OCD is a complicated disorder and some subtypes have interlinkages that are important to understand. Even with Harm OCD, some subtypes of OCD do have overlaps as we shall see below.
The first presentation that has an overlap with Harm OCD is one of the layers – False Memory OCD (FMO). In FMO with Harm OCD, the fear is not about causing harm or death in the future, but a strong suspicion that the horrible deed has already been done in the past. Everything remains the same except the feeling that you already are a psychopath or murderer. That your crime has not yet been discovered and that some underserving person may be lying dead and undiscovered somewhere due to your fault. You may try to ‘remember’ the details to confirm your fear and when you do not remember the details clearly (because they do not exist), you may feel anxious. As mentioned in S1C5, FMO is not a different presentation, but a layer on any existing presentation. So, FMO may appear in presentations other than Harm OCD as well. The description of FMO provided here is specific to Harm OCD.
The second presentation that has an overlap with Harm OCD is the other layer – Magical Thinking OCD (MTO). In MTO, the link between cause and effect seems to get impaired and you may link unrelated things through your obsessions. For example, you may get an obsession that if you do not do some ritual like switching the fan on and off a specific number of times, you may cause some loved one’s death. Again, this is a layer and not a separate presentation, and therefore can appear in other presentations of OCD as well. This example is specific to Harm OCD.
There are other presentations of OCD that have death anxiety or harm anxiety as well such as contamination, and checking. So, if there are some shades of Harm OCD in the other obsessions you experience, please make a note of them too. Based on this information, discuss with your family what symptoms of Harm OCD you experience and fill in the same information in Worksheet 1.5.