![]() ![]() One that would be linked would be repetitively checking the air pressure in the car tires to alleviate the fear of someone’s tire blowing out on the freeway and killing them. These compulsions are sometimes thematically linked to the obsession in some way, but not always. You described a really common loop in OCD, where you have an obsessive thought (in your case, that your loved ones might be harmed) and then your brain tries to seek reassurance or reduce the stress and tension caused by this thought through engaging in some sort of compulsive behavior. It’s a tricky issue and a lot of therapists aren’t going to be super well-equipped to help you deal with this unless they actually specialize in treating OCD. I would also ask whether you are s eeing someone who is trained in treating OCD. But if it’s possible for you to get weekly therapy, that would likely be even better. There are obviously questions of access to treatment, insurance, etc. With the amount of concern that you have, it strikes me that twice-monthly therapy may be a little sparse. It seems like you have a lot of awareness about your patterns already, which is great and I’m proud of you for getting some treatment. The reason you are so concerned about them and that they freak you out enough to get treatment is that they are inconsistent with who you are. They do NOT mean that you have a desire to harm your family buried deep down in there. The reason I’m trying to be clear about this distinction is that you need to remember that these obsessive thoughts are unwelcome intrusions. ![]() In this way, a lot of people with intrusive thoughts from OCD are freaked out and scared by their thoughts because they feel like they are going crazy, whereas someone who is delusional may fully stand behind their thought patterns regardless of how separated from reality they are. They crash into your mind and are unwelcome. In OCD, the thoughts are not consistent with you as a person. Now, this is a little different from the obsessive thoughts that come along with OCD. This is your reality, which is why it’s so hard to cope with delusions without the help of medication. Delusional thoughts are interesting because they are consistent with your view of yourself. For instance, you might have a delusion that your food is being poisoned or you might have the delusion that you are involved in an important organization like the FBI. These are thoughts that are not congruent with reality, but you believe them. In schizophrenia or other forms of psychosis, you have what are called delusional thoughts. To start, let’s talk about how thoughts in OCD work vs another disorder like schizophrenia. So, I totally understand why you would want to figure out a way to reduce these thoughts. Fears of harming others are extremely common in individuals with OCD. First off, I want to say that you are not crazy and you are not alone in this. I just wanted to hear your thoughts on this and if there’s any way to separate my fears from reality. I started taking medication 2 months ago as well. I started therapy a few months ago but only have appointments maybe twice a month. I feel almost powerless to that fear even if that side of me doesn’t exist. Recently I’ve been having this strange feeling that in any moment my “true” self will emerge and hurt the ones I love. I perform compulsions to ensure nothing bad happens to them, and if it does then I carry extreme blame and guilt. My biggest fear is harm of my friends and family. I have OCD, specifically rumination and intrusive thoughts. I’ve been listening to your podcast for a while, and I think you give great advice with accompanying ways to cope. In this post, I discuss the topics of OCD and intrusive thoughts and offer my thoughts on what you can do to help combat unhelpful ruminations such as this. ![]() In episode 290, I received a question from a listener who has OCD and struggles with intrusive thoughts particularly related to the worry of harm coming to their family and friends. ![]()
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