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I think it is kind of an inverted fight response. You are dealing with stress and it reminds you of situations where you were a target of physical violence so your first reaction is rage and the desire to do violence in turn, but you don't want to really hurt others in the present day because your conscience won't let you, and also the stress isn't really something you can punch, a person physically attacking you makes sense to fight against but how do you punch a deadline? Or a faceless technology company? So all that rage turns inward and you start calling yourself names. And if you are around other people you can let it slip how you're feeling about yourself, ie calling yourself worthless to a teacher or job supervisor when they talk with you about how to improve your work.
But all this is just adaptations to a bad situation that then become the default response for all stress because of how often you felt like you had to be strong and alert all the time to defend yourself and the fear of weakness of any kind making you a target again. It is like adjusting to college life after previously being involved with street gangs.
I told someone where i work and that my head tells me i am a pedophile and that i should die. I am not one and i dont know what made me identify with one. I mean identify with one and not identify with pocd. This is not who i am. I cant explain what happens to me.