You're holding your newborn at 2am and, out of nowhere, a thought flashes through your mind: what if I dropped her down the stairs? You're standing in the kitchen and catch sight of the knife block, and a thought arrives, unbidden: what if I picked one up and hurt someone? You're driving your best friend home and think, what if I swerved into oncoming traffic right now?

If thoughts like these have ever crossed your mind, you may have felt a jolt of horror, followed by a flood of questions. Does this mean something is wrong with me? Am I secretly capable of this? Should I be worried?

For most people, these thoughts pass in a second and are forgotten. But for some, they get stuck, looping over and over, demanding to be resolved. This is often what's known as Harm OCD, a form of Obsessive-Compulsive Disorder where the mind fixates on the fear of causing harm to someone else, or sometimes to yourself. This article looks at what Harm OCD actually is, why it takes hold, and what genuinely helps.

You did well. By most measures, you did really well. But you can't quite let yourself feel it, because there's always something you could have done better. The presentation went smoothly — but that one stumble in the middle. The project was excellent — but it could have been more polished. The meal was delicious — but you overcooked the vegetables slightly.

You didn't mean to spend an hour reading about bushfires, global conflict, and economic collapse before bed. You just picked up your phone. And then, somehow, here you are: wide awake at midnight, heart slightly elevated, with a low-grade sense that everything is quietly unravelling.

It usually starts with a thought — quiet, then louder. 'Do I actually love them? What if I'm with the wrong person? What if I feel nothing? What if they feel nothing for me?' Most people have moments of doubt in relationships. But for some people, these thoughts don't pass. They loop.

You text your partner after a difficult conversation: 'We're okay, right?' They reassure you. Ten minutes later, the thought creeps back. You scroll through the message thread just to check. You bring it up again over dinner. Sound familiar?

You'd think that someone with high standards would be the most productive person in the room. The one who gets things done early, who never misses a deadline, who always delivers.

And sometimes that's true, for a while. But if you look closely at how perfectionism actually plays out in people's lives, there's a pattern that surprises almost everyone who recognises it in themselves: the higher the standard, the harder it becomes to start.

This is the perfectionism–procrastination loop, and it's one of the most common things we see in our therapy rooms. Not because the people sitting across from us are lazy or unmotivated, quite the opposite. They care so much about doing things well that the fear of falling short becomes paralysing.