How To Overcome Self-Harm OCD | Suicidal Obsessions
In this episode, I discuss a type of Harm OCD known as Self-Harm or Suicidal OCD. This is when a person experiences unwanted thoughts related to causing them self harm or the possibility of one day hurting themself. I also discuss different compulsions people engage in and a few very important steps in the treatment process.
00:04 All right. Hey everyone, and welcome to another episode of the restored mind show. In this episode we're going to talk about self-harm, OCD. And again, this is a kind of, one of the sub categories aren't on our intrusive thought a series. So, um, you know, in this, in this, uh, series in this episode, what I want to talk about is the idea of self harm, OCD. And, and what I want to do in the first point that I want to really cover is distinct, uh, and making a distinction between the idea of self harm, OCD versus suicidal ideation, like true suicidal ideation. And so again, to first and foremost, I just want to like clearly say if you are having like thoughts of hurting yourself and those thoughts do sound, you know, appealing to you or anything like that, you must seek medical help. And so go to the nearest emergency room, uh, you know, call your doctor, uh, you know, call nine one one or you know, whatever emergency services that are available to you, please seek those out.
00:56 Um, but with that said, when it comes to self harm, OCD, let's go ahead and distinct kind of what the, the differences. And so, you know, it's not uncommon in the human experience to have thoughts of not wanting to live anymore, right? Like, I mean, I, I feel like those are actually pretty common thoughts. You know, when you talk to people in the general population that, you know, life gets tough and you know, you're just kinda like, Oh, you know, I don't want to keep doing this sometimes. Right. And realizing that those thoughts are going to take places just part of, you know, and most of us are able, when those thoughts pop up, just to kind of brush them off, like, yeah, whatever. That's just a weird thought. Right? And what happens with, um, you know, and in this could take on a variety of forms, right?
01:35 And so, you know, people might be, um, the brain will produce all sorts of weird thoughts, right? And that's, and that's part of what you know, we need to realize in this interest of thought series is just having a thought is very different than, you know, giving into thoughts, right? You know, we have thoughts all the time that don't make sense or that, you know, don't reflect who we are. And for the most part, we were able to brush them off. What makes someone with OCD different from people without OCD is that they'll have these intrusive thoughts, but then they'll have an extreme emotional reaction towards that thought. And then by having that reaction, they often do compulsive behaviors that then reinforce those thoughts, right? And it reinforces the idea that that thought was dangerous, that that thought is something they need to take seriously.
02:19 And then the more and more they do the compulsion's, the more and more the thought produces. And it just ends up in this vicious loop. And what we know is OCD, right? And so when we talk about, um, self harm, OCD, I want to cover three main points today. So the first point is differentiating the idea of self-harm, intrusive thoughts versus real suicidal or self-harm ideation. And what we're really looking for with a, if you're, if you're talking with someone with those kinds of thoughts, is this idea of, you know, we want to assess if they're ego-dystonic and egosyntonic, right? So someone who has self-harm, OCD, you know, they're reacting to just the presence of the thought itself versus someone who's actually, you know, it has true self harm intentions. They are, they, they really want to hurt themselves, right? I mean, like are there, they've really con they're contemplating that idea, right?
03:15 They're contemplating the idea of, you know, ending their life or you know, really actually causing themselves harm. Someone with self harm, OCD, they're, they're getting anxious because that thought popped into their head. Okay. And, and they, they don't, they realize that thought's not something they want. They realize that that thought is intrusive, that it doesn't reflect their real desires or anything like that. But because that thought popped into their head, they're having this overreaction of anxiety to it and then, which is causing them to react and to come into compulsive behaviors and ultimately trying to get rid of the thought or seek reassurance or avoid things. And again, that, that's just making it more and more, um, you know, frequent, right? Making the presence of the thought more and more frequent. And so when we're, um, when we're looking at this, it's important to realize this because I've seen so many cases and, and heard of so many cases where people that have self harm OCT have been hospitalized or things like that.
04:11 Um, you know, you know, start to these higher services that they actually didn't need because again, it was an OCD issue, right? And it wasn't a suicidal issue. And, but you know, clinicians who, who aren't familiar with those seed, oftentimes they'll misdiagnose and because they hear those, you know, words about, you know, suicide or, you know, harming themselves, things like that, they react to it as if, um, it is an actual impulse in something that someone wants to carry out. And then they, you know, we'll go as far as hospitalizing people that don't need to be hospitalized, which again you can imagine, does a real disservice to the person with OCD because it just reinforces the idea that those thoughts are dangerous and those thoughts are something that they, they should be responding to, you know, in this compulsive ways. And so the point, point number one is first differentiating the idea between self-harm, intrusive thoughts or self harm obsessions versus real self harm ideation, right?
05:04 And the second point that I want to talk about in this episode is, you know, again the idea of ego-dystonic and egosyntonic, right? And once we can determine that these thoughts are in fact ego-dystonic that these aren't something that the person wants to have, that these, there's the presence of the thoughts alone are actually what's causing the anxiety, then we can realize and accurately assess that this is in fact an OCD issue and not a, um, not a self harm issue. And so that's really kind of point number two is realizing that this is an OCD problem versus a suicidal problem, right? Because again, whatever the problem is is going to dramatically alter the treatment path, right? And so if we're treating it like a suicidal problem and we just keep popping up hospitalizing people again and again and again because they're having these intrusive thoughts, well we're not actually helping them on that because if it is an intrusive thought issue, it needs to be treated as OCD in the OCD treatment process.
06:01 And so realizing that again, and that goes with OCD across the board, right? If someone comes, um, to my office and they're worried about, you know, germs and contamination, we, we come to the understanding that it's not a contamination issue, right? It's not an AIDS issue. It's not a hit and run issue or a religious issue or any of the other themes that OCD takes on. And that's really what we do with self harm. OCD as well. We realized that it's an OCD issue. And so the point number two is really distinctly, you know, making it clear that this is an OCD issue, right? And once we know it's an OCD issue, then we move into the treatment process. And that's kind of 0.3 that I want to talk about in this episode is how do we treat this? Right? How do you, how do you work with someone who has self-harm obsessions?
06:46 And you know, the, the basic treatment method for OCD is exposure and response prevention. And what exposure response prevention involves is really identifying, Hey, what are all the compulsive behaviors that the person's doing that has these thoughts? Right? What are they doing that is reinforcing these thoughts, whether it's avoiding certain things, whether it's checking something again and again and again, getting reassurance, whether that's verbal reassurance from their family members or even going to their therapist and asking for reassurance again and again and again can actually be a very common form of reassurance that someone with this, uh, this form of OCD seeks, which is why if, if you are a treatment provider and you're constantly reassuring someone else, you're not going to hurt yourself. You're not gonna hurt yourself. You're not gonna hurt yourself again and again and again and again. Cause like, are you sure I'm not going to hurt myself?
07:38 Are you sure? Right. And that's, and that's what someone with this form of OCD will say. Again, any of those, just ask that same question again. And if you're reassuring them, it's actually making the OCD worse. Right. And that is a, it's, it's a, you know, it's a hard thing to realize about once we realized that we need to, we need to cut off the reassurance cause that's what exposure and response prevention is. It's exposing yourself to the feared situation. Whether it's those thoughts that they're having in their head or certain situations, whether it's, if they're on a bridge and they're afraid they might jump off or they're driving a car and they're afraid they might swerve in, you know, to the Lake or something like that. It's actually putting ourselves in the situation where we experience our fear and then preventing ourselves from responding with compulsion's.
08:18 Right? And so identifying all the compulsion's is just, again, it's so critical that we're able to identify all the physical and mental compulsions and then kind of systematically remove them to allow that anxiety to drop. Because if, if we can experience the thought enough and sit with the uncomfortable feelings when they come up, but not do compulsion's, what happens is eventually our brain learns that these aren't actual dangers and it stops producing that over, you know, over, um, overpowered, signal of fear and alarm. And eventually we're able to just have the thought experience it. And, and ultimately the treatment, um, you know, and the recovery method for, for sunlight. We want to get them to a point where they can have these thoughts and they don't react to them and they're able to just brush them off. And we do that through, you know, again, prolonged exposure and response prevention.
09:11 And again, it's set up in a, in a hierarchy hierarchy. So we know we're attacking the smaller levels and then bigger and bigger and bigger and bigger. And so, um, and so in this episode, you know, just to quickly summarize, and again, if this is something that you struggle with or you know, um, I cover this stuff in depth in, uh, [email protected] You know, and I have a entire program just on OCD alone, you know, where we really go into in depth on, you know, teaching people how to do exposure hierarchies, um, ERP and all that and, and the entire treatment process. So, um, again, it's, if this is something that you do struggle with, I really encourage you to check that out. In fact, we have links down in the notes, um, you know, right below. So, um, and again, there's free resources, assessments, all that.
09:53 And again, it's at a restored mine's dot com for those of you that are listening. And so, um, but just to quickly summarize this, uh, this episode here. So again, it's when it comes to self harm OCT, um, and self harm obsessions, it really comes down to distinctive. You're making a distinction of the idea of self harm, obsessions and self harm or intrusive thoughts versus true suicidal ideation. Um, and then that ego-dystonic and egosyntonic, um, process and realizing that this is an OCD problem, not a suicidal problem. And once we realize that it's an OCD problem and we've actually made those distinctions with points one and two, then it's about, you know, going forward with the proper treatment, which in this case is exposure and response prevention. And that's tailored to the individual, you know, based on their specific thoughts and compulsions. And so hopefully this was helpful and cleared this up.
10:45 I know it's a, it's a pretty common form of, um, OCD. So again, uh, there's links below, um, letters, links down below, so you know, free resources stuff to help you on your journey. If this is something that you struggle with. And again, please subscribe, like, comment, you know, um, you know, across all our channels, whether it's on the podcast or YouTube or a Facebook, Instagram and Twitter. And again, we're at restored minds and, uh, again, thank you so much for taking the time to be here with us on this episode and I hope you found it helpful and I hope you guys have a wonderful week and I'll see you in the next episode where we're going to continue this series on intrusive thoughts. Take care.