Austin Therapist for Intrusive Harm Thoughts:
You're Not Dangerous
Are you having graphic, disturbing thoughts about harming your baby? Thoughts of dropping, shaking, or hurting them that won't go away no matter how hard you try to suppress them?
These thoughts do NOT mean you will act on them.
You're not dangerous. You're not a bad mother. You have postpartum OCD—a treatable medical condition that affects 3-5% of new mothers.
The fact that these thoughts horrify you is proof you would never want to harm your baby. Mothers with postpartum OCD are often the most vigilant, protective parents precisely because they are so disturbed by their thoughts.
Understanding Intrusive Harm Thoughts
Intrusive harm thoughts are unwanted, graphic mental images or thoughts about accidentally or intentionally harming your baby. They feel foreign, disturbing, and deeply wrong—because they ARE wrong. They're not reflections of your true desires or intentions. They're symptoms of postpartum OCD.
Common Intrusive Harm Thoughts
- • Thoughts of dropping, shaking, or throwing your baby
- • Images of suffocation, drowning, or smothering
- • Violent thoughts involving knives, scissors, or other household objects
- • Fears of "snapping" and losing control during crying or tantrums
- • Thoughts of your baby falling down stairs or out of windows
- • Images of harming your baby during routine caregiving (bathing, feeding, changing)
These Thoughts Have Specific Characteristics:
- Ego-dystonic: They feel deeply disturbing and wrong to you (NOT wanted or acceptable)
- Repetitive: They intrude repeatedly despite your best efforts to suppress them
- Anxiety-provoking: They trigger intense distress, guilt, shame, and fear
- Foreign: They feel like "not you" or like they're coming from outside yourself
How Common Are Intrusive Harm Thoughts?
More common than you think:
- • 3-5% of postpartum mothers experience clinical-level intrusive harm thoughts (postpartum OCD)
- • Up to 50% of mothers experience fleeting intrusive thoughts that are milder and don't meet clinical criteria
- • Vastly under-reported due to intense shame, fear of judgment, and worry about having baby taken away
You are NOT alone. These thoughts are hidden because mothers are terrified to admit them—but they're far more common than most people realize.
Intrusive Thoughts vs. Actual Danger: What's the Difference?
THIS IS THE MOST IMPORTANT SECTION TO UNDERSTAND.
If you're reading this page, seeking help, and feeling horrified by your thoughts, you almost certainly have postpartum OCD—NOT a dangerous condition.
| Intrusive Harm Thoughts (OCD) | Actual Risk (Postpartum Psychosis) |
|---|---|
| "What if I drop my baby down the stairs?" | "I need to harm my baby" |
| Horrified and distressed by the thought | Feels justified, rational, or necessary |
| Avoids triggers (stairs, knives, bathtub) | Plans or prepares to act on thoughts |
| Seeks constant reassurance and help | Withdrawn, lacks insight into condition |
| NO intention to act | Delusions, hallucinations, paranoia |
| Common (3-5% of mothers) | Extremely rare (0.1-0.2% of births) |
The Proof:
If you're reading this page, desperately searching for answers, and feeling terrified by your thoughts, you have postpartum OCD.
The distress you feel IS the proof you would never act on these thoughts.
Mothers with postpartum OCD are often the most careful, protective parents. Your brain's threat-detection system is malfunctioning—not your love, not your character, not your fitness to be a mother.
Why Intrusive Harm Thoughts Occur
Postpartum OCD is not your fault. It's a medical condition with clear biological, psychological, and environmental causes.
Biological Factors
- • Hormonal plummet (estrogen, progesterone)
- • Serotonin dysregulation (linked to OCD and anxiety)
- • Sleep deprivation weakens thought-filtering
- • Oxytocin surge → hyper-vigilance
Psychological Factors
- • New responsibility triggers catastrophic thinking
- • "If I don't prevent every danger..."
- • Gap between expectations and reality
- • Pre-existing OCD/anxiety (40-50% increased risk)
Environmental Factors
- • Social isolation and lack of support
- • Cultural silence around maternal mental health
- • Traumatic birth experiences
- • History of abuse/trauma (2-3x increased risk)
"Intrusive harm thoughts are your brain's misguided attempt to protect your baby. The protection system is malfunctioning—not your love, not your character, not your fitness to be a mother."
Evidence-Based Treatment for Intrusive Harm Thoughts
Postpartum OCD is one of the most treatable perinatal mental health conditions. With specialized therapy, 70-80% of mothers see significant symptom reduction.
Exposure & Response Prevention (ERP)
Gold standard treatment for OCD with 70-80% effectiveness. Gradual, controlled exposure to intrusive thoughts WITHOUT performing compulsions. Teaches your brain: "I can have this thought and NOT act on it."
Cognitive Behavioral Therapy (CBT)
Addresses thought-action fusion (thinking ≠ doing). Challenges catastrophic thinking, builds tolerance for uncertainty, and teaches you to distinguish OCD false alarms from real danger signals.
Mindfulness & Acceptance
Learn to observe intrusive thoughts without judgment or engagement. "Thoughts are mental events—they have no power unless I give it to them." Grounding techniques for moments of panic.
Treatment Timeline
Most mothers notice improvement
70-80% symptom reduction
Maintenance to prevent relapse
What Treatment Looks Like
Starting therapy for intrusive harm thoughts can feel terrifying—especially if you've been hiding them out of shame or fear. Dr. Rundle creates a safe, confidential, non-judgmental space where you can share openly.
Important: You will NOT be reported to CPS for having intrusive thoughts. These are symptoms of a medical condition, not evidence of danger.
Step 1: Initial Assessment & Safety Validation
- • Discuss nature, frequency, and triggers of intrusive thoughts
- • Identify current compulsions and avoidance behaviors
- • Differentiate postpartum OCD from other conditions
- • Validate that these are OCD symptoms, NOT evidence of danger
- • Create personalized treatment plan with clear goals
Step 2: ERP Hierarchy Building
- • Rank intrusive thoughts and triggers from least to most distressing
- • Identify your current compulsions and safety behaviors
- • Learn response prevention strategies
- • Always starting with manageable exposures to build confidence
Example Hierarchy:
- 1. Thinking the word "harm" (least distressing)
- 2. Looking at stairs while holding baby (with partner present)
- 3. Walking near stairs with baby (with partner nearby)
- 4. Walking near stairs with baby alone
- 5. Bathing baby alone (most distressing)
Step 3: Active Treatment
- • Weekly 50-minute sessions (in-person or virtual)
- • Practice ERP exercises together during sessions
- • Complete assigned exposures between sessions
- • Track: 1) Reduction in compulsions, 2) Decrease in distress, 3) Frequency of thoughts
- • Learn to distinguish OCD-generated thoughts from real danger signals
Step 4: Long-Term Management & Relapse Prevention
- • Identify early warning signs of symptom return
- • Create action plan to address symptoms quickly if they recur
- • Transition to less frequent check-ins as you gain confidence
- • Goal: Enjoy motherhood without constant interference of intrusive thoughts
Serving Austin & Surrounding Communities
Primary Service Areas
- • North Austin (78750, 78759, 78731)
- • Cedar Park
- • Round Rock
- • Pflugerville
Austin Neighborhoods
- • The Domain
- • Great Hills
- • Anderson Mill
- • Wells Branch
Virtual Therapy Available
- • Lakeway
- • Georgetown
- • All of Texas
- • HIPAA-Compliant Platform
Office Location
13706 N Highway 183, Suite 114
Austin, TX 78750
Frequently Asked Questions About Intrusive Harm Thoughts
How do I know if my harm thoughts are OCD or if I'm actually dangerous?
If you are horrified by your thoughts, actively trying to suppress them, and feeling intense distress, you have postpartum OCD—NOT a dangerous condition. The fact that these thoughts disturb you is proof you would never want to harm your baby. Mothers with postpartum OCD are often the most vigilant, protective parents. Actual danger (postpartum psychosis) involves thoughts that feel justified or necessary, planning to act, lack of distress, and often delusions or hallucinations. It's extremely rare (0.1-0.2% of births) and looks very different from intrusive harm thoughts. If you're reading this page and seeking help, you almost certainly have treatable postpartum OCD.
Should I tell my partner or doctor about these thoughts? Will they take my baby away?
Having intrusive harm thoughts is a symptom of postpartum OCD, NOT evidence of danger to your baby. You will NOT have your baby taken away for seeking treatment for OCD symptoms. Healthcare providers understand the difference between intrusive thoughts and actual risk. We recommend starting therapy first, where you can process these thoughts in a safe, confidential space. Dr. Rundle can help you decide when and how to share with your partner or OB-GYN, and can provide educational resources to help them understand that these are medical symptoms, not true intentions.
How long does treatment take? Will these thoughts ever go away?
Most mothers notice improvement within 4-6 weeks of starting ERP therapy. Significant symptom reduction (70-80% improvement) occurs within 8-12 weeks of consistent treatment. The thoughts may never completely disappear—but their frequency, intensity, and distress level decrease dramatically. You'll learn to dismiss them as "just OCD noise" rather than something meaningful or dangerous. Many mothers describe feeling like themselves again, able to enjoy their baby without constant fear.
Can I still breastfeed while being treated?
Yes. ERP therapy and CBT are non-medication treatments and do not interfere with breastfeeding in any way. If your symptoms are severe and your healthcare provider recommends medication as part of your comprehensive treatment plan, many SSRIs are considered safe while breastfeeding. The decision about medication is always yours to make in consultation with your OB-GYN or psychiatrist. Dr. Rundle provides therapy-based treatment and can coordinate with your medical providers if medication is being considered.
What if I've already tried therapy and it didn't work?
General talk therapy or anxiety management techniques often don't work for postpartum OCD. You need specialized ERP therapy delivered by a provider who understands perinatal OCD. If you've tried therapy before without success, it's likely because the approach wasn't tailored to OCD. ERP is the gold standard treatment for OCD with the highest success rates of any therapeutic modality. Dr. Rundle specializes in perinatal OCD and uses evidence-based ERP protocols specifically designed for new mothers. The approach is different—and far more effective—than general talk therapy.
Payment & Insurance Information
Dr. Rundle is considered an out-of-network provider on all insurance panels. We provide Super Bills after each session that you can submit to your insurance company for reimbursement if you have out-of-network benefits.
What is a Super Bill?
A Super Bill is a detailed receipt that includes all the information your insurance company needs to process an out-of-network claim: diagnostic codes, session dates, provider credentials, and treatment details. We provide this automatically after each session, making it easy for you to submit for potential reimbursement.
Questions about payment or understanding your out-of-network benefits? Contact us for a free 15-minute consultation. We'll help you navigate your insurance coverage and answer any questions about fees and payment options.
You're Not Dangerous—You're Sick, and You Can Get Better
The intrusive harm thoughts you're experiencing are not your fault. They don't mean you're a bad mother, unfit to parent, or secretly dangerous. They're symptoms of postpartum OCD—a medical condition caused by hormonal shifts, sleep deprivation, and an overactive threat-detection system in your brain.
The distress you feel about these thoughts is proof you would never act on them.
With Specialized ERP Therapy, You Can:
- ✓ Reduce the frequency and intensity of intrusive thoughts
- ✓ Stop avoiding your baby or caregiving tasks out of fear
- ✓ Eliminate compulsive checking and reassurance-seeking
- ✓ Feel confident and safe as a mother
- ✓ Bond with your baby without constant fear and anxiety
Dr. Rundle has helped hundreds of mothers find relief from postpartum OCD and intrusive harm thoughts. You don't have to suffer in silence or shame.
You're not dangerous. You're a mother who needs help—and help is available.
Phone: (512) 648-2722
Email: contact@bloompsychology.com