Week 3 – Harm OCD: Visions of Psychopathy

Introduction & Recap

Imagine for a moment that you’re not yourself, and rather take on a character of a man or woman going about their day. You’re on your way to work in the morning and you’re waiting the 6:30am train to arrive. It arrives, and you board it with everyone else. The train is crowder and a person accidentally bumps you, but you palm it off as nothing.

You see that same person and you tackle them to the floor. They look horrified. You strike them in the head again and again with a hammer. There is blood everywhere, and you burst out laughing.

You are standing around the coffee machine with your co-workers and finding out how each other’s weekends went.  You see that same person and you tackle them to the floor. They look horrified. You strike them in the head again and again with a hammer. There is blood everywhere, and you burst out laughing.

Your boss asks you about how that assignment is going. You answer him in a mechanical way with the least amount of energy. You see that same person and you tackle them to the floor. They look horrified. You strike them in the head again and again with a hammer. There is blood everywhere, and you burst out laughing.

Harm OCD (Obsessive Compulsive Disorder) is when an individual experiences intrusive and unwanted thoughts and urges about ultra-violence towards the self and others. These thoughts and urges can last between days, weeks, and months at a time. The thoughts and urges consume the individual and they spend the majority of their time questioning their own psyche. Am I insane? Do I enjoy seeing a person beaten to death? Is my destiny to be a killer? Compared to traditional OCD, these thought suppressions are considered to be more ego-dystonic (Moulding, R et al, 2013).

1. What is your design challenge?

How do you stop a thought or urge from occurring when the chemicals inside a brain are telling an individual who suffers from Harm OCD to think a certain way? Providing a instant fix is a flight of fancy since Harm OCD thoughts not only have a high probability of recurrence, but the triggers which activate those violent thoughts are unknown (Lee & Kwon, 2003, cited by Moulding, R et al, 2013).

Instead we aim to provide an educational solution to a user suffering from Harm OCD.

2. What is your positive computing strategy?

There are numerous debates as to the foundational cause of Harm OCD, however the majority belief is that it is a combination of bio-chemical imbalance where the brain gets “locked” into an obsessive thought pattern (Schwartz, JM, 1997), genetic & hereditary pre-disposition, and environmental factors.

We aren’t aiming to fix OCD, rather, to educate a user so that over time they will re-program themselves with methods on actively avoiding looped episodes. Our positive computing strategies include:

Positive emotions – Reframing

Cognitive reframing is the act of changing a person’s mindset in both a positive and negative way through the analysis of their thoughts and patterns. Over time, reframing allows for a disciplined path to self-awareness and the eventual habitual change of thought process.

Self-Awareness – Online CBT Study

CBT training in its basics is when a person suffering from a disorder is helped to overcome their mental difficulties by modifying their thinking, behaviour, and emotional responses to factors they have little to no control over.

Breaking CBT down reveals a core methodology of Socratic Questioning as its foundation which is developed from the Socratic school of philosophy.

Beyond positive computing

The most important attribute to our solution will be the most accurate empathetic representation with a user suffering from Harm OCD. We want to allow them to ‘breathe’ so that they can ignore the taboos created in the mass minds of a conventional society.

We aim to create a digital physical interface which will the user to educate themselves on raw symptoms of the condition without a feeling of judgement. Rather, we want their will power to be enriched by providing knowledge and relatability.

3. What did the literature tell you about it?

That there should be a focus on CBT combined with cognitive reframing. Often times there is confusion between reframing and restructuring, the later which means to encourage the user to adopt positive thinking. This however is not possible in Harm OCD and the aim it to instead encourage objective thinking of the self.

“Repeatedly telling yourself that no bad thing will happen is compulsive. Sitting with the following (both negative and positive thoughts) is more effective” (OCD Centre, 2012).

Motto: Question instead of convince.

The CBT aspect goes into specifics of traits of those suffering from Harm OCD, and in particular the attributes that surround their thoughts. Below are a few examples of a thought possibility, an illogical assumption resulting from that thought, and then an educational realisation.

Thought: I’ve had mental images of shooting all my workmates these past few weeks. They can’t know these things. If they find out, I’ll be locked up forever.

Illogical assumption: The person believes that their thoughts control their lives. They think that because they’ve had thoughts of violence, they will immediately go to prison.

Educational realisation: This person is using “black-and-white thinking” where they believe an action causes an immediate and concrete certainty, and that this certainty is the final truth.

Thought: I can’t stop thinking of wanting to stab that girl. It must mean that I want to do it. And when I do it..I’ll be a killer. And if I’m a killer then the police will be after me and I’ll have to go on the run. I’ll never be able to see my family or friends again. They are going to arrest me and take me to prison or a psych ward. They’ll think I’m insane. I must be insane, I must be a psychopath.

Illogical assumption: The person believes that a chain of events will occur due to a singular initial thought. Their thought process will go on and on in a loop until they have exhausted all their energy. They believe whole-heartedly in this scenario becoming their reality.

Educational realisation: This person is “catastrophising”, or perceiving a thought to be worse than it actually is. They have imagined the worst case scenario that could be a possible consequence of an action from their thought, and then built upon it until an entirely alternate reality has been created in their mind. When this reality doesn’t end up happening the person feels withdrawn, alienated, and confused by their actual reality.

4. Who is your user group?

We aim to cater for males aged between 16-25. Statistics have been hard to find on purely Harm OCD, with the majority being just OCD related. A few of the papers leading in the field however are from USYD, so we’ll be trying to get in touch with those researchers.

References

Repugnant obsessions: A review of the phenomenology, theoretical models, and treatment of sexual and aggressive obsessional themes in OCD (Moulding, R et al, 2013)

Brain Lock: Free Yourself from Obsessive Compulsive Behaviour (Schwartz, JM, 1997)

Harm OCD Treatment: Mindfulness Based CBT (OCD Centre of Los Angeles, 2012)