried you will lose control and do so, you see a person standing at the edge of a cliff, your mind is probably more likely to have a thought of pushing them in. The OCD might even just worry that it's going to have the thought and not actually have it. The person would be doing mental compulsions over and over reassuring themselves that they didn't have the thought, or weren't going to, or if they did, they didn't mean and here's why, etc.

Violent and horrific mental images

Violent or horrific images may pop into the person's head unprovoked. They might see themselves pushing someone in front of a moving subway train, kicking a dog, screaming in church, or jumping out of a moving car. Someone may close their eyes and see themselves harming other people, including loved ones. For example, a new mother might get a sudden image of throwing her baby off a balcony to its death or squeezing the infant too tightly and breaking its neck. Images may not include any actions from the person with OCD, but include thigs like mutilated bodies from a war zone, cemeteries from a horror movie, or upsetting things that are just bizarre.

Doing something shocking or embarrassing

Also falling into this category of obsessions is a fear doing shocking or embarrassing things. An example of this might be a fear of swearing by accident, blurting out obscenities or insulting someone on purpose. For instance, the person might be sitting in church, and worry they are going to scream out a swear word. The person would not do this, nor do they want to, but the OCD tells them they might or maybe they did and did not realize. This is not too be confused with something like Tic Disorders or Tourette Syndrome.

This may manifest itself in a fear of doing something embarrassing, like doing a task wrong to let everyone down, forgetting the words in a speech, writing something incorrectly in an email. Many people are afraid of public speaking, but for a person with OCD the reason for that might be different if they have this form of obsessions. They may be trembling with anxiety, but it could be because they are terrified they will forget their words, blurt out a swear word or that they killed a person (not true), or maybe they even worry that there will be a hole in their clothes and a private area might be showing. A normal person may worry that their speech will fall flat or that they might forget something, but this anxiety manifests itself differently. Unless the person has social phobia (which actually is often comorbid with OCD), in which case the anxiety may be even more debilitating, an OCDer with these fears might obsess for weeks in advance of a big event like this.

The person with this form of OCD might also have a fear of doing something non violent but illegal. For example, they might worry that they will accidentally steal something, and come home with a pocket full of stolen goods. They might even worry that they will look wrong at the security guard in a department store, who will then suspect of them of being a thief.

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Scientific References

Çili, S., & Stopa, L. (2015). Intrusive Mental Imagery in Psychological Disorders: Is the Self the Key to Understanding Maintenance? Frontiers in Psychiatry, 6, 103.