Phobia of Committing Impulsive Acts: What it Is and How to Treat it

How do you identify a phobia of committing impulsive acts?

From a professional point of view, phobia of committing impulsive acts is a form of OCD. And whether we look at it as a kind of OCD or as its own phobia, it’s a condition that involves an intense fear of your own impulses. 

The main clinical characteristics of this disorder are:

• Being invaded by thoughts that deal with following an impulse and losing control. 
• That the contents of these thoughts all have something to do with anticipating an “aggression.” It could be towards yourself or towards other people.
• Feeling intense fear just from the fact of having these kinds of thoughts. 
• Behaving in a way that you think will prevent these kinds of thoughts from becoming reality.

What are the most common impulses?

People who see a professional and are diagnosed with phobia of committing impulsive acts can usually identify the thoughts that make them most scared: harming loved ones, jumping off a balcony, swerving on the highway, or jumping in front of a train. In all of these cases, the patient has a kind of thought-action fusion.

The way that phobia of committing impulsive acts develops is that:

• First, they have a thought or mental image where they “see” themselves following an impulse and losing control. They see that image or thought as catastrophic.
• Then they’ll use all the psychological resources they have to “erase” those images or thoughts. But since focusing on their thoughts is the wrong strategy, the anxiety gets even worse and their anticipatory thoughts get even more powerful.
• Since they can’t control what they think about (no one can), they reinforce the power of the idea that they’ll lose control. And that will make their feeling of fear even stronger.

The most common consequences of phobia of committing impulsive acts

Any kind of OCD or phobia (if what they’re afraid of is there every day) will lead to a huge reduction in a person’s quality of life. This happens because they work hard to control their fear and avoid situations that make them anxious. So bit by bit, without even realizing it, they end up throwing away parts of their personal life and wasting a lot of their energy trying to control their fear.

Another thing that happens is that you make yourself the enemy. Since it’s an egodystonic disorder, your self-demand for controlling these thoughts is extremely high. (An egodystonic disorder is  when there’s a disconnect between what you think and what you want.) At the same time you also feel like you’re fighting against yourself. 

That is, the obsession and fear will take over the person’s attention. But they think that since it’s external, they can control it. When they can’t, they feel like it’s them who’s causing the obsession. Hence why they feel like they’re fighting against what their mind tells them. If it persists, this internal struggle will lead them to anxiety and depression, which may also need therapy. 

What is the treatment for the phobia of committing impulsive acts?

The treatment for the phobia of committing impulsive acts, whatever the obsession is — whether it’s about harming yourself or others — will always be psychological. But if a patient has extreme anxiety, therapy and prescription medication is often appropriate. In general, treating it with therapy is similar to treatment for people with OCD. 

It always has to be psychological treatment because psychologists are the only people with the training and experience needed. Treatment will include:

• Understanding how they got this problem and how it’s affecting them now.
• Evaluating and identifying the different ways they’ve tried and failed to deal with their disorder.
• Developing the things they tried that did work.
• Understanding how their mind and the disorder work. That way they can take control of what happens to them.
• Detaching themselves from their thoughts. This means that thinking something doesn’t mean doing it or being capable of it. It also doesn’t make it any more likely to happen. 
• Getting back valuable parts of their life that they’ve neglected.
• Preventing relapses and strengthening the psychological tools they’ve learned.

Psychological treatment

Lastly, we want to mention that even though there are different psychological approaches for treating phobia of committing impulsive acts, the only ones with research behind them are cognitive-behavioral strategies. 

That doesn’t mean other approaches aren’t valid. It just means that they still haven’t scientifically proven whether they work or not. This is probably because they don’t do many studies on other therapeutic models that are harder to standardize. Brief strategic therapy is one example.

If you identify as someone with phobia of committing impulsive acts, remember that it’s a psychological problem. T he sooner you face it, the sooner you’ll find relief.  Psychologists are your greatest allies! So stop putting it off, and if you need to, take that step: ask for help.