Are your intrusive thoughts so intense or disturbing that they feel dangerous? You’re not alone. Harm OCD is when you have specific thoughts that you might hurt someone. You might think “I’m afraid I’m going to hurt my child”. Keep reading to learn the difference between intrusive thoughts and real desires, and why your brain targets the things you care most about.
Understanding Harm OCD and Intrusive Thoughts
“But what if I have dangerous intrusive thoughts?” This is the question someone asked after I published a video teaching an important skill for working with intrusive thoughts called cognitive defusion.
Cognitive defusion is the skill of taking annoying, repetitive, unhelpful thoughts and just creating a little space between you and your brain. You can thank your brain for the thought or just say, “There’s my word machine, making words again.”
“Great, great strategy, thanks Emma. But what if my thoughts tell me I might hurt someone else, or hurt myself, or assault someone? I mean sure maybe I could ignore a thought that says I’m a bad person, but I can’t ignore a thought that says, ‘What if someone comes in the kitchen while I’m making dinner and I stab them with this knife?’”
I think a lot of people wonder this, especially people with OCD. “What if my thoughts are different? What if mine are actually dangerous?” What if those thoughts are so threatening that you can’t just ignore them? This is harm OCD.
Do Intrusive Thoughts Mean I’m Dangerous? Here’s What the Science Says
You might ask, “What if I keep thinking about hurting someone?” or, “Does this thought mean I’m a danger to others?”
First off—if you’re having these kinds of thoughts, I want you to take a deep breath. Having a scary thought doesn’t mean you’re dangerous. It means you have a brain.
There are a ton of research studies with average people that have shown over and over that most people have intrusive thoughts—and by most people I mean around 94% of people experience intrusive thoughts at some point in their lives! These thoughts are usually unwanted, distressing, and often go against a person’s values or beliefs. They can range from violent or aggressive thoughts to sexual, blasphemous, or bizarre ideas.
So intrusive thoughts just mean that you have a brain.
And that brain? It’s designed to throw all sorts of random, weird, and even horrifying thoughts your way. Not because they’re true, but because they’re connected to what you value most.
Understanding Intrusive Thoughts and Why They Feel So Scary
There’s a key to understanding why intrusive thoughts feel so scary—intrusive thoughts tend to latch onto what matters most to you. If I had the intrusive thought, “What if I’m wearing orange pants?”, that thought wouldn’t feel very scary to me. I’d just laugh it off.
But if I had a thought like, “What if I hurt my baby?”, that thought is going to feel much scarier because it’s about something super important to me.
If you deeply value kindness, you might get intrusive thoughts about harming others. If you love your partner, you might get intrusive doubts about messing up your relationship. If you value being a good parent, you might have horrifying thoughts about hurting your child.
Your brain isn’t giving you these thoughts because they’re true. It’s because your brain is built to scan for danger and protect what you care about. And because these thoughts target your values, they feel extra sticky—like they must mean something about you. But thoughts aren’t evidence. A thought is just…a thought.
I talked about this with my good friend and OCD expert Dr. Kat Green. Here’s what she said.
Intrusive thoughts have this quality of increased thought action fusion. So there’s this idea that if I think it, it makes it more likely to happen, it makes it more real. This is why these thoughts like, “What if I hurt someone? What if I jump in front of a bus? What if I drive off this bridge?”, [this is why] all of those thoughts feel number one. That feels scary. This concept of thought action fusion, [is that] those sticky thoughts, [those] intrusive thoughts…carry some of this extra power. That if I think it, it makes it more likely that it will happen. If I say it, I’m just asking for it. And it’s
a really sneaky, effective way for thoughts to stick around because if they can stay so scary that you can’t see it, say it, do it, even think about it, they’re just gonna kick around, right? They’re like, “Yeah, I’m just gonna keep coming back because I’m so scary you can’t even approach me.“
So yes, intrusive thoughts feel dangerous, but you’re going to learn that just because you think something, doesn’t mean you’re going to act on it. The thought itself feels scary, but it isn’t dangerous.
Intrusive Thoughts vs. Genuine Desires: How to Tell the Difference
Now, let’s clear up one of the biggest fears: what’s the difference between an intrusive thought about hurting someone and a real desire to hurt someone?
Intrusive thoughts are:
- Unwanted: You don’t want these thoughts, and they usually come with a lot of anxiety and distress.
- Ego-dystonic: This means the thought goes against your values and who you are as a person. If you’re a person who never wants to hurt someone, the thought, “What if I hurt someone?” feels alarming.
- Reactive: You try to push the thought away, avoid it, or check to make sure it’s not true.
A real desire to hurt someone is completely different. It looks like:
- Wanting: There’s a desire or intention behind the thought. For example, “I would love to punch my boss in the face.”
- No anxiety: The thought doesn’t cause distress—it might even feel satisfying to think about.
- Planning: There’s a focus on how to carry out harmful actions, rather than fear and avoidance.
The very fact that you’re worried about these thoughts is strong evidence that they’re intrusive thoughts, not real desires. You’re afraid because these thoughts violate your values, not because they reflect them.
Harm OCD and the Fear of Acting on Dangerous Thoughts
Now there’s something I want to be super clear on, intrusive thoughts can feel extra sticky when you have OCD. Here’s what that might look like. Someone with OCD might look at the list above and start evaluating their thoughts. Maybe they’ve had a thought like, “What if I stab my husband while chopping vegetables?” They don’t want to stab their husband, they’re terrified that they might, so they realize, “Oh phew, that means this is an intrusive thought.” But then OCD says, “But what if it’s not?” OCD can make it very hard to feel certain, and it can take you down a rabbit hole of “What if” forever.
By the way, OCD will never let you solve this question. “What if I’m the exception? What if this time, my intrusive thought really comes true?” OCD literally is a brain difference where people just never feel 100% certain so they keep doing safety behaviors to try to magically prevent bad things from happening.
Safety Behaviors Fuel Intrusive Thoughts
Here’s the other essential thing to know about intrusive thoughts. There’s something you’re doing that actually makes intrusive thoughts so sticky. You’ve probably built up a huge set of habits around thoughts to try to keep yourself “safe” from them. Here’s what Dr. Green says about safety behaviors.
So for example, if you’re afraid, you have this intrusive thought, “What if I drop my baby on purpose?” I’ll see people do a lot of scanning and checking around “Am I holding [the baby] appropriately? Am I far enough from the stairs?” They’re checking their body, they’re checking their surroundings just to make sure. And they get that little bit of relief where their brain’s like, “Ooh, that was close.” And that feeling of “that was close” reinforces the whole idea that it was dangerous to begin with. “All right, that was close. Who knows what I would have done if I hadn’t checked it?”
If we take a look at the anxiety cycle, you’ll see that when we avoid something that feels scary, we feel a sense of relief. That relief tells our brain, “Phew, I survived! Good thing I avoided that dangerous thing.” And your brain thinks, “I kept us safe. I’d better make my human do that again.” So the brain increases our anxiety around that thing, and that intrusive thought feels scarier and scarier.
Whenever we do something to avoid a scary thought, that’s called a safety behavior. And it’s safety behaviors that send a message to your brain that the thought itself is actually dangerous.
Common safety behaviors include:
- Avoidance, distraction
- Scanning: “Is that thought back?”; “Am I too close to the stairs?”
- Checking: “Am I holding the knife safely?”
- Reassurance seeking: “Are you sure I won’t hurt the baby?”
Intrusive Thoughts Aren’t Dangerous — Avoidance Is
The problem is that safety behaviors keep your brain from learning that the thought isn’t dangerous. I’ll say it again. Thoughts aren’t dangerous. You can have them. They might feel uncomfortable, but an intrusive thought doesn’t hurt anyone. It’s the safety behaviors, taking little actions to control those intrusive thoughts, that tell your brain, “This thought is actually dangerous.”
We can’t logic our way out of intrusive thoughts. That’s actually what keeps us stuck in OCD. Instead you can show your brain that thoughts can’t actually hurt you. Yes, they can make you feel emotions, but emotions also can’t actually hurt you. The way we show our brain that these thoughts aren’t dangerous is by approaching them instead of avoiding them. Avoidance fuels intrusive thoughts and approaching them quiets them.
They may feel uncomfortable, but when you learn to make space for them, you’re actually going to increase your capacity to feel them and be okay.
ERP for Intrusive Thoughts and Harm OCD
OK, so now that we understand intrusive thoughts—most people have them, they’re not actually dangerous, they don’t mean anything about you, and safety behaviors are what’s keeping them sticky—what can we do about them?
In therapy, with a skilled therapist, you would practice exposure response prevention (ERP) where you would intentionally bring up the thought, allow it to be there, and learn through experience that just because you think something doesn’t mean you’ll act on it.
For example, you might have the intrusive thought, “What if I stab someone while I’m cutting vegetables with this knife?”, and you’ve built up all these safety behaviors in response to that thought, like not being in the kitchen with someone else, or holding the knife in a specific way, or not using knives any more. Dr. Green’s recommendation is to say the following:
“I’m not one-hundred percent sure, but I think that’s an intrusive thought. So, I’m not going to follow it right away.” Then you start introducing delays and listening to it. … You’re saying, “How would I want to live this moment? If I didn’t have this really annoying, bossy part of my brain threatening destruction all the time, [what would I do?]” And what you’re trying to do is get yourself closer. [You’re] taking little steps to get closer to the life you want to be living, how you would live that moment if you weren’t following all the rules of the specific intrusive thought. Where you’re like, “Well, if I wasn’t worried about stabbing my partner, I would be in the kitchen. I would turn on music while I worked.” You’re trying to break down small ways to approach it. Even just writing it down. Again, you think about that thought action fusion, writing the exact same sentence over and over again can actually be really helpful. Because at first it seems so scary. And then over time you’re like, “My hand hurts.” [The brain] is not able to maintain the same panic.”
In therapy, your therapist might have you work with a knife—yes, a real knife. She migh be in the room with you and practice various settings where you would use the knife, carry the knife, walk around the therapy office with a knife—all while having the thought, “What if I hurt someone?” Pretty soon you’ll get better at noticing that you CAN have the thought without taking any action. And your brain will learn through experience that the thought is just a thought. Your thought isn’t actually dangerous.
3 Self-Help Strategies for Scary Intrusive Thoughts
“Okay, so what do we actually do with these thoughts?”
When you’re not in a therapist’s office, I want you to practice this:
1. Notice the Thought
Step one, notice the thought. Say, “Oh, there’s that scary thought again.” You could say, “Thanks brain. You sure are pumping out a lot of thoughts today.” And you could remind yourself, “This is just a thought—it doesn’t mean anything about me.”
Now, I know you might be thinking, “But this thought feels so real! It must mean something!”
This is where we bring in a skill from Acceptance and Commitment Therapy (ACT) called defusion. Defusion is all about creating space between you and your thoughts so you can see them for what they are: just words or images in your mind; not truths you have to obey.
Try this:
Instead of saying, “What if I hurt someone?”
Say, “I’m having the thought that I might hurt someone.”
Instead of saying, “This thought means I’m dangerous.”
Say, “I’m noticing my brain offering the thought that I’m dangerous.”
Can you feel the difference? We’re stepping back and noticing the thought instead of fusing with it. That little shift can help loosen its grip.
2. Allow the Thought, Delay It
Step two, allow it, delay it. Picture it like a bad radio station playing in the background. You don’t have to fight it or even turn it off. Just let it play.
You’re going to have an urge to do some kind of avoidance or safety behavior here. You might feel like avoiding holding your child or cutting vegetables, or you might seek reassurance from your partner. Just start by delaying that impulse. Allow the thought to be there without trying to make it go away.
3. Get On with Your Life and Your Values
Step three, get on with your life. The goal isn’t to get rid of the thought. Instead, you show your brain, through experience, that you don’t have to react to these intrusive thoughts. Instead of fighting your thoughts, you’ve got to shift your attention to the things you actually care about.
If you haven’t done a values clarification exercise, now might be a good time to do one. What is most important to you? What leads to a rich and meaningful life for you? Is it spending time with your family? Is it making art, or researching microbes? Whatever is more important to you than arguing with your thoughts will do.
You notice the thought, allow it to be there, and shift your attention back to what you care about.
Scary Intrusive Thoughts Can Lose Their Power
And over time, as you stop fueling the fire, these thoughts lose their power. They might still pop up, but they won’t own you anymore because you’re showing your brain that these thoughts just aren’t that important. And then your brain will naturally decrease your anxiety around these thoughts and they’ll start to get quieter.
Live by Your Values, Not Your Intrusive Thoughts
So, instead of trying to figure out why you’re having this thought, try asking yourself, “What kind of person do I want to be, even with this thought in my head?”
And then go live your life, knowing that your thoughts don’t define you—your actions do.
Taking Charge of Intrusive Thoughts
Dr. Kat Green, whom I’ve quoted in this post, is an OCD specialist. She and I built an online course to help you regain control of your life through simple skills. Learn from a professional how to handle intrusive thoughts, and bring a sense of confidence and calm back into your life. Click the link below to learn more.
