I’m 35 years old with a 20 + year history of OCD - mostly harm OCD but the theme has moved around over the years. About a month ago, I had a random thought that maybe my life isn’t real / this is some sort of simulation and I’ve been stuck on this ‘possibility’ ever since… I did some research and found out about existential OCD and that it is an actual thing, which comforted me (as one of my obsessions is that it’s not OCD and instead I am fully delusional or have some form of schizophrenia / psychotic disorder; this has never been diagnosed but I obsess about it quite often).
However, a few weeks ago, I had this same simulation thought - what if this is all a simulation, AND the only way out is to harm someone (my worst fear)?…and I’ve been paralyzed with terror ever since. I’ve had lots of obsessions in the past about being scared of hurting someone (both by accident or on purpose), but never one about HAVING to hurt someone for some sort of outcome…I haven’t been able to find an example of someone with a similar obsession so now I am very terrified that it’s not OCD and is something else…I am terrified that I really believe this / maybe this time I really am delusional… I keep thinking and thinking about how do I know what I really believe? Do I believe that harming someone is what I have to do? Do I know in my heart it’s just OCD? Or could it really be actually objectively real/true? How do I know it’s not real? And so on and so on.
My therapist and I are working out my ERP treatment plan now, but I just don’t understand how you can do imaginal exposure to this sort of obsession; the fear that you have to do something…I feel so alone, and am terrified ERP will make it worse / will make me actually hurt someone, which I don’t want to do and is my worst fear.
I guess I am wondering, has anyone experienced anything similar? Is it OCD or something else?
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I'm new here, but thought I'd contribute to your question. Although I haven't experienced an obsession to cause harm in order to facilitate some sort of necessary outcome, I will say that this sounds familiar in my own journey to understand OCD.
I'm reading a book, from which I'll quote:
"One of the things that makes your harm thoughts so upsetting is that they are ego dystonic, meaning they do not line up well with your preferred or historic identity. Why would I, of all people, be thinking such horrible things? This is an OCD sufferer's question."
Overcoming Harm OCD, by Jon Hershfield (MFT)
You don't feel the need to cause harm. You fear it.
Okay, so to start please know it is your OCD. I have to remind myself of this daily. You aren't alone in this. OCD attacks the things you fear, the things you love, it is ego-dystonic, it is against everything you stand for. You are real, you are okay, you will get through.
Well said! OCD thrives on pairing the worst things you can think of with the people you care the most about. It is against everything you stand for.
I agree with the sentiment that you're fearing the thought, urge, or impulse, as opposed to feeling the need to actually be doing it.
As a former existential/philosophical OCD sufferer, I think that I get you. Like, I have had all sorts of dumb and bizzare (not dumb to you at all when you're having the thought, I know 😜) thoughts and 'questions'. This one was near the beginning. I'm pretty sure that I recall eventually having the thought, "hmm, what if I need to do something SO ridiculous, fatal, or insane, in order to 'see the real world'". I did eventually end up being able to 'drop' it, due to the fact, that I was starting to go a little bit crazy from all the incessant streams of thoughts (and of course, starting to have an increasing sense that reality "really might not be real").
My existential/philosophical OCD persisted though (it was just less 'active'). Some years later, I was trying to think about logic, and then came up with (a teacher once told me this in the past), "can you break logic?" "what if you can break logic?" And then I just couldn't let it go for like the longest time. I naturally, of course, linked my previous experience and thoughts of "we are in a simulation" with this "you need to break logic" thing (like, if you somehow break logic, then you can "see the real world"). So I instantly saw the connection up above in your writing - connecting random things together, even if they're not all necessarily OCD.
Also, I don't know if you'll actually find this funny, but I just thought I'd share this with you: You have mainly a harm OCD, and I have (mostly in remission) a philosophical OCD. For me, I did the exact same thing that I think that you're doing right now: Instead of having some random philosophical thought that all of a sudden ties in to a harm OCD, I did the reverse: I philosophized to the point where I was unsure if I could even trust my own reasoning/logic/memory, and then had a random thought of (physically or sexually I think) harming someone, and THEN, "wait a second, how do you ACTUALLY know that you don't want to harm someone?" And that actually gave me quite a scare, and I tried quite a bit I think to suppress the thought or urge. (The worry about the "harming" stayed around for a couple months I think).
I think that in regards to trying to figure out if it's OCD or not, there is probably something that you will eventually need to discover about OCD. I don't think that I am qualified to tell you though. And as for what the ERP will look like: I'm simply guessing, but I think that we might be able to separate them into: 1) thoughts about harming people and 2) thoughts that we live in a simulation (and so then you'd probably be able to do the ERP for both of those things separately, one at a time).
I would actually also say that, "the thought that I have to harm someone in order to find out if the world is real" is also a sub-part or extension of the above thought #2 (the simulation one), simply as a former sufferer of existential/philosophical OCD (but please please please listen to your therapist, especially if she tells you something different, lol - I am 100% not a therapist, and am, again, for the most part, just speaking from my personal experience).
With Pure O type thoughts about harm, sexual themes and the like - I don't think ERP (where you focus on the intrusive thought) is helpful as it just reinforces the story and the association to the fear responses in the brain.
It is better to see ERP as the running of new stories with new associated feelings.
For example, if you are afraid of knives (in case you may harm somebody) the best ERP is to imagine you are preparing dinner for a loved one with your knife, then washing and putting it away, then enjoying a beautiful meal with them.
Of course with other types of OCD the ERP is to sit with the discomfort of not doing the compulsion - ie washing your hands.
People think Pure O does not have compulsions - but it does, the compulsion to avoid something/someone - therefore the ERP is to install new more loving thought and feeling processes.
Wow! Sounds so similar to something I went through. I have pocd and at one time I was so scared that God would ask me to molest someone. Ok now everyone KNOWS God would never ask anyone to do such a thing. But ocd made me doubt that. Such an ocd thing to do. I'm sorry your struggling with this!! It's so so scary! It's just another one of ocds tactics to trick you into obsessing and compulsing. Just agree with the thot maybe even laugh at it! "Haha ocd you are so funny!! Man wish I could be that creative!" Then turn your attention back to what you were doing. Ocd doesn't deserve your attention.
I'm not sure when this was written, how has ERP worked for you? That all sounds like OCD... anything can turn into a fear or an obsession. Literally anything. I think if we identify we're spending more time than normal ruminating on something then that's 100% your ocd. ERP has been working for me but I'm nervous about stopping, I think I might need more work. I obsess over social injustices done by me or other people, question myself constantly, constantly ruminate
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