I'm going to quote things here that say it far better than I could. The OCD Centre of Los Angeles put it like this:
'Harm OCD is a manifestation of Obsessive Compulsive Disorder (OCD) in which an individual experiences intrusive, unwanted, distressing thoughts of causing harm. These harming thoughts are perceived as being ego-dystonic, which simply means that the thoughts are inconsistent with the individual’s values, beliefs and sense of self. Harming obsessions typically center around the belief that one must be absolutely certain that they are in control at all times in order to ensure that they are not responsible for a violent or otherwise fatal act.'
How do I experience this day to day?
I'll use the example of a walking group I used to lead. All we had to do was meet at our office and go on a half hour walk. What could possibly go wrong? And what could that possibly have to do with people drowning or dying? I hope you've lost me now and think.... huh? What have those horrible things got to do with anything? If I haven't lost you then you're one of my people!... We're the ones with overactive 'harm-alarms'.... we suffer from Harm OCD.
I'll try to explain. When my husband or therapist, and I suppose people who don't have Harm OCD, think of taking out a group on a walk they think... 'I hope its a nice day' or 'I'm looking forward to being out by the river'. There may be some anxieties but these would hopefully not interfere with their normal life in the lead up to the day. Unfortunately my brain, along with other sufferers, doesn't process things like that.
I become aware of my own voice telling me, 'I'm responsible for their safety, if anything happens to them it will be my fault, you don't want to be locked up do you? Better make sure you keep everyone safe then! You can't miss any risks, someone will die and you'll know it was because of you.' It's is like there's another me and it keeps tapping me on my shoulder and it's obsessed with preventing others from being hurt. It likes to show it to me on a big screen too, showing the imagined harm happening. This is really upsetting.
The thoughts and images are accompanied by safety behaviours or compulsions. In this case I had to count people almost constantly during the walk making it really difficult to have conversations and I had to ask people to stay away from the water every five minutes, much to their annoyance. I also thought of avoiding it all together, as I became so convinced someone was only moments away from harm. The week afterwards I had to find discrete ways to check if everyone was still alive, in case I'd accidentally allowed them to get lost on the walk and they hadn't returned home. That was really embarrassing. I had to also ask for constant reassurance from my husband that the walk would be ok, and living with my daily fear and distress in the days before was debilitating to us both.
The OCD Centre of Los Angeles also say this:
'It is not fair to say that one form of OCD causes more pain than another. In our experience of treating individuals with OCD, those with compulsive hand washing appear to be in no less pain than those who live in fear of being sexual deviants or psychopaths. What sets Harm OCD apart is the way in which it attacks the things we love the most, and does so with such brutality and lack of mercy as to astound even the most creative minds. The moments that we most want to be highlighted by memories of peace and contentment suddenly become contaminated by mental imagery of horrific violence and feelings of relentless guilt.'
This is exactly it. I hope one day to become a mum, but I worry my baby will hurt itself and it will be my fault. This sort of worry is normal but in OCD its obsessive and relentless - its intrusive images and obsessive fear and its disordered because it prevents you from living a normal life. Instead of day dreaming about cuddles or baby's first steps, for Harm OCD sufferers its more likely to be baby's first trip, fall or choke. It's constantly obsessing over safety to make sure you don't inadvertently harm someone, and it attacks the things most important to you.
If you'd like to know more about the kinds of thoughts and obsessions that characterise Harm OCD then there's a really good questionnaire from the OCD Centre of Los Angeles to help you identify the extent of the illness and understand more about its nature http://ocdla.com/harm-ocd-test.
So how can we deal with this illness?
I don't know yet...sorry!.... well I don't have all the answers. I'm still in treatment, but, here's a few things that have helped me so far:
1. I identified the problem and told someone
Part of the problem with Harm OCD is that its hard to tell anyone. You're so ill that you are sure you must be reckless or dangerous and you feel incredibly ashamed. The first step on a long recovery was telling my husband and my GP. I now go to an expert therapist, I've got a support group and I've found some people I can talk to about it (and I have my blog!).
2. I temporarily stopped being in situations my anxiety was too high for
When I hit breaking point it had become so bad that I simply couldn't function on my University course anymore. It was tough to step back, I had no job or course and I started medication and therapy. But it was what I needed. You can get back to these things, but sometimes you have to stop life for a bit and get help. Just like any physical illness we go into hospital for, we need treatment for mental illness too. I'm now back at work and I lead a pretty normal life.... I just spend a lot of time in therapy, I run a support group for anxiety and OCD and I spend a lot of time learning self-help techniques, but I am getting better... slowly.
3. I went back to face triggering situations in a graded way with professional help and I volunteer a lot
When I was out of work I used voluntary work as a way of building up my confidence again and I still use it now. When I'm volunteering I'm helping others and myself, and that gives me a great self-esteem boost. There is also less pressure. I can face a triggering situation and its much less daunting to ask for help or step back than it is in the workplace.
4. Do more of the things your OCD doesn't attack
Running my support group isn't something that everyone would feel confident to do. When I've told people about it they've asked whether I worry about various things? And the truth is I don't. It's something I just don't have obsessional problems with. So I focus on this, on my skills and the confidence I have. I try to use CBT and Mindfulness to look at how I can challenge my OCD using this confidence.
5. Finding a support group, a therapist and self-help
I've been lucky enough to have had excellent treatment using Exposure Response Prevention (ERP), Cognitive Behavioural Therapy (CBT), Mindfulness-based CBT and psychodynamic techniques, and in the last 4 years I have had quite a lot of success in doing the things that trigger my OCD. I had to find private treatment because the NHS doesn't offer the kind of help I needed to get better. Therapy isn't for everyone, but I couldn't have recovered without it. So I would encourage you to explore whats out there, even if the NHS coverage is patchy, there are often private options at a range of prices.
Support groups can be a really great place to share your experiences and can help you feel less isolated and alone. Again, not for everyone, but worth seeing whats around. With my group I totally respect if its not right for people and I'm more than comfortable for people to come along for just one session, and if its not for them, then no problem.
I'm trying this self-help book at the moment for my OCD The Mindfulness Workbook for OCD and I'm finding it really make sense to me. There are lots of online resources, books and audiobooks now that address OCD with a variety of physiological approaches. Again, its worth trying to see if any of them might appeal to you. Do a Google search now or pop along to your local Library... there might just be some answers there.
That's all for now!
I've been lucky enough to have had excellent treatment using Exposure Response Prevention (ERP), Cognitive Behavioural Therapy (CBT), Mindfulness-based CBT and psychodynamic techniques, and in the last 4 years I have had quite a lot of success in doing the things that trigger my OCD. I had to find private treatment because the NHS doesn't offer the kind of help I needed to get better. Therapy isn't for everyone, but I couldn't have recovered without it. So I would encourage you to explore whats out there, even if the NHS coverage is patchy, there are often private options at a range of prices.
Support groups can be a really great place to share your experiences and can help you feel less isolated and alone. Again, not for everyone, but worth seeing whats around. With my group I totally respect if its not right for people and I'm more than comfortable for people to come along for just one session, and if its not for them, then no problem.
I'm trying this self-help book at the moment for my OCD The Mindfulness Workbook for OCD and I'm finding it really make sense to me. There are lots of online resources, books and audiobooks now that address OCD with a variety of physiological approaches. Again, its worth trying to see if any of them might appeal to you. Do a Google search now or pop along to your local Library... there might just be some answers there.
That's all for now!
Compassionista xxx
P.S. I must stress that these are my own personal tips and experiences. I am not a trained medical professional and these ideas wouldn't suit everyone. If you are concerned about any emotions, feelings or symptoms your experiencing, please seek the advice of a trained medical professional as soon as possible.
