The Psychology of Self-Injury: Exploring Self-Harm & Mental Health

Self-Harm OCD vs. Nonsuicidal Self-Injury, with Nathan Peterson

Episode Summary

Nathan Peterson, LCSW, from OCD and Anxiety Counseling in Allen, Texas, explains the difference between Self-Harm OCD and nonsuicidal self-injury as well as Exposure and Response Prevention (ERP) for harm OCD.

Episode Notes

Approximately 1-4% of people throughout the world experience obsessive-compulsive disorder (OCD). Individuals with OCD are more likely than those without OCD to engage in nonsuicidal self-injury (NSSI), and recent research has shown that, among those who self-injure, having a diagnosis of OCD predicts more severe self-injury.

In this episode, licensed clinical social worker and OCD expert Nathan Peterson explains how he differentiates nonsuicidal self-injury (NSSI) from Self-Harm OCD, which is just one of many subtypes of OCD and one in which a person experiences intrusive thoughts or mental images of violence toward oneself. He then walks us through how he uses Exposure and Response Prevention (ERP) for Self-Harm OCD in therapy. 

Learn more about Nathan and his therapy practice OCD and Anxiety Counseling here. He has nearly 100k subscribers on YouTube (@ocdandanxiety) where his videos receive thousands and thousands of views. You can also follow him on Instagram (@ocdandanxietyonline), Twitter (@ocdandanxiety1), and Facebook.  Click here to take his online "Do I Have Harm OCD? Test." Below are additional resources about OCD and/or NSSI:

  1. Browning, M. E., Lloyd-Richardson, E. E., Schneider, R. L., Faro, A. L., Muehlenkamp, J. J., & Claudio-Hernandez, A. (2022). Obsessive compulsive disorder and co-occurring nonsuicidal self-injury: Evidence-based treatments and future research directions. The Behavior Therapist, 45(6), 199-208.
  2. International OCD Foundation at
  3. Winston, S. M., & Seif, M. N. ( 2017). Overcoming unwanted intrusive thoughts: A CBT-based guide to getting over frightening, obsessive, or disturbing thoughts. New Harbinger.
  4. Baer, L. (2012). Getting control: Overcoming your obsessions and compulsions (3rd ed.). Plume.

To learn more about how medication can help address OCD (most often in tandem with ERP but not discussed in this episode), click here

Follow Dr. Westers on Instagram and Twitter (@DocWesters). To join ISSS, visit and follow ISSS on Facebook and Twitter (@ITripleS).

The Psychology of Self-Injury podcast has been rated #5 by Feedspot in their "20 Best Clinical Psychology Podcasts" and also featured in Audible's "Best Mental Health Podcasts to Defy Stigma and Begin to Heal."

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