Thursday, January 31, 2013

Harm OCD - A Terrible Mysterious Secret




Mom's Thoughts:

There is nothing more horrible and heart-wrenching than seeing your own child in pain - real, agonizing pain - and not being able to do anything about it.  And not being able to understand it.  I'm sure people whose children have cancer or some other horrible disease know how this feels.  You suddenly become obsessed with finding out everything you can about the disease and how to treat it or cure it if you can.  The fact-finding is a bit of a salve - it makes you feel better to know more about what you are dealing with - but is a bit like putting a band-aid on a severed limb when you are in the throes of dealing with your child's pain. 

Elizabeth has several types of OCD - kind of a cruel trick of OCD's, really, that you can have more than one kind, and the way they manifest can change suddenly.  And I can't say that one kind is more painful or cruel than another.  Is a handwashing compulsion "better" than a checking or cleaning compulsion?  They are equally painful.  But a lesser-known type, Harm OCD, is harder for me to wrap my head around, and just seems particularly cruel punishment for its victim.  That's just my opinion, but I really think that.  It's a particularly terrible secret that a person with OCD thinks she has to keep, and it's so mysterious and hard to understand that it seems incomprehensible.

You never hear about people suffering from this, and it's easy to understand why:  these poor men, women and children think they are crazy, dangerous, and oh boy, you better not tell anyone what you are thinking!  I've found a new blog from the OCD Center of Los Angeles that has helped me understand this a bit better, and I am dying to share it, even before I've really even finished the entire thing.  Here's an excerpt from that website describing Harm OCD - the link to the entire article is at the bottom of this page:

Harm OCD is a manifestation of Obsessive Compulsive Disorder (OCD) in which an individual experiences intrusive, unwanted, distressing thoughts of causing harm. These thoughts are perceived as being ego-dystonic, which simply means that the thoughts are inconsistent with the individual’s values, beliefs and sense of self. Harming obsessions typically center around the belief that one must be absolutely certain that they are in control at all times in order to ensure that they are not responsible for a violent or otherwise fatal act.... (underscore is my addition)

What sets Harm OCD apart is the way in which it attacks the things we love the most, and does so with such brutality and lack of mercy as to astound even the most creative minds. The moments that we most want to be highlighted by memories of peace and contentment suddenly become contaminated by mental imagery of horrific violence and feelings of relentless guilt.

I feel a sense of relief when I read this, because I know so purely and completely that there are few people in the world as kind-hearted as my Elizabeth.  She loves children and animals and is amazing to watch when she interacts with them.  She is a hard-working, conscientious person who always tries her hardest to do what is right.  She volunteers her time, helps others without a second thought, and is so averse to mean-spiritedness that she has never been able even to watch America's Funniest Home Videos, saying it's just too mean.  She hates seeing others take pleasure in someone else's misfortune or pain, and has even served on the Anti-Bullying Committee at her school as a peer leader and attending workshops on how to help others if you observe bullying going on.  

So how in the world is SHE the one struck with this type of OCD?  I can imagine some strange, depressed, goth kind of person being prone to this type of violent thought, right?  Isn't that how it works?  No, apparently not.  In fact, Harm OCD typically afflicts people who are so horrified and guilt-ridden about their thoughts that they are highly distressed.  Many people have strange thoughts of doing something to hurt another person - things they would never, ever do - but are able to shake them out of their minds and move on with their day.  People with Harm OCD can't shake them out of their minds; they review them over and over, analyzing their responses, feeling crushing guilt and fear that they would actually do the things they have envisioned.  However, people with this kind of OCD are no more a danger to others or themselves than any "normal" person.  They are just afraid they are.  In Elizabeth's case, they generate panic attacks, making it even more difficult for her to calm down.

Harm OCD can manifest through fears of hurting others, or of hurting yourself.  Or both.  Elizabeth recently has been obsessing about hurting herself, which is very distressing to her father and me, as well as to her.  When she is suffering through an "attack," she thinks she "wants" to hurt herself - more to stop herself from "being crazy" than anything.  She wants to stop the pain in her head by causing pain to herself - you know, the old "if you want to stop thinking about the pain in your toe, hit yourself over the head with a hammer" mentality.  But she really doesn't want to hurt herself... this is the child that was so afraid of getting hurt that it took her forever to learn how to ride a bike.  But it's a testament to how much pain she's in mentally.  This is what makes me want to get rid of OCD more than anything!!  

It is fairly easy to see what the obsession is, but what about the compulsion?  According to the OCD Center of Los Angeles, Harm OCD is sometimes called "Pure O" - as if there is no compulsion associated with it, just obsessions.  This is not true.  People with Harm OCD have many kinds of compulsions, and I see some of them in Elizabeth.  Some of the compulsions are, checking (to be sure you haven't actually hurt someone or yourself,) avoidance (avoiding places, being alone with people, knives, etc.,) reassurance seeking (asking others for reassurance that you are not a bad person, haven't done anything bad, etc.,) and mental rituals (compulsive praying, mental checking or reviewing thoughts or memories to be sure you haven't done anything, thought neutralization, etc.)  You can learn more about this on the blog I linked below.)

IF YOU SUFFER FROM HARM OCD, YOU ARE NOT CRAZY!!  It IS treatable with Cognitive Behavior Therapy!  Be sure to find a specialist in CBT for people with OCD.  Do not seek help from someone who does not do a form of CBT!!

Treatment of Harm OCD

As with other forms of OCD, it is important that the sufferer seek treatment with a psychotherapist who specializes in Cognitive Behavioral Therapy (CBT) specifically for the treatment of OCD. The primary CBT technique used in treating Harm OCD is the same as that used in treating other types of OCD, and is called Exposure and Response Prevention (ERP). Unfortunately, many individuals with harming obsessions seek out traditional talk therapy or psychodynamic therapy, both of which can swiftly worsen a Harm OCD sufferer’s condition by encouraging them to further examine these meaningless thoughts, which only serves to unnecessarily inflate their importance.

OK, that is all for today.  If you'd like to learn more, please visit the blog website of the OCD Center of Los Angeles:

http://www.ocdla.com/blog/harm-ocd-1-1488




No comments:

Post a Comment