If you’ve ever had a fear of losing control and hurting someone, you’re not crazy and you’re not dangerous. Sometimes, that’s just how OCD works.
Harm OCD is brutal because it doesn’t just make you doubt what might happen. It also makes you doubt who you are. The fear of losing control and hurting someone can feel so real that it leads you to avoid everyday things like knives, scissors, certain people, even your own thoughts.
But ICBT (Inference-Based Cognitive Behavioral Therapy) offers a way out. It doesn’t rely on exposure therapy or trying to “logic your way out” with talk therapy. It helps you recognize how the doubt got there and what keeps it going.
Here’s what that ICBT actually looks like, in an example of harm OCD. You can learn about other OCD subtypes here.
How OCD pulls you in
Meet Ava. She’s 34, an attorney, and a mom of two girls. One afternoon she’s making dinner, and out of nowhere she has the thought “What if I snapped and stabbed one of the girls?” A gruesome image pops in her mind. Her stomach drops. She feels sick and disgusted. She puts the knife down and walks away.
She spends the next hour searching online, replaying memories, asking her partner if he thinks she seems “off.”
In ICBT, we look at this as a specific sequence:
- Trigger: Cutting vegetables
- Doubt: “What if I snapped?”
- Consequence: “I would harm someone I love. I would go to prison. Everyone would be horrified and disgusted with me.”
- Dread: Fear that she’s dangerous, unstable, not who she thought she was
- Compulsions: Avoiding knives, seeking reassurance, analyzing her feelings
This fear of losing control and hurting someone isn’t about actual risk. It’s about doubt. Obsessional doubt pulls Ava into a terrifying story that feels like it needs solving but it isn’t grounded in her real life.
The stories OCD tells about the fear of losing control and hurting someone
These doubts don’t come from nowhere. OCD always builds a case. Ava’s brain pulls together:
- That time she yelled in college and threw a hairbrush
- A news story about a woman with postpartum psychosis
- Her belief that “good moms are always in control”
- And the classic OCD trap “It’s possible.”
Put together they form a story that seems to support her doubt that she’s the kind of person who might have a dark side she’s not aware of.
It’s not just scary. It’s about her and the kind of person she is (or might be) deep down. That’s what makes it stick.
In ICBT, we call this the feared self. The feared self is the version of yourself you’re terrified of being, becoming, or being seen as. For Ava, it’s someone evil and unknown to herself. But that story isn’t coming from her senses. It’s coming from imagination.
How ICBT helps you get unstuck
Ava starts learning ICBT and sees what’s actually happening.
She names the pattern: trigger → doubt → consequence → dread → compulsion. That alone gives her some distance.
Then she notices how OCD builds its case. The story isn’t built on real evidence, but through possibility, past personal experiences, irrelevant connections, and a total mistrust of her own senses. It’s not logic, it’s obsessional reasoning.
Instead of arguing with the story and the fear of losing control and hurting someone, Ava practices telling a grounded story. She doesn’t argue with her OCD, but connects with what she knows, deep down, to be true.
I’m here, chopping vegetables. I’m calm. I love my children and they’re safe with me. Nothing in my senses tells me I’m at risk of hurting anyone.
The goal isn’t to feel better or to get rid of a feeling. It’s to notice what’s real.
The OCD bubble is all imagination
The next time the fear hits, Ava recognizes it. She observes the urge to act, avoid, or figure it out. It becomes her signal She slows down and realizes it’s the pull of the OCD bubble.
And she uses her skills to pause, observe with her senses, and proceed with her day. It’s simple but it’s not easy. She’s stepping out of imagination and back into reality.
Your real self isn’t dangerous
This part matters more than it sounds. The feared self feels real because it’s so far from Ava’s actual values. But that’s exactly why OCD targets it.
Ava’s every day life is full of data. She’s thoughtful. She loves spending time with her kids and doing activities with them. Tucking them into bed at night is her favorite part of the day. She loves to read them stories and cuddle. She feels sick at the thought of anyone being hurt. She even carries bugs outside instead of smashing them. That matters.
She doesn’t need to prove she’s not dangerous. She just needs to reconnect with what’s already true.
You don’t need to solve the fear of losing control and hurting someone to move forward
If you’ve been caught in the fear of losing control and hurting someone, I want you to know that ICBT doesn’t ask you to debate your fears or sit with them forever.
It gives you a plan for seeing what OCD’s actually doing and how to step out of it. If you want to learn more, my ICBT for OCD program walks you through this process.
Join the waitlist here and I’ll send you the details when the next round opens.
