Fear of Harm FOH and Fears

Question: Can you explain FOH’s second symptom, Fear of Harm? Isn’t everyone afraid of being harmed? How is that a symptom?


Answer: There are 7 criteria that are used to help diagnose Fear of Harm. In this series we’re going to cover the first 5, which are all observable. In this installment we’ll look at the 2nd symptom, called “Fear of Harm”, which includes:

    • Fear that harm will come to self and/or others,
    • Easily misperceives and experiences neutral stimuli as threatening,
    • Obsessive bedtime rituals,
    • Fear of the dark,
    • Fear of intruders,
    • Separation anxiety,
    • Contamination fears,
    • Hypervigilance,
    • Territorial and reactive aggression in response to limit setting and perceived threat or loss.


So, this 2nd symptom is the criteria that gives its name to how we refer to this disorder, and “fear of harm” is what it sounds like: it’s the child’s intense and exaggerated fear that they, or someone they love, will be harmed or killed, usually in some violent and terrifying way. 


Now while yes, everyone has things that they are afraid of, and yes, kids get scared, these fears go beyond anything that would be considered developmentally normal childhood fears. These fears are experienced as enormous and distorted reactions to normal things that the child experiences in their environment. They will see threats that do not exist, either by misperceiving something neutral in their environment as threatening, or by feeling excessively defensive as a result of feeling embarrassed, misunderstood, unheard, dismissed, or rejected. 


As a result of these fears kids often create elaborate rituals at bedtime, mealtime, bath time, and transition times. These rituals are often seen by adults as avoidance strategies and those adults find the delays they cause intolerable. But the truth is that these rituals are created by kids to protect themselves from the harm they believe surrounds them. 


These kids can struggle with debilitating levels of separation anxiety, fear of germs, fear of intruders, or of the dark.  These fears severely limiting their ability to function normally in school, at home, and in the community.


Also a part of the symptom called “fear of harm” is a PTSD like symptoms constant hypervigilance that leave the child on constant alert, looking for threats and dangers they are convinced are there waiting to harm them, even when the environment is neutral or even entirely safe. 


Everything from simple limit setting to minor correction or redirection can be misperceived as threatening, or as a loss, and result in aggressive and reactive responses that seem to outsiders as disproportionate or inappropriate to the situation. But seeing threats where they don’t exist plagues those with Fear of Harm, encouraging their fears and perceptions of danger.

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