Many people experience intrusive thoughts, often in the context of obsessive-compulsive disorder, post-traumatic stress disorder, or anxiety disorders. They can be very disturbing. Read on to learn about the different types of intrusive thoughts and some helpful strategies.
There Are Multiple Types of Unwanted Thoughts
Intrusive thoughts are thoughts that you wish you didn’t have. They’re unwanted and disturbing. They can happen to any of us but happen most often for survivors of trauma, those with anxiety, and those with OCD.
People who suffer from post-traumatic stress sometimes experience memories of the traumatic event that pop up even when they’re not relevant to what’s happening at that moment. Such memories can range in intensity from annoying to destabilizing to all-consuming. In their most extreme form, these memories arise as flashbacks, in which the memory feels so real that it’s as if the event is happening again.
For those who suffer from anxiety, worry thoughts can happen at any time and sometimes feel intrusive. These can be thoughts about almost anything — for example, not being liked by someone, being unhappy in a relationship, or making a bad decision. Intrusive thoughts for those with anxiety can sometimes take the form of an image — for example, an unwanted image of a sick loved one (whether or not the person is sick) or of failing at an important task.
Perhaps the most common type of unwanted intrusive thoughts is obsessions, which are a symptom of obsessive-compulsive disorder (OCD). Obsessional thoughts tend to be about certain topics (more on this below) and immediately cause anxiety. They are often described as “what if” thoughts — for example, what if I jump in front of that moving train? or, what if I just blurt out something obscene right now in this crowded church? These thoughts lead people to think about them repeatedly — they can be hard to shake.
This article focuses on intrusive thoughts that typically occur for people with OCD (i.e., obsessions).
OCD Intrusive Thoughts
The role of taboo in OCD obsessions
Every society has certain actions or ideas that are considered morally wrong or otherwise prohibited. Perhaps the most common examples in our society involve sex, violence, and religion. In these contexts, there are some ideas or actions that are considered markers of being morally corrupt or otherwise flawed. These are exactly the topics that obsessions are usually about.
For example, pedophilia, perhaps our society’s biggest taboo, is the theme of an entire subtype of OCD. Most, if not all, taboo sexual relationships or acts can be the focus of intrusive thoughts. These can include relations with someone much different in age, with animals, family members, or even inanimate objects.
For those who believe in God, saying or thinking things against God can be a major taboo. Unsurprisingly, this can also be a focus of obsessions for religious people. For example, the thought Jesus was a terrible person, or I never really loved God, or sexual thoughts about religious figures or clergy can all be obsessions.
Violence is another major taboo, especially toward vulnerable people like children or the elderly. Many people with OCD have obsessions on these themes. These thoughts can involve violence toward strangers or loved ones — romantic partners, parents, sons, daughters, or anyone else.
Common Intrusive Thoughts
Sexual intrusive thoughts
People have sexual thoughts and images frequently, though that frequency varies significantly from one person to the next. Sexual thoughts are not considered intrusive or obsessional unless they are experienced as unwanted, disturbing, and inappropriate.
For example, if someone identifies as heterosexual and has sexual thoughts about another person of the same gender, they may experience that as unwanted or disturbing. If they interpret these thoughts to mean that they might be gay, and are anxious and disturbed by the thoughts, they may be struggling with a form of obsession informally known as HOCD or SO-OCD.
However, if that same person has sexual thoughts about someone of the same gender and does not experience them as cause for concern, they will not be disturbed or anxious. Why? Because what you interpret the thoughts to mean determines how much anxiety follows the thoughts.
Racist intrusive thoughts
Racist actions, speech, and thinking are considered taboo — perhaps increasingly so in recent years. For this reason, more people have obsessive thinking about racism now than decades ago. Racist intrusive thoughts do not mean that the person having them is racist. Typically, the opposite is true — the person suffering from the thoughts is disturbed by them precisely because they find racism to be so repugnant.
People with these thoughts often try to cope with them by attempting to prevent the thoughts from ever happening again. This is typically a losing battle because of the inherent difficulty in trying not to think about something. Failure at this task is interpreted as further proof that someone with these thoughts is indeed racist. This creates a vicious cycle.
Racist obsessions can include any of the following:
- urges to yell or say a racist slur
- thoughts about hating ethnic/racial groups when one does not harbor such feelings
- repeatedly wondering if you said something racist in a recent conversation despite not intending to
Violent intrusive thoughts
Violence is an old, established, and important taboo in our society. No form of behavior is so universally shunned. So it makes sense that unwanted violent thoughts are some of the most disturbing we can have. Violent intrusive thoughts can be directed toward strangers or those we care about.
Violent thoughts (which can also take the form of impulses or images) often lead to avoiding situations that could theoretically lead to violence. For example, many with violent intrusive thoughts will put away sharp knives when loved ones are home or will walk through crowds with hands firmly in their pockets for fear of striking a stranger. This tendency to avoid can inadvertently supercharge intrusive thoughts, making them increasingly frequent over time.
RELATED: What Is Harm OCD?
Intrusive thoughts about suicide
Similar to violent intrusive thoughts, intrusive thoughts about suicide typically involve a fear that you will lose control and act contrary to your wishes. This can take the form of a thought about immediate action, such as jumping off a bridge or balcony. It can also take the form of a fear of future action, e.g., what if one day I go crazy and kill myself?
For many people, these thoughts are accompanied by doubts about one’s true desire to stay alive. If I don’t want to kill myself, why do I keep having this thought? It’s easy to see how these doubts serve to make the thoughts even scarier than they were before. This type of obsessive thought is sometimes referred to as self-harm OCD.
Intrusive thoughts during pregnancy and postpartum
Pregnancy is a unique time. You’re responsible for your unborn child in a way you’ve never been responsible for anyone before. If you’re prone to intrusive thoughts, it’s common to have thoughts about harming your baby or about harm befalling your baby during or after pregnancy.
It’s important to remember that having such thoughts does not mean anything negative about you as a person, as a mother, or mother-to-be. In fact, they don’t mean much of anything other than that you may need some help coping with this anxiety symptom.
In the postpartum period, women can be prone to depression and anxiety. Anxiety during this period affects 17% to 20% of women. Of that group, some will experience intrusive thoughts. These are particularly difficult for the mother because they are very challenging to share with others.
As with other types of intrusive thoughts, intrusive thoughts during and shortly after pregnancy will become more problematic the more weight you give them. For help changing the way you understand these thoughts, see below.
Religious intrusive thoughts
If you are a religious person, intrusive thoughts can center around religious themes. Having inappropriate or blasphemous thoughts can be extremely distressing. Many people with these thoughts are plagued by the fear they will go to hell or suffer other punishment for the thoughts. This is fueled by the belief that God or another spiritual entity is aware of the thoughts, and may not forgive them.
Consulting with a pastoral counselor or clergyperson may be helpful in these situations. If that is not possible, consider seeking out a mental health provider with expertise in intrusive thoughts (more on this below).
Do Intrusive Thoughts Make You a Bad Person?
Absolutely not! Character is not defined by thoughts — especially thoughts we don’t want to be having in the first place. Being a good or bad person is about what’s in your heart as well as about what you do. Remember, if you’re having intrusive thoughts, part of the reason is that it’s important to you not to act on them. This speaks well of you as a person — more than the thoughts themselves do.
How to Stop Intrusive Thoughts
If you suffer from obsessive or intrusive thoughts, you’d like nothing better than to find a way to silence them forever. Unfortunately, there is no such solution. However, people are able to overcome intrusive thoughts by changing their mental relationship with them. This usually involves a three-step process, often undertaken in the context of cognitive-behavioral therapy:
- Reevaluate what it means that you have these thoughts. For example, if you have intrusive thoughts about your sexual orientation, you likely consider the thoughts themselves as evidence that you are gay, straight, or bi. But is this really true? Considering other possibilities is part of the solution.
- Practice recognizing thoughts as what they are — just thoughts. Consider all the other unimportant thoughts you have — they’re not always profound or impressive or even important at all. Is it possible your intrusive thoughts might be just as unimportant?
- Reduce problematic behaviors related to the thoughts. Examples of such behaviors include a) avoiding things, and b) doing something to assure yourself that the intrusive thought is unfounded. These behaviors can admittedly help you feel calmer in the short term, but over the long term, they make things worse.
One form of psychotherapy is particularly helpful for intrusive thoughts — cognitive-behavioral therapy, or CBT. Specifically, a version of CBT called exposure and response prevention (ERP or ExRP) is helpful for intrusive thoughts and other aspects of OCD. Even if you don’t think you have OCD, seeing a CBT therapist trained in ERP is a good idea for the treatment of intrusive thoughts.
Why is cognitive-behavioral therapy helpful for intrusive thoughts? Because it helps you focus on how you process these thoughts when they arise. This is more helpful than focusing on what the thoughts mean about you as a person. It’s also more helpful than trying to figure out why they’re happening in the first place. And it’s certainly more helpful than trying to prevent the thoughts from coming up.
A CBT therapist experienced in treating intrusive thoughts will be able to offer strategies that you can practice for handling the thoughts in a healthy way.
Another helpful resource for coping with intrusive thoughts in a healthy way is to practice mindfulness. Mindfulness is a type of awareness that we all have, but don’t usually develop. Perhaps the best way to do so is to practice meditation, but there are many other ways.
From the perspective of mindfulness, intrusive thoughts are not so different from ordinary thoughts, and we can practice dealing with them as such. Mindfulness helps us be less mentally reactive to our own thoughts. It also helps us be less reactive to things that happen around us. This ends up being quite helpful for managing stress. It also helps improve emotional stability.
If you would like to consult with a mental health professional about your struggles with intrusive thoughts, please contact us. Even if you’re not in the New York area, we may be able to assist you via telehealth or recommend an appropriate mental health provider near you.