Self-Harm OCD

Obsessive-compulsive disorder is a mental health struggle characterised by intrusive thoughts and ritualistic compulsions. This can manifest in many ways, including compulsive cleaning, organizing, avoidance, and in 7% of cases, self-harm.

The intrusive thoughts associated with OCD can range from annoying to extremely distressing. In the case of self-harm-centered OCD, it’s often the latter.

In this article, we’ll cover everything you need to know about self-harm OCD, including:

• What it is
• What causes it
• Signs you may be experiencing it
• It versus non-suicidal self-injury
• How it’s treated

How is OCD and Self-Harm Related?

Obsessive-compulsive disorder (OCD) is marked by uncontrolled, recurrent intrusive thoughts and repetitive behaviors.

Self-harm OCD occurs when the intrusive thoughts are about causing harm to oneself. These thoughts cause anxiety over the fear of self-harming and may lead people to self-harm.

These thoughts sound a lot like:

• “What if I lose control of myself and hurt myself?”
• “What if I want to hurt myself?”
• “What if I use this to hurt myself?”
• “Do these thoughts mean I want to hurt myself?”

These disturbing thoughts are often accompanied by disturbing images of self-harm. These cause anxiety and compulsions to either engage in self-harm or avoid situations with a perceived danger of self-harm.

Related Resources: Is Self-Harm an Addiction

What Causes Self-Harm OCD?

We don’t know exactly what causes self-harm OCD, but we do know why people with it don’t typically harm themselves. 

The intrusive thoughts of any form of OCD are distressing. This is because they go against personal values, beliefs, and goals. 

Ego-Dystonic Thoughts vs Ego-Syntonic Thoughts

Ego-dystonic thoughts are closely associated with self-harm OCD.

They're thoughts and behaviors that are inconsistent with personal beliefs and values. This includes intrusive thoughts and compulsive behaviors. You may love taking care of plants, but during a depressive episode, you stop caring for them. You might be a gentle and kind person, but your anxiety response is to be snappy and mean to friends. These are ego-dystonic behaviors.

Ego-syntonic behaviors and thoughts align with personal values, beliefs, and goals. There’s not nearly as much guilt associated with them, and they’re consistent with self-image. These are more closely associated with non-OCD related self-harm.

It’s important to know that everyone will experience ego-dystonic thoughts and behaviors at some point in their life. It’s not an abnormal experience, but that doesn’t make them any less disturbing.

Know When to Reach Out

The challenge with ego-dystonic thoughts and behaviors is learning how to live with them and knowing when to reach out for help. If you ever feel your thoughts and behaviors are getting in the way of you living the life you want, that’s a good time to reach out.

Sequoia Behavioral Health provides treatment for people who struggle with all kinds of mental health issues. This includes issues like addiction and mental health issues like OCD and generalized trauma.

If you’re questioning whether OCD is making your life challenging, reach out to Sequoia Behavioral Health to get your questions answered.

Related Resources: Should I Be Worried About Intrusive Thoughts?

Signs of Self-Harm OCD

Spotting OCD behaviors in yourself can be difficult. Sadly, there’s a stigma surrounding OCD that makes it difficult for people who experience it to talk about their symptoms without judgment. OCD is also often downplayed; it’s used to define quirky personality traits. In reality, OCD is a distressing disorder to experience.

If you’re questioning whether or not you’re experiencing self-harm OCD symptoms, talk with a healthcare professional. They’ll be able to answer any questions and take a close look at your specific experience.

Distress Over Perceived Danger

Common household items like kitchen knives can become items that cause major anxiety for someone with self-harm-centered OCD. Instead of a tool for cooking or opening packages, these items become something they might accidentally use to harm themselves.

This manifestation of OCD makes it hard to function regularly. Common household chores become nightmarish, and most will avoid these activities at all costs. 

Graphic Thoughts of Violence Toward Self

Another sign of self-injury OCD is distressing, unwanted visualizations of self-harm. These visions can come at random times and are distressing to experience.

Sudden visions of self-harm will cause anxiety and make people worried that they intend to engage in the behavior. However, just because you’re experiencing what if thoughts, doesn’t mean you want to act upon them. 

Avoiding Objects That Could Cause Harm

People who experience self-harm OCD will usually do what they can to avoid entering environments or situations that could provide them with an opportunity to cause self-harm. This could look like avoiding specific rooms or social gatherings.

Seeking Reassurance

A common OCD compulsion is the compulsion to seek reassurance. This is also true of people who experience self-harm OCD.

Reassurance compulsions feel like the excessive need to ask others for assurance. Questions like:

• “Is this safe?”
• “Are you sure it’s ok?”

This can also manifest as confessing intrusive thoughts to soo how people will react. Needing reassurance from others to feel safe isn’t sustainable for a healthy lifestyle.

This compulsion helps soothe distressing feelings by hearing from others that you’re ok. Hearing this from others makes people feel like they’re less likely to engage in self-harm. 

Checking

Feeling the need to check if doors are locked or ovens are off are hallmarks of OCD. For self-harm OCD, this includes checking if objects of self-harm aren’t present, and checking the body for any marks of self-harm.

NSSI vs Self-Harm OCD

Non-suicidal self-injury behaviors aren’t associated with suicidal ideation. These are similar to compulsions and are used as poor coping skills.

NSSI and self-harm OCD can overlap, but NSSI most likely overlaps with other forms of OCD. The main difference between self-harming as a behavior and OCD self-harm is the intention, or lack thereof, behind it.

Feelings About Self-Harm

The intrusive thoughts of self-harming OCD are ego-dystonic and therefore, not something you want happening. 

If you experience intrusive thoughts about self-harm, it’s not likely that you engage in self-harm.

Self-Harm Behaviors

People who struggle with NSSI use it as a way to cope with big feelings. There may be a part of them that wants to stop self-injuring, but their intrusive thoughts act more like urges in times of difficulty.

Instead of experiencing ego-dystonic thoughts about self-harming, they experience ego-syntonic thoughts that align with their urge to self-harm. They likely act our on these urges.

Why It’s Important to Know the Difference

Self-harm OCD and NSSI are two very different struggles that require different treatment approaches. 

If you’re struggling with self-harm, it’s important to get the right treatment for your behaviors and thoughts. This could include short-term hospitalization, a 30-day treatment, or weekly therapy sessions.

Self-harm OCD Treatments

Self-injury OCD is treated the same way all forms of OCD are treated. This is through talk therapy and managed medication.

Cognitive Behavioral Therapy

Cognitive Behavioral Therapy (CBT) is the most popular form of talk therapy. It helps people identify any negative thinking patterns and connect them with problematic behaviors.

This can help people with OCD identify and reframe their ego-dystonic thoughts and quell compulsive behaviors.

Emotional Freedom Techniques

Emotional freedom techniques (EFT) are a holistic self-help tool used to regulate emotional responses to difficult situations.

EFT uses ideas from acupressure and tapping to help people find a calm headspace. There are nine pressure points used during EFT:

• Side of the hand
• Eyebrow
• Side of the eye
• Under the nose
• Chin
• Collarbone
• Under arm
• Top of head

Tapping these points calms the amygdala and creates a sense of calm. While using EFT, you’re encouraged to think about what the problem is, measure the intensity of your emotions, set up an intended goal (could be to calm down), and mindfully tap.

A health professional may help you understand and use this technique, but it is something you could try out on your own.

Medication

Selective serotonin reuptake inhibitors (SSRIs) are a prescription drug that increase the concentration of serotonin. This helps decrease the obsessive thoughts and compulsive behaviors. Another medication option includes anxiety medication. Because intrusive thoughts create distress and anxiety, your health care provider may want to put you on anxiety medication.

It’s important to take prescription medication only as directed and always consult your healthcare provider before starting any treatment.

Related Resources: A Guide to Antidepressants

Get Help for Self-Harm OCD at Sequoia

Sequoia Behavioral Health is a holistic treatment center for people dealing with addiction and behavioral issues. We treat the symptoms of mental health issues while also treating the root cause.

Contact us to learn if Seuqoia Behavioral Health is a good fit for your mental health treatment needs.