The Fear of Losing Control With OCD

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Obsessive-compulsive disorder (OCD) is a psychiatric condition that involves both obsessions and compulsions. Obsessions are recurrent, persistent, intrusive thoughts, images, or urges that cause anxiety or distress. Compulsions are repetitive behaviors or acts that are meant to reduce or neutralize anxiety and fears. 

Obsessions such as contamination concerns and those involving perfectionism are 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.

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 the Journal of Obsessive-Compulsive and Related Disorders found 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.

Such fears are accompanied by heightened and excessive responsibility to prevent such disasters. This can lead to checking behaviors, such as:

  • Calling loved ones to make sure they are okay
  • Checking appliances to make sure they are turned off
  • Checking that the door is locked so that an intruder doesn't break into the house
  • Engaging in superstitious behaviors such as counting, tapping, or repeating words
  • Repeatedly checking to make sure the oven is off in order to avoid starting a fire
  • Washing and re-washing food or hands in order to prevent contamination

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 objects
  • Avoidance of distressing material that can trigger intrusive thoughts
  • Avoidance of being alone
  • Checking for dangers
  • Checking that safety precautions have been taken

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 find uncertainty extremely 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 include seeking reassurances from others, checking behavior (locks, windows, schedules), and mental rituals that involve trying to seek clarification.

Intrusive Thoughts

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 objects
  • Avoiding songs, movies, or readings that involve murder, death, or injury
  • Avoiding touching or caring for a loved one who has been the subject of the unwanted thoughts
  • Avoiding being alone with the loved one

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.

Getting Help

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 include cognitive behavioral therapy (specifically, a type called exposure and response prevention) and medication (such as selective serotonin reuptake inhibitors).

If you have treatment-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.

5 Sources
Verywell Mind uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
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  2. 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

  3. Williams MT, Mugno B, Franklin M, Faber S. Symptom dimensions in obsessive-compulsive disorder: Phenomenology and treatment outcomes with exposure and ritual preventionPsychopathology. 2013;46(6):365-376. doi:10.1159/000348582

  4. 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

  5. Kellner M. Drug treatment of obsessive-compulsive disorderDialogues Clin Neurosci. 2010;12(2):187-197.

Additional Reading

By Marla Deibler, PsyD
Marla W. Deibler, PsyD, MSCP, is a licensed clinical psychologist and nationally-recognized expert in anxiety disorders and other mental health topics.