Harm OCD Care in California

• “What if I stab someone while cooking?”
• “What if I snap and push someone in front of a train?”
• “What if I lose control and hurt my partner or my child?”

• “What if I hit someone while driving and didn’t notice?”
• “What if I left the stove on and caused a fire?”
• “What if I contaminated something and made someone sick?”

These are fears of accidentally hurting yourself, not suicidal intent:

• “What if I jump off this balcony without meaning to?”
• “What if I swerve on the freeway?”
• “What if I use a kitchen knife on myself by accident?”

(If someone is experiencing active suicidal intent, that is a separate clinical issue—not OCD—and requires immediate attention.)

• Reassurance-seeking (“Would I ever do this? Does this mean I’m dangerous?”)
• Rumination, analysis, mental reviewing
• Checking emotional responses (“Did I want that thought?”)

• Avoiding knives, driving, holding their baby, or being alone with loved ones
• Repeatedly checking locks, appliances, and surroundings
• Seeking reassurance from partners, therapists, or online communities

• Suppressing thoughts
• Trying to “think good thoughts”
• Avoiding certain rooms, places, or situations

You’re more likely to be dealing with Harm OCD if:

• The thoughts feel repulsive, not aligned with your values
• They cause panic, guilt, fear, or disgust
• You spend time analyzing, checking, or seeking reassurance
• You avoid situations or objects you believe could make you act
• You fear being alone with children, partners, or clients
• You fear “snapping,” “losing control,” or “becoming violent” despite no history of violence

Harm OCD can affect anyone, at any age. Many of my clients describe:

• Feeling terrified they’re “a bad person”
• Avoiding loved ones due to fear of losing control
• Feeling ashamed of intrusive thoughts
• Worrying about becoming a risk, even with no history of violence

Exposure and Response Prevention (ERP) is the gold-standard, evidence-based treatment for OCD, recommended by the APA and International OCD Foundation. ERP helps by:

• Teaching you to allow intrusive thoughts without reacting to them
• Reducing fear and urgency around “dangerous” thoughts
• Stopping compulsions so the brain learns the thought is not a threat
• Rebuilding confidence in your ability to tolerate uncertainty
   

Examples of ERP exercises for Harm OCD may include:

• Holding a kitchen knife while cooking normally
• Driving without checking mirrors repeatedly
• Writing out feared thoughts and practicing non-engagement
• Being around loved ones without reassurance rituals
   

ERP is done gradually, collaboratively, and always at a pace that feels workable.