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481 Harm OCD Explained: What It Is, Why It Happens & How to Manage It
00:31:26
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- [00:02]
A
Okay, I'm going to let you in on a little secret. I have not told anybody this yet except my husband and my assistant. And I wanted to give you as much heads up as we can. Now, next week on April 21, we are doing a special launch of your OCD toolkit. Now, this is our comprehensive, step by step course for ocd. If you're somebody who struggles with OCD and you're wanting to really understand exactly what I do with my clients, you're gonna love this course. It is a beast. It's about seven hours. It has tons of bonus modules, all about the subtypes and everything. But the reason I'm telling you about this right now is for 48 hours only, we will be doing a live Q and A bonus. So the bonus live Q and A will be in several weeks after this live. It will give you enough time to take the course. But if you purchase your OCD toolkit on either April 21 or April 22, before midnight, you will be able to come and ask me any questions you have about the course content. You can ask me questions about struggles you're having. You can ask me questions about how you might do exposure. Exposures specifically, we are going to go through and answer as many questions as we can. And if you're unable to make that live Q A, you're more than welcome to give me your questions ahead of time. And I've done this for the rumination reset. We did it for the Self Compassion toolkit. And it was probably the most rewarding thing that I have done. I have found it to be so, such a beautiful event. So I just wanted to let you
- [01:53]
B
know there's no pressure.
- [01:55]
A
All of these again episodes are free. This is here for you for free. But if you would like to join us, you've been on the fence about joining your OCD toolkit. This is your little nudge. You can sign up on the 21st. We will have links ready at CBT school. Put it in your calendar, write a note on your fridge, whatever you need to do to remember so that you can get that free bonus. All right? Okay. I'm gonna let you get to the show because that's what you're here for. But I just wanted to let you in on the secret. And I will remind you again in the bonus episode coming up this week. Take care.
- [02:33]
B
Have you ever walked down the street and all of a sudden you're hit with an intrusive thought that maybe. What if you want to hurt someone, maybe it's someone you Love. Maybe it's someone you care for, or maybe it's just some random stranger on the street. If that. I want you to know there is nothing wrong with you. And we are here today to talk about homocd. What it is, why it happens, and how you can manage it. Now, the exciting thing here is I have one of my amazing therapists who work at our clinic. Her name is Lacy Ekelson, and she's here to kind of talk with me. We're together going to sort of present to you what Homo CD is. Lacy has specifically specific lived experience, which I think you're going to find so inspiring, and we're going to really get to the bottom of what you can do if you're struggling with Harm ocd. So thank you, Lacy, for being here.
- [03:25]
C
Of course. I'm happy to be here.
- [03:27]
B
Oh, my gosh. Okay, so, first of all, you tell me a little bit about your history or your relationship with Harm O cd.
- [03:37]
C
Oh, man. It's been quite a ride. I think I first started noticing that something was off as young as, like, seven years old. I. I remember, like, laying in bed at night, not being able to sleep, not being able to turn my brain off. I shared a room with my sister at the time, my little sister. And I just had these vivid thoughts of hurting her. And it almost felt like my brain was, like, plotting all these ways to do it and all these ways that I could do it. And it was terrifying, Absolutely terrifying. I remember going to my mom. It was early in the morning. She was sitting at the computer, and I distinctly remember going up to her and telling her that I thought I had voices in my head telling me to hurt people. I just. I was so confused.
- [04:28]
B
What did she do?
- [04:29]
C
The hard part is, is that my mom's mom had schizophrenia. So I think she got really scared and didn't know what to do. Not because she didn't love me or didn't care about me. I just. I think she didn't know what to do and was hoping that maybe it would just go away or it was just, like, my young kid imagination. But I think, like, in a way, that kind of sent me a message of, like, this is wrong. This is bad. If she's not doing anything or not saying anything or it's not being brought up or talked about again. Like, what does that mean?
- [05:04]
B
Yeah, I mean, how old were you when you found out that your grandmother had schizophrenia? Because that would be triggering for people with Homo CD as well.
- [05:13]
C
Yeah, I mean, my mom would talk about it. I could probably Count on one hand how many times I met her. I just remember hearing really wild stories about her, about how she would like write messages on the walls and do some like really scary stuff, stuff that kind of fed into another subtype. I dealt with thinking that, you know, maybe I was schizophrenic because I had these thoughts in my head, but I probably didn't really understand until, understand her diagnosis, probably until later on. 15, 16. Yeah.
- [05:49]
B
So, okay, so you were having the onset of these intrusive thoughts, what compulsion? So we know that Harm OCD is a particular subtype of ocd. A type of ocd. And then when we have these OCD obsessions and these subtypes, we engage in compulsions. What were some of the compulsions that you were engaging in to sort of reduce or remove the uncertainty that you felt around these thoughts?
- [06:13]
C
Yeah, I had a lot of mental compulsions. I would do a lot of reassurance, just constantly reassuring myself I would never do that. I'm a good person. I would use situations as evidence. Right. Like, well, I was just in the kitchen with knives and I didn't do anything. So that means that, you know, I'm okay. And so much avoidance. So much avoidance. Anything that could be used as a weapon I avoided.
- [06:42]
B
So you were avoiding knives or scissors
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C
or needles or what was avoiding any type of knives, whether it was plastic, butter knife, steak knives. I avoided boiling water. I didn't like being in the kitchen because I didn't like being around anything of that vicinity. I avoided garbage disposals, I avoided razors. I didn't like shaving my legs, I didn't like doing anything like that. I mean it got so bad, so bad that it was to the point where like anything that could be used as harm, I avoided it. I avoided going near my windows because I was afraid I was going to jump out of my windows.
- [07:30]
B
So you had self harm as well?
- [07:32]
C
Yes.
- [07:33]
B
Self harm, Self harm obsessions or a subtype. Right. So, okay, and during this time you're still sleeping with your sister, so I'm guessing, like how did you fall asleep? Like, what was that? Like, how did you play with her or did you avoid her completely too?
- [07:48]
C
I, I, I didn't avoid her so much because during the day I'd like to say that, like I was a little bit more distracted. There was a lot of other stuff going on and she was younger than me, so she, she kept me busy for sure. But I begged my parents to put a TV in my bedroom because it was the only way that I Could shut off my thoughts and go to bed. Was that.
- [08:14]
B
And did that.
- [08:15]
C
Yeah, they did.
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B
They did.
- [08:17]
C
Until this day. I mean, there's times where I'm like, I need the tv, but I know I don't.
- [08:23]
B
Okay, interesting. So did you ever, like, where did you start to, like, learn that you could retreat this or that this was a problem that wasn't just yours? Like, what was the evolution? Now you are a fully trained OCD therapist. You work for me, you work with Claire clients with ocd, and you treat our clients with homo cd. How did you go from that little girl who avoided everything to now where you are? What did that look like for you?
- [08:52]
C
It looked like a lot of different things. You know, like, I don't think I really understood what was happening until I was probably, like, 21 years old.
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B
Wow.
- [09:05]
C
Yeah. So. So. And I think an important thing to mention was that I never told anybody what was happening in my head. And probably until then. So I went years and years just suffering in silence. And you would never have known, but I was probably 21. I was at college at Penn State, and I was sharing a dorm room, dorm room with three other girls. And it was, like, unbearable. I was terrified to do, like, anything with them. I was afraid to be around them. I was afraid to be alone in the apartment with them. And I just remember being. I was going home for a weekend and I was on one of those buses. I think it's like a three and a half hour bus ride. And I just spent the entire bus ride researching, like, what is wrong with me? Why do I have these thoughts that I want to hurt people, but I don't want to hurt people? And that's probably the first time I saw anything about ocd. And of course, I felt, like this wave of relief. I'm like, oh, okay. Like, I'm not this, you know, psychopath serial killer that I've convinced myself I am for the last, you know, 15 years of my life. So, I mean, that felt good. But it was kind of like a roller coaster because when I got back to school, we had a. Our mental health department was called caps. And I remember going in there to speak to a psychiatrist. But something when, you know, when you go into a mental health facility, you have to fill out the assessment where it's like, do you have any thoughts of hurting yourself? And I'm like, I don't know what to put. Like, do I put yes? Do I put no? I truly, like, did not know what the answer.
- [10:54]
B
What did you write?
- [10:55]
C
I put yes, set yes, you're honest.
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B
And what did they say?
- [11:03]
C
I knew there was also a really long waiting list, so I was like, all right, well, maybe if I, I, I need to get in. Like, I need to see somebody today. But it actually set me back a little bit because I went in to talk to one of the psychiatrists, and again, like, I can remember this so vividly. And she had, like, a student with her, so I guess somebody that was shadowing her. And she kind of let her take the reins a little bit. And I just, like, word vomited. Like, I just let it out. I was like, I have these intrusive thoughts that I'm going to hurt people. I can't do anything. Like, everything I do makes me, like, my imagination will just connect to anything. And the psychiatrist was like, whoa, whoa, whoa, whoa, whoa. Like, I need to, like, step in and be the one to, like, take the reins on this. So she kind of, like, not pushed the other, you know, the student out of the way, but kind of took control a little bit, which, like, freaked me out because I was like, oh, my gosh, like, why is she panicking? Yeah, I was like, oh, my God, she's going to send me the hospital. Like, I'm going to get admitted. I'm not going to, like, graduate college. Like, oh, it was a really, really scary experience. And she gave me medication and sent me on my way. But there was no, like, psychoeducation. She didn't once bring up the term ocd. I. She just really assessed me, like, do you have intent? Do you want to do these things? No. Okay, well, here you go.
- [12:31]
B
So what happened then?
- [12:35]
C
I mean, I think by this point, like, I had tried so many therapists that had. I mean, it's partially, like. I don't want to say my full fault, but, you know, I wasn't. That was the first time I was really honest about my thoughts. And I think at that point I was like, well, I guess I just gotta do this on my own.
- [12:55]
B
Yep.
- [12:56]
C
Yep. So I spent more hours, you know, researching and learning, like, what can I do to fix this? Or, you know, make this a little bit better. And it's hard to, like, think back because I spent so much time doing that that it took away from, like, my college experience, but I just did a lot of my own exposures. I would purposely do the things that my thoughts would tell me not to do. If I walked by, you know, a knife in the kitchen, my initial reaction was to avoid and, like, go isolate in my room, but I would, like, open up the fridge and be like, huh, what can I cut up for dinner tonight? And really just tried to, like, lean into it. It was hard.
- [13:43]
B
You were doing that on your own. How did you know to do that? Did you research? Did you. How did you. Yeah, like, you were doing this on your own. That had to be hard.
- [13:54]
C
Yeah. I did a lot of research on the treatment for ocd. I kind of just diagnosed myself. I know. And just learned about different ways that I could, you know, expose myself in certain situations. I mean, I would. I would go to, like, something else that was really triggering for me was going to the mall because I didn't, like, walking on the third floor. So I would, like, purposely go to the mall and walk on the third floor. And I mean, looking back now, there was definitely a bit of, like, mental compulsion going on at the time. I don't think I was educated enough at the time to really realize what I was doing. But I also think it helps that, like, once I really got trained in erp, I could incorporate it even more into my life, which I do now every day. Having children was something that I was absolutely terrified to do. If you would have asked me 15 years ago if I would have two kids, I'd be like, not a chance. I was so afraid to have kids. But now it's like, I. I use them as. I don't want to say, like, I use them as my erp. But did your.
- [15:08]
B
Did your harm. OCD attack your partner? Like, was that, like. Some people will say, like, yeah, sleeping next to somebody is really scary. Or they'll say no because I knew that they were bigger than me or they could stronger than me. Like, how. How did that go for you to have to all of a sudden be sleeping in the same room?
- [15:27]
C
Yeah, it definitely targeted my partner. It's almost like it would attach to whoever was, like, closest to me physically. So, like, growing up, it would attach to my sister, my parents, my brother. You know, when it was just me and my partner, it would definitely att to him. I think what's. What helped me, though, was that my partner was so amazing and is so amazing that I felt safe enough to share with him what I was experiencing. Not so much in, like, a reassurance way, but more of just like, this is. This is what happens in my head. And just, like, being able to share that with him felt really freeing and helped.
- [16:09]
B
What did he say? Like. Like, if. If you would have. Like, if that if he did a good job, like, we could use it as, like, a transcript for Folks like, what, what did he do? How did you share like, tell me a little bit about what that looked like.
- [16:23]
C
Yeah, I mean, to be fair, my husband is not an ERP specialist. He does not know anything about ocd. So there was definitely a little bit of reassurance happening. But maybe it was more assurance than reassurance. He really just listened and kind of validated. He's like, wow, that must have been really hard for you to grow up like that. You know, the re, the, the assurance piece of, you know. Well, I know you and I know that you're, you know, a amazing, caring, compassionate person. Whereas like hearing that, I mean I'm sure it felt good because it felt like reassurance at the time. But hearing that was, you know, helpful, a lot of validation and then just like kind of asking me questions of like, is there anything I can do that you know, can help or what do you need from me? How can I know when you're having a hard time, like, do you feel comfortable sharing that with me? So him just really providing like that open, safe, validating space for me was really want to say kind of like life changing in a way.
- [17:33]
B
Yeah.
- [17:34]
C
You know, he was like the first person that wasn't family or blood relative that I, you know, shared that with and to, you know, have that type of reaction because you know, for people with harm ocd, they're afraid that they're going to get, you know, they're going to get locked away or people aren't going to want to be around us. So yeah.
- [17:57]
B
Now as you know, I have a private practice. I have six amazing therapists in Calabasas, California. However, we do not take insurance. Now if you are looking for insurance covered OCD or BFRB treatment, I want to let you know about nocd. NOCD provides face to face live video sessions with specialized licensed OCD therapists. Now their therapists use exposure and response prevention. We know this is the gold standard standard for ocd. So you can be absolutely confirmed that you're in the right place there. And they have a clinically proven app that helps you stay connected to your therapist and others who have OCD between sessions. So you'll always feel supported. Now the cool thing is NOCD is available in all 50 US states and even internationally and they accept most insurance plans making it affordable and accessible. We love that. Now if you think you might have OCD or you're struggling to manage your symptoms, you can book a free call. Just click the link in the show notes@nocd.com I am honored to partner with NOCD. I want to remind you that recovery is possible. Please do not forget that. Now, big hugs and let's get back to the show. And I think too, when you have homo cd, your inner narrative is really mean. Like a bad person. I'm disgusting. I'm a horror. Like, I shouldn't deserve good things. Like I don't deserve love. What kind of person could I be? Like, your brain really can attack you. So being treated. I've had clients who've said, like being treated kindly felt like almost like a bizarre triggering thing because their brain was like. No, they, they. What if they don't know you? And what if they miss something? Or what if I didn't explain it properly enough? I think it's so interesting how ocd, specifically harm, can completely attack somebody's identity or view of themselves. Did that happen for you?
- [20:00]
C
Yeah, I would definitely say so. I, you know, especially during those younger years, I was convinced that I was like this terrible psychopath that was going to eventually, like turn into a serial killer. I was a horrible person for even having these thoughts because what type of person would think these things about loved ones? Normal people don't think this way. So there was a lot of that self talk going on and zero self compassion, especially because I did. I had no idea what was happening. So I mean, I can't like, you know, for someone who's experiencing such and, you know, it also felt like just to add like the intrusive Harm thoughts also felt like urges sometimes. Like some. There were times where it almost felt like my body was like pulling me to do something.
- [20:56]
B
Yeah.
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C
Which was even more confusing because it's like, well, now these, these aren't just thoughts now. They're. They feel like urges. Like my body's like pushing me towards this knife.
- [21:06]
B
Yeah.
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C
And what kind of person would do that or think about that or have these thoughts?
- [21:11]
B
And they happen so rapidly too. Like, I think I remember when I had a newborn, my daughter and I was standing. I've talked about this on the podcast before, but I was standing on. My parents had an apartment. It was like on the 8th floor or the 18th floor. I can't remember. It was very, very, very high up. And I remember holding my new baby. She's so sweet. And I had that urge to throw her off the edge of the balcony, but it wasn't a thought. It was like this visceral feeling in my veins and my muscles of my arms where I was it. And it felt like it's something I could have decided and initiated and completed within 2.2 seconds. That scared me. You know, it wasn't like, oh, maybe you want to. It was like, oh, no, no. It's happening, like in. In less than a second.
- [21:56]
C
And it's so scary.
- [21:57]
B
Yeah. I mean, take me to now, though, like. So you're a therapist who treats OCD now.
- [22:03]
C
Yes.
- [22:03]
B
And you do exposures with clients with harm. How are you. How has that for you? Do you get. So I've, I've consulted with therapists, lots of OCD therapists, who are afraid that doing exposures with clients is going to make them snap or it's going to trigger them again. Like, how is it now for you in this place?
- [22:22]
C
Yeah, I mean, I would be lying if I said, like, intrusive thoughts didn't still pop in and out. You know, I just, I've learned not to engage with them. I don't really give them any importance or value anymore. I try to look at it from, like, OCD has taken enough from my life. Like, I'm not going to let it take anymore. So I think a significant part of my journey has just been, like, working on taking that power back. So, yeah, I mean, when I'm doing, you know, harm exposures with clients. Yes, intrusive thoughts might still pop up, but they're as quickly as they come is how they go.
- [23:05]
B
Yeah.
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C
And I, like, I almost feel like having a harm OCD can help me be even more creative with my exposures. Like a garbage disposal. Like, some of my, like, my co workers or even some of my clients are like, why would you even think that? And I'm like, well, yeah, you're like,
- [23:25]
B
being there, done that. I do think it's really nice when you have OCD to know that your therapist gets it right, that they've been there, that they know the terror of harm obsessions. So that's one perspective. I also want to say, like, OCD therapists who haven't had this OCD or type of OCD are still highly, you know, going to be able to treat it because OCD is ocd.
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C
Ocd, absolutely.
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B
So just for everybody listening. But what I do love about your story in particular is you got started on your own. It's not like you came into a routine treatment manual, you know, manualized treatment. You plugged away at this on your own. And a lot of people who are listening and watching might be feeling like, oh, God, it's. I need a professional. This is too dangerous or scary. Like, what advice might you give them if they're trialing this on their own, or maybe they don't have access. A lot of what we do is giving access to people who don't have therapy or access to therapy. What advice would you give them?
- [24:29]
C
Um, I think I would tell them that. I mean, I understand the belief that, like, or the thought that it's too hard or it's. It. It's impossible. I think we are so much more capable than we think we are.
- [24:46]
B
So, so many people here listening. If you're listening and watching, we know that CBT school is about giving resources to folks who maybe don't have one on one therapy. You did this on your own, right. You didn't have a manualized therapist who are treating you using, you know, this very routine treatment. What were the steps like for you? You did research first, obviously. How did you get the confidence to start to do these exposures on your own? Because you shared about them. But I want to make sure people like, no, they obviously weren't easy to do. What was that like for you?
- [25:17]
C
I think, you know, in that in those moments, I just felt really, like, hopeless. And I kind of got to, like, a breaking point of like, I'm just really tired of living like this. I'm tired of OCD telling me what I can do, where I can go, who can. Who I can be around. I just wanted. I want to say I wanted my life back, but there's a part of me that's like, I just wanted to learn what my life could be like. So, unfortunately, at the time, it was very difficult for me to find an OCD therapist. I went to school in a small town, so I felt like my only option was to just do it myself. And I really just leaned into it. I think I used fear as almost like a motivator in a way. The idea of not living a life was scarier than these exposures. And I think I started to realize that the more that I did it and, you know, I would do one exposure, and that would kind of give me the confidence to do three or four exposures. And before I knew it, it turned into 10 exposures. And then, you know, I was just living it and just incorporating it into my everyday life.
- [26:45]
B
Yeah, amazing. Okay, so I think you've done this beautiful job of explaining, like, and validating and how I think people are going to feel very understood in how you've explained it. Take me to, like, zoom in to the moment where you have the intrusive thought. Back then you would have avoided. You would have judged yourself. You would have ruminated, like, what are the steps you take now when you. Okay, you've just had that intrusive thought. Maybe you've had the urge, or maybe it's this image that flashes across your mind. Mind. What are some of the steps that you take now to get you through that without doing compulsions?
- [27:24]
C
Yeah, well, I. I use values a lot in my. Not just in my work as a therapist, but in my personal life as well. I think that, you know, like I mentioned earlier with having two kids at home, a lot of my harm. Obsessions attached to them because they are the most important things in my life and I love them dearly. So, you know, if I'm, you know, cooking at the kitchen counter and I'm using, you know, a sharp knife to cut something up and my kid is sitting right there, you know, a couple years ago, my initial reaction would be like, get out now. And now I kind of, like, lean into it. I use a lot of, like, thought diffusion statements. There's a skill that I use with my clients a lot. I refer to my OCD as the high school bully. So, like, if you yell back at the bully, it's just going to feed into him. He's just going to make him get louder. If I try to avoid or run away from the bully, he's going to follow me. But if I just kind of, like, acknowledge him, like, oh, hey there, thanks. Thanks for stopping by and then go on about my way, the bully's going to get bored and he's going to leave me alone. And that's kind of how I. I treat my OCD now is when the thought pops up, I'm like, all right, thanks. Thanks for stopping by and just kind of go on about my day. I really try to lean into it. Like, if my OCD is telling me, you know, I could hurt my child and I need to leave, I will just do the opposite and I'll go give my child a hug and squeeze them a little bit tighter. And, yeah, I think that's really helped me remain, I guess, like, I don't know. I don't know what I was going to say there.
- [29:15]
B
What does it help you remain? How has it helped you?
- [29:18]
C
It's helped me stay in the present, for sure. Be in the present with my kids, doing what's important, being with things that matter to me.
- [29:28]
B
Yeah, amazing. So we. I think that you've done this beautiful job and thank you. Because this is vulnerable information. I'm so grateful. I'm number one. I'm grateful that I Get to work with you. I'm so grateful you shared this story. I love that my staff are coming onto the show. It makes me so happy. If there was one message that you wanted to give someone who has harm ocd, or even if family members are listening, what. What would it be that you would really want them to know?
- [29:54]
C
The first thing that pops up is something that I consistently share with my clients, and it's that the thoughts aren't the problem. The reaction is. And, yeah, I don't know why that's just the first thing that pops up, but it's something that I consistently share with myself, with clients. Yeah, I think I feel like it's a important message.
- [30:18]
B
Amazing. Lacy, I have loved chatting with you about this. I feel like we could go over this for hours, right? Because there's so many nuances that we could learn as treating harm o cd. If people want to do this on their own, they can head over to the your OCD toolkit, which is at CBT school, and they can work with you by going to my website, because, again, you're amazing. Thank you so much for coming on today and sharing your wisdom and your story and your cool, like, little ways in which you've gotten through this. It's very, very inspiring.
- [30:51]
C
Of course. I'm very grateful to be here and to be able to share this, and hopefully it reaches somebody who needs it.
- [31:02]
B
Please note that this podcast or any other resources from CBTSchool.com should not replace professional mental health care. If you feel you would benefit, please reach out to a provider in your area. Have a wonderful day and thank you for supporting CBTSchool.com.