OCD Types The Fear of Losing Control With OCD By Marla Deibler, PsyD Marla Deibler, PsyD Facebook Twitter Marla W. Deibler, PsyD, MSCP, is a licensed clinical psychologist and nationally-recognized expert in anxiety disorders and other mental health topics. Learn about our editorial process Updated on July 29, 2022 Medically reviewed Verywell Mind articles are reviewed by board-certified physicians and mental healthcare professionals. Medical Reviewers confirm the content is thorough and accurate, reflecting the latest evidence-based research. Content is reviewed before publication and upon substantial updates. Learn more. by Akeem Marsh, MD Medically reviewed by Akeem Marsh, MD LinkedIn Twitter Akeem Marsh, MD, is a board-certified child, adolescent, and adult psychiatrist who has dedicated his career to working with medically underserved communities. Learn about our Medical Review Board Print MoMo Productions/Getty Images Table of Contents View All Table of Contents Fear of Losing Control Fear of Harm Intrusive Thoughts Getting Help 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 okayChecking appliances to make sure they are turned offChecking that the door is locked so that an intruder doesn't break into the houseEngaging in superstitious behaviors such as counting, tapping, or repeating wordsRepeatedly checking to make sure the oven is off in order to avoid starting a fireWashing 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 objectsAvoidance of distressing material that can trigger intrusive thoughtsAvoidance of being aloneChecking for dangersChecking 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 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 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? 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. The Best Online Therapy Programs We've tried, tested and written unbiased reviews of the best online therapy programs including Talkspace, Betterhelp, and Regain. 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. 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. Additional Reading Booth, B., Friedman, S., Curry, S., Ward, H., & Stewart, E. Obsessions of Child Murder: Underrecognized Manifestations of Obsessive-Compulsive Disorder. J Am Acad Psychiatry Law 42:66–74, 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 Psychiatry 169: 360-363, 2012. doi:10.1176/appi.ajp.2011.11050667 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. See Our Editorial Process Meet Our Review Board Share Feedback Was this page helpful? Thanks for your feedback! What is your feedback? Other Helpful Report an Error Submit Speak to a Therapist for OCD Advertiser Disclosure × The offers that appear in this table are from partnerships from which Verywell Mind receives compensation.