Table of ContentsView AllTable of ContentsFear of Losing ControlFear of HarmIntrusive ThoughtsGetting Help
Table of ContentsView All
View All
Table of Contents
Fear of Losing Control
Fear of Harm
Intrusive Thoughts
Getting Help
Close
Obsessive-compulsive disorder(OCD) is a psychiatric condition that involves both obsessions and compulsions.Obsessionsare recurrent, persistent, intrusive thoughts, images, or urges that cause anxiety or distress.Compulsionsare repetitive behaviors or acts that are meant to reduce or neutralize anxiety and fears.
Obsessions such as contamination concerns and those involvingperfectionismare common obsessional themes of OCD that can manifest as cleaning, washing, checking, and arranging. However, some cases of OCD are misunderstood, misdiagnosed, and not always effectively treated, such as those involving the fear of losing control.
Evidence supports the connection between fear of losing control and behaviors that are often characteristic of obsessive-compulsive disorder. A 2017 study published in theJournal of Obsessive-Compulsive and Related Disordersfound that people who feared losing control were significantly more likely to exhibit checking behaviors.
This often centers on what is called fear of harm or over-responsibility for harm. People who have such fears experience intrusive thoughts, impulses, and anxiety about the possibility of hurting someone as a result of their carelessness or negligence.
Obsessive thoughts can result in compulsive actions, often centered on checking as a way to limit the risk of harm.
The Fear of Harm
OCD fears often center on the prospect of someone being harmed as a result of something the individual does or fails to do. Some examples include forgetting to turn off the oven and burning down the house or forgetting to wash hands and accidentally making loved ones sick.
If you have OCD, you may fear losing control in a way that results in harm to yourself or others. As a result, such fears may lead to compulsions that are focused on maintaining safety.
Compulsions to keep you safe may include:Avoidance of knives or sharp objectsAvoidance of distressing material that can trigger intrusive thoughtsAvoidance of being aloneChecking for dangersChecking that safety precautions have been taken
Compulsions to keep you safe may include:
In addition to checking behaviors, people who have a fear of losing control and causing harm may also engage in either physical or mental rituals. This includes repeating certain words, phrases, or counts.
If you have OCD, you might finduncertaintyextremely distressing, thus increasing any obsessive thoughts you may experience.In these cases, compulsions are carried out as a way of trying to gain certainty.
Compulsions may includeseeking reassurancesfrom others, checking behavior (locks, windows, schedules), and mental rituals that involve trying to seek clarification.
While people with OCD often engage in behaviors designed to ensure safety, they may also experience unwanted thoughts that are intrusive and inappropriate. Intrusive thoughts can enter awareness unexpectedly and may feature content that is bizarre, distressing, disturbing, or even taboo. These thoughts may be centered on topics such as sex, death, or violence.
These intrusive thoughts may lead to fears that you might actually lose control, act on such thoughts, and harm somebody that you love. In such cases, it is important to work with a mental health professional to distinguish between intrusive thoughts and potentially harmful ideation.
If you have OCD, your fear of losing control may manifest with compulsions that appear neglectful or avoidant. However, these compulsions are carried out to ensure loved ones are safe.
Compulsions to keep another person safe from you include:Avoiding knives or sharp objectsAvoiding songs, movies, or readings that involve murder, death, or injuryAvoiding touching or caring for a loved one who has been the subject of the unwanted thoughtsAvoiding being alone with the loved one
Compulsions to keep another person safe from you include:
You may carry out these compulsions as a means of reassuring yourself that you won’t hurt your loved one, even if you lose control. While such behaviors may often look like simple avoidance of specific objects or situations, they are rooted in a desire to keep others safe.
How Can I Stop Intrusive Thoughts?
It is important to distinguish truly violent, antisocial behavior from the unwanted, intrusive thoughts of OCD. To do that, seek help from a professional and do not try to self-diagnose these upsetting thoughts.
If you have any of these thoughts, it is important to speak with your doctor or therapist. Current evidence-based symptom treatments for OCD and the fear of losing control includecognitive behavioral therapy(specifically, a type called exposure and response prevention) andmedication(such as selective serotonin reuptake inhibitors).
If you havetreatment-resistant OCD, there are a number of treatment options available that may be helpful. Your doctor may recommend different medications or psychotherapy approaches. They may also suggest that you try a procedure such as deep brain stimulation (DBS) or transcranial magnetic stimulation (TMS).
A Word From Verywell
OCD is often related to control. The fear of losing control can result in behaviors that can disrupt your ability to function normally. If you are experiencing symptoms of OCD or the fear of losing control, reach out to your doctor or mental health professional. They can offer a diagnosis and treatment recommendations that will help you get back on track.
The Best Online Therapy ProgramsWe’ve tried, tested and written unbiased reviews of the best online therapy programs including Talkspace, Betterhelp, and Regain.
5 SourcesVerywell Mind uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.Froreich FV, Vartanian LR, Grisham JR, Touyz SW.Dimensions of control and their relation to disordered eating behaviours and obsessive-compulsive symptoms.J Eat Disord. 2016;4:14. doi:10.1186/s40337-016-0104-4Gagne JP, Radomsky AS.Manipulating beliefs about losing control causes checking behaviour.Journal of Obsessive-Compulsive and Related Disorders. 2017;15:34-42. doi:10.1016/j.jocrd.2017.08.013Williams MT, Mugno B, Franklin M, Faber S.Symptom dimensions in obsessive-compulsive disorder: Phenomenology and treatment outcomes with exposure and ritual prevention.Psychopathology. 2013;46(6):365-376. doi:10.1159/000348582Hezel DM, Stewart SE, Riemann BC, Mcnally RJ.Standard of proof and intolerance of uncertainty in obsessive-compulsive disorder and social anxiety disorder.J Behav Ther Exp Psychiatry.2019;64:36-44. doi:10.1016/j.jbtep.2019.02.002Kellner M.Drug treatment of obsessive-compulsive disorder.Dialogues Clin Neurosci. 2010;12(2):187-197.Additional ReadingBooth, B., Friedman, S., Curry, S., Ward, H., & Stewart, E.Obsessions of Child Murder: Underrecognized Manifestations of Obsessive-Compulsive Disorder.J Am Acad Psychiatry Law42:66–74, 2014Cocchi L, Zalesky A, Nott Z, Whybird G, Fitzgerald PB, Breakspear M.Transcranial magnetic stimulation in obsessive-compulsive disorder: A focus on network mechanisms and state dependence.Neuroimage Clin. 2018;19:661–674. Published 2018 May 23. doi:10.1016/j.nicl.2018.05.029Glazier K, Swing M, Mcginn LK.Half of obsessive-compulsive disorder cases misdiagnosed: vignette-based survey of primary care physicians. J Clin Psychiatry. 2015;76(6):e761-7. doi:10.4088/JCP.14m09110Himle M, Franklin, M.The More You Do It, the Easier It Gets Exposure and Response Prevention for OCD.Cognitive and Behavioral Practice. 2009;16:29-39. doi:10.1016/j.cbpra.2008.03.002Hudak, R. & Wisner, K.Diagnosis, and Treatment of Postpartum Obsessions and Compulsions That Involve Infant Harm.Am J Psychiatry169: 360-363, 2012. doi:10.1176/appi.ajp.2011.11050667
5 Sources
Verywell Mind uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.Froreich FV, Vartanian LR, Grisham JR, Touyz SW.Dimensions of control and their relation to disordered eating behaviours and obsessive-compulsive symptoms.J Eat Disord. 2016;4:14. doi:10.1186/s40337-016-0104-4Gagne JP, Radomsky AS.Manipulating beliefs about losing control causes checking behaviour.Journal of Obsessive-Compulsive and Related Disorders. 2017;15:34-42. doi:10.1016/j.jocrd.2017.08.013Williams MT, Mugno B, Franklin M, Faber S.Symptom dimensions in obsessive-compulsive disorder: Phenomenology and treatment outcomes with exposure and ritual prevention.Psychopathology. 2013;46(6):365-376. doi:10.1159/000348582Hezel DM, Stewart SE, Riemann BC, Mcnally RJ.Standard of proof and intolerance of uncertainty in obsessive-compulsive disorder and social anxiety disorder.J Behav Ther Exp Psychiatry.2019;64:36-44. doi:10.1016/j.jbtep.2019.02.002Kellner M.Drug treatment of obsessive-compulsive disorder.Dialogues Clin Neurosci. 2010;12(2):187-197.Additional ReadingBooth, B., Friedman, S., Curry, S., Ward, H., & Stewart, E.Obsessions of Child Murder: Underrecognized Manifestations of Obsessive-Compulsive Disorder.J Am Acad Psychiatry Law42:66–74, 2014Cocchi L, Zalesky A, Nott Z, Whybird G, Fitzgerald PB, Breakspear M.Transcranial magnetic stimulation in obsessive-compulsive disorder: A focus on network mechanisms and state dependence.Neuroimage Clin. 2018;19:661–674. Published 2018 May 23. doi:10.1016/j.nicl.2018.05.029Glazier K, Swing M, Mcginn LK.Half of obsessive-compulsive disorder cases misdiagnosed: vignette-based survey of primary care physicians. J Clin Psychiatry. 2015;76(6):e761-7. doi:10.4088/JCP.14m09110Himle M, Franklin, M.The More You Do It, the Easier It Gets Exposure and Response Prevention for OCD.Cognitive and Behavioral Practice. 2009;16:29-39. doi:10.1016/j.cbpra.2008.03.002Hudak, R. & Wisner, K.Diagnosis, and Treatment of Postpartum Obsessions and Compulsions That Involve Infant Harm.Am J Psychiatry169: 360-363, 2012. doi:10.1176/appi.ajp.2011.11050667
Verywell Mind uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
Froreich FV, Vartanian LR, Grisham JR, Touyz SW.Dimensions of control and their relation to disordered eating behaviours and obsessive-compulsive symptoms.J Eat Disord. 2016;4:14. doi:10.1186/s40337-016-0104-4Gagne JP, Radomsky AS.Manipulating beliefs about losing control causes checking behaviour.Journal of Obsessive-Compulsive and Related Disorders. 2017;15:34-42. doi:10.1016/j.jocrd.2017.08.013Williams MT, Mugno B, Franklin M, Faber S.Symptom dimensions in obsessive-compulsive disorder: Phenomenology and treatment outcomes with exposure and ritual prevention.Psychopathology. 2013;46(6):365-376. doi:10.1159/000348582Hezel DM, Stewart SE, Riemann BC, Mcnally RJ.Standard of proof and intolerance of uncertainty in obsessive-compulsive disorder and social anxiety disorder.J Behav Ther Exp Psychiatry.2019;64:36-44. doi:10.1016/j.jbtep.2019.02.002Kellner M.Drug treatment of obsessive-compulsive disorder.Dialogues Clin Neurosci. 2010;12(2):187-197.
Froreich FV, Vartanian LR, Grisham JR, Touyz SW.Dimensions of control and their relation to disordered eating behaviours and obsessive-compulsive symptoms.J Eat Disord. 2016;4:14. doi:10.1186/s40337-016-0104-4
Gagne JP, Radomsky AS.Manipulating beliefs about losing control causes checking behaviour.Journal of Obsessive-Compulsive and Related Disorders. 2017;15:34-42. doi:10.1016/j.jocrd.2017.08.013
Williams MT, Mugno B, Franklin M, Faber S.Symptom dimensions in obsessive-compulsive disorder: Phenomenology and treatment outcomes with exposure and ritual prevention.Psychopathology. 2013;46(6):365-376. doi:10.1159/000348582
Hezel DM, Stewart SE, Riemann BC, Mcnally RJ.Standard of proof and intolerance of uncertainty in obsessive-compulsive disorder and social anxiety disorder.J Behav Ther Exp Psychiatry.2019;64:36-44. doi:10.1016/j.jbtep.2019.02.002
Kellner M.Drug treatment of obsessive-compulsive disorder.Dialogues Clin Neurosci. 2010;12(2):187-197.
Booth, B., Friedman, S., Curry, S., Ward, H., & Stewart, E.Obsessions of Child Murder: Underrecognized Manifestations of Obsessive-Compulsive Disorder.J Am Acad Psychiatry Law42:66–74, 2014Cocchi L, Zalesky A, Nott Z, Whybird G, Fitzgerald PB, Breakspear M.Transcranial magnetic stimulation in obsessive-compulsive disorder: A focus on network mechanisms and state dependence.Neuroimage Clin. 2018;19:661–674. Published 2018 May 23. doi:10.1016/j.nicl.2018.05.029Glazier K, Swing M, Mcginn LK.Half of obsessive-compulsive disorder cases misdiagnosed: vignette-based survey of primary care physicians. J Clin Psychiatry. 2015;76(6):e761-7. doi:10.4088/JCP.14m09110Himle M, Franklin, M.The More You Do It, the Easier It Gets Exposure and Response Prevention for OCD.Cognitive and Behavioral Practice. 2009;16:29-39. doi:10.1016/j.cbpra.2008.03.002Hudak, R. & Wisner, K.Diagnosis, and Treatment of Postpartum Obsessions and Compulsions That Involve Infant Harm.Am J Psychiatry169: 360-363, 2012. doi:10.1176/appi.ajp.2011.11050667
Booth, B., Friedman, S., Curry, S., Ward, H., & Stewart, E.Obsessions of Child Murder: Underrecognized Manifestations of Obsessive-Compulsive Disorder.J Am Acad Psychiatry Law42:66–74, 2014
Cocchi L, Zalesky A, Nott Z, Whybird G, Fitzgerald PB, Breakspear M.Transcranial magnetic stimulation in obsessive-compulsive disorder: A focus on network mechanisms and state dependence.Neuroimage Clin. 2018;19:661–674. Published 2018 May 23. doi:10.1016/j.nicl.2018.05.029
Glazier K, Swing M, Mcginn LK.Half of obsessive-compulsive disorder cases misdiagnosed: vignette-based survey of primary care physicians. J Clin Psychiatry. 2015;76(6):e761-7. doi:10.4088/JCP.14m09110
Himle M, Franklin, M.The More You Do It, the Easier It Gets Exposure and Response Prevention for OCD.Cognitive and Behavioral Practice. 2009;16:29-39. doi:10.1016/j.cbpra.2008.03.002
Hudak, R. & Wisner, K.Diagnosis, and Treatment of Postpartum Obsessions and Compulsions That Involve Infant Harm.Am J Psychiatry169: 360-363, 2012. doi:10.1176/appi.ajp.2011.11050667
Meet Our Review Board
Share Feedback
Was this page helpful?Thanks for your feedback!What is your feedback?HelpfulReport an ErrorOtherSubmit
Was this page helpful?
Thanks for your feedback!
What is your feedback?HelpfulReport an ErrorOtherSubmit
What is your feedback?