Obsessions are thoughts that cause anxiety, are intrusive and disturbing (Goodman et al., 2014). Obsessions in Harm OCD may take many forms. They may take the form of a thought. Thoughts could be in the form of doubts or questions. For example, ‘What if I want to hurt my teacher?’ or ‘Am I an evil person?’ OCD is called a ‘what-if’ disorder because there are many thoughts or fears in OCD that start with a ‘what-if’. ‘What if I am really like the villain in the movie?’ ‘What if I have been hiding my evil nature all this while?’ ‘What if I suddenly lose control and stab my dog?’ OCD is also called a doubting disorder and doubting is a standard feature of OCD. Any doubts regarding the relationship may be obsessions. For example, ‘I doubt if I am a good person.’ Or, ‘I doubt if I will be able to resist the urge to hurt people’ Or, ‘Do I have the good sense and willpower to resist my harm urges?

Obsessive thoughts may take the form of definite statements. For example, the obsession could be ‘I am evil’ or ’I should be punished.’ When definite statements become obsessive, people have a hard time as they believe them to be real thoughts. But they are still obsessions, because they cause distress. If you were a bad person and really wanted to cause harm, it would not cause you anxiety.

Obsessions may be in the form of still or moving images. You may be bothered by recurrent images of hurting people, blood, weapons and so on. Or, you may be bothered by images of being punished for your actions.

Obsessions may be in the form of dreams. Like all other obsessions, you do not have control over your dreams either. Thus, intrusive thoughts may make themselves visible in your dreams. You may begin to feel that your dreams indicate your real intention since dreams are considered to be a reflection of your innermost desires, but they are still obsessions and should be treated as such.

Obsessions may be in the form of urges or impulses. For example, you may get the urge to break a bottle on your mother’s head. Or, you may get the urge to push a person out of a moving train. 

Obsessions are not to be confused with normal day-to-day worrying. Obsessions are consuming, take up a lot of your productive time, may be sticky, and may bring about distressing emotions like anxiety, guilt, jealousy, hatred, or shame. If you are able to dismiss the thought that you may hurt someone, it is not an obsession. If, however, the thoughts cause distress that you cannot handle without compulsive rituals, they are obsessions.

Obsessions also seem real. They do not feel like thoughts that have been thrust upon you. They feel as if they are your own thoughts; as if you want them. You question yourself that if they were not real why would you get them? Yet, you also know that you do not want them. Otherwise, you would not be struggling so much to get rid of them. There would be no Harm OCD.

Obsessions outlined in the Y-BOCS symptom checklist (Goodman et al., 1989 a, b) have been provided in Additional Resource 3.5. Read through them to identify if any of them seem similar to what you experience. Using Additional Resource 3.5 and earlier worksheets (1.5 and 3.4) write down your obsessions in Worksheet 3.5.

First, write down the name of your Harm OCD (such as Jay) in the space provided. Next make a list of all your obsessions. Observe your behavior and identify what your obsessions are. Then convert your obsessions into statements beginning with ‘Jay is telling me’, or ‘Jay is asking me to’. Complete this exercise before moving to the next chapter.

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