What are intrusive thoughts?
Intrusive Thoughts are unwanted thoughts or images that you find distressing and/or disturbing. These unwanted thoughts are known as obsessions. Intrusive thoughts can also result in compulsions, which you do to help you cope with unwanted thoughts.
You may believe that they mean something bad about you as a person. This page helps show you what form they take and that they are just thoughts and do not reflect on you as a person.
The page is very detailed, it’s about a 20-minute read, but I have included a table of contents below to help you navigate your way.
This article aims to help give you some distance between what you are currently thinking and feeling so that you can understand what is happening to you.
What I hope you will get from this page is
- a clear understanding of what intrusive thoughts are
- an understanding that you as a person have not changed, you have not suddenly become a bad person, capable of things that are difficult for you to think about, and
- how to seek help.
Intrusive thoughts are part of OCD. They can make you want to squeeze your face, turn your head away, or shake your head as you are so alarmed, repulsed or scared of the type of thoughts in your head. These thoughts are uninvited and hard to get out of your mind and go against your deeply held beliefs about yourself. These thoughts may become obsessive. It is useful to think of the Latin origins of the word obsessive, which means to besiege. Intrusive thoughts besiege your mind.
This page contains informational content on intrusive thoughts. If you were looking for Self Help, you could find it here; if you wish to read more articles on intrusive thoughts and OCD, you can find them here.
Estimated reading time: 19 minutes
Dr Elaine Ryan
Dr of Psychology
This article was reviewed and update by Dr Elaine Ryan on 21 March 2021
30-second summary
- Intrusive Thoughts are part of OCD
- We all get them, but they cause problems if they interfere with your daily life and you believe them to be true
- You will not get intrusive thoughts about the pleasant things; intrusive thoughts that you get will go against what you hold dear and value in life
- There is effective treatment available and a self-help option on this site.
Table of contents
- What are intrusive thoughts?
- Treatment for Intrusive Thoughts
- Examples of Intrusive Thoughts
- OCD and Intrusive Thoughts
- Stop Intrusive Thoughts from ruining your life
Why do I have them?
Random thoughts bombard everyone’s mind all the time.
I watched TV last night and had a random thought that my living room would be better without curtains. Then I saw a large tree on the television and thought, ‘that would be a good place for a hanging.’ Both are random thoughts that I had no control over while watching TV, but one might become intrusive.
The thought itself is not the problem; it is how you react to the thought that is the problem.
In the first paragraph above, what thought grabbed your attention most?
- Random thought 1 living room better without curtains
- Random thought 2 large trees would be good for a hanging
I’m guessing you thought number 2 (large tree would be a good place for hanging) as this would disturb you more than whether my living room had curtains! I might sound flippant, but I am deadly serious when I say they are both the same; both are random thoughts.
You could well be thinking, the second thought could cause harm, or it says something about you as a person. This judgement is part of making random thoughts more likely to stick in your mind and become intrusive or obsessive.
How do thoughts become intrusive thoughts?
Take a moment and think about the different kinds of thoughts that can wander through your mind. If you find yourself at work, at a meeting, and your mind wanders onto “Did I turn the dishwasher on….What will I have for dinner…?” you will not pay too much attention to this.
However, if you are going about your daily business and thought of a sexual nature that you consider disgusting or obscene pops into your head, you will pay this serious attention as it will not be just neutral.
By not neutral, I mean it will probably make you feel something in your body.
You might feel anxious, embarrassed, feel your face go red, screw your face up as if somehow you can shake the thought. You basically get a small stress response the first time it happens. So what does this do? In combination with the thought, this feeling of anxiety might be enough for your brain to mark this as a threat.
Stress Response, Threats and Intrusive Thoughts
Our brain stores potential dangerous situations for us; we want it to do this. For example, the first time you place your hand on the ring of your new stove and feel that burning pain shoots through your fingers, hand and all the nerve endings up your arm, your brain takes a note of this.
The next time you go to place your hand on the stove, your brain matches up the image of the stove with danger and pain, which hopefully stops you from repeating it. Your brain has detected the stove as a ‘threat’ – something that can cause your harm, and therefore you need to be protected from it. Your brain gives you an automatic feeling of fear the next time you touch it, which is a good and helpful thing.
It is not so helpful, though, when your brain does something similar for thoughts that have been marked as possible ‘threats.’
What has this got to do with intrusive thoughts? A lot, really.
When you first start having intrusive thoughts, and it makes you feel something in your body, anxious, nervous, fear, shame, your brain matches the thought with the feeling.
If you are a visual person, your intrusive thoughts may also be intrusive images. In this case, your brain can make a stronger link between the thought, image and feeling you get in your body, but instead of getting fear (as I mentioned in the hot stove example above), your brain gives you anxiety.
There is an important difference between fear and anxiety that I explain in the video below. In a nutshell, fear is a clear, tangible danger, such as the stove. Anxiety is where there is no danger there; it is more of an anticipated danger from your thought processes.
The more you think, the more times you feel anxious because of this, the more your brain learns, and I shall explain this now.
Neurons that fire together, wire together
You might have come across this saying before, and I shall explain it in a way that hopefully makes sense! Your brain learns from repeated practice or repeated experiences.
For example, if you want to learn to drive a car, you are not ready for Formula One the first time you get behind the wheel. That’s because your brain has yet to create a little pathway about driving – think of a pathway of an instruction manual for now.
The more driving lessons you have, the bigger this instruction manual becomes in your brain – the pathway is getting developed. With every driving lesson that you have, neurons are firing in your brain; signals are getting sent until the instruction manual – the pathway is complete.
This is an important bit. When the pathway is complete, you can drive on automatic pilot; it is very different from your first lesson when you had to think about everything, now you get in the car and drive.
Your brain learns from repeated practice and experience and can do the same if you ‘practice’ your intrusive thoughts enough.
If you keep worrying about the thoughts in your head, trying to analyse and keep feeling anxious, this like a practice, a repeated experience, and your brain learns. Eventually, a pathway is created, and your thoughts can come automatically.
Why do the thoughts start? The answer to this question depends on how much you attend to the thought, how you judge it, and whether you react to the thought as if it were true.
I want to start by mentioning some judgments you might make;
- it says something about me as a person
- I am a bad person for thinking that.
- I’m not normal, etc.,
In these types of judgments, you react to the random thought as if it could be true. You may question the initial thought–why did I think that? All judgements and further analysis mean that you are giving time and space in your head to the random thought. You are giving the thoughts attention.
The more you attend to a thought, especially if the thought makes you anxious, the more likely you will have that thought again.
Like most people with an uncomfortable thought, you might try not to think about it, to push it out of your mind, but that only makes the thought stronger, as you can see in the video below.
It is important to note that all intrusive thoughts start as a random thought that pops into your head. If you can let it go, it will pop back out of your head. Unfortunately, the analysis you undertake, the disgust and fear you feel, you are unwittingly teaching your brain that this thought is important, and you are more likely to have it again.
Who gets intrusive thoughts?
All of us have experienced unwanted thoughts before and not taken much notice of them. However, intrusive thoughts can impact a person’s life when they are part of mental health conditions. You can experience intrusive thoughts with the following mental health conditions.
Obsessive-Compulsive Disorder OCD
People with OCD experience intrusive thinking when they are thinking, for example. Did I lock the door? Have I done something terrible in the past?
Postpartum depression
You may experience postpartum OCD with anxiety-related thoughts that make you think you could harm your baby, which causes intense distress.
Post-traumatic Stress Disorder PTSD
The mental flashbacks associated with post-traumatic stress are one of the significant symptoms of PTSD.
Why are my Intrusive Thoughts about ‘bad things’?
I think the best way for me to answer this is to do it in two parts;
- what things are important to you, and
- how much attention you pay to the thought.
Intrusive thoughts latch on to the things that are important to you. For example, I adore animals. If the idea popped into my head that I could harm an animal, this would certainly grab my attention, as it would shake my values to their core and cause me untold amounts of anxiety.
I could have several unwanted involuntary thoughts in my head, but most will go unnoticed. The ones that go against my core values will stick out from the rest. If you get an unwanted thought that goes against your core values, you will probably feel something, such as fear, disgust, anxiety or alarm. These strong negative emotions make the idea appear stronger than it is.
So answering the first part of why the thoughts are about bad things, it is essential to note that it differs from person to person. It is what you consider bad; what would attack your core values?
Someone else could have the thought about harming animals, and it might slip under the radar for them, as they might be into hunting. An animal being hurt may not give the same fear response that I would get. So this thought may never become intrusive for them.
The only difference between an intrusive thought that pops into your head and then leaves, and an intrusive thought that is distressing, is how you respond to it.
To finish answering why the thoughts are about bad things, you also need to attend to them. When I say ‘attend to them’, it is sort of like planting a flower, if you leave it alone, it will die and wither, but if you tend to it, water it and feed it, it will survive and flourish.
Dr Elaine Ryan
Once a thought strikes your core values, if you leave it alone, it will wither and die, but if you pay attention to it, think about it, analyse, give it special attention amongst all the other thoughts, it will become stronger.
Hence when I am working with people with Intrusive Thoughts, I aim to get them to disregard the thought and not add fuel to the fire, or maybe I should say fertiliser to the soil to continue with the flower example.
The vital point to note is that it is not the thought that is the problem; rather, the problem arises with what you do with the thought, how much you feed it.
Will they ever go away?
As I mentioned above, we all have random thoughts every day, and these do not go away. Thoughts that become obsessive or intrusive that is causing you distress can go away with the right treatment. Learning not to react to the thought as if it is true to deprive it of the attention you are giving it, the thought loses its power, and you are less likely to think it, or if you do, it does not disturb or frighten you anymore.
Do I need to see a Doctor?
It is advisable to meet with your doctor or a licensed mental health professional who can give you a correct diagnosis. Getting a diagnosis and understanding why the thoughts occur can be used as the basis or a treatment plan. I shall talk to you now about diagnosis and treatment.
How are they diagnosed?
If you meet with a mental health professional, they will undertake a complete assessment of your presenting problem to provide you with a diagnosis. This diagnosis is to formulate a plan of treatment.
The psychologist or physiatrist will ask you a series of questions to determine, for example, if your unwanted thoughts are occurring because of a specific mental health condition, such as OCD.
There are two main manuals that a clinician may refer to for diagnostic criteria
- International Classification of Diseases; ICD1
- Diagnostic and Statistical Manual of Mental Disorders; DSM2
In my career, I would have referred to the DSM and is according to DSM, obsessions are
- Recurrent and persistent thoughts, urges, or images experienced during the disturbance as intrusive and inappropriate and that cause marked anxiety and distress.
- The person attempts to suppress or ignore such thoughts, impulses, or images or neutralise them with some other thought or action.
If, for example, your diagnosis is that your intrusive thoughts are occurring because of having Obsessive-Compulsive Disorder, your clinician can then devise treatment based on the diagnosis of OCD.
Treatment for Intrusive Thoughts
If you have read about me, you shall know that I am a psychologist who specialises in anxiety disorders. I work a lot with people who have disturbing thoughts and recommend the following type of treatment program.
Whether you choose to start my online program or work with another therapist if you want to overcome intrusive thoughts, you need to do the following;
- Learn to accept your thoughts
- Take the thoughts less personally.
- Take the fear out of your thoughts, and
- Stop changing your behaviours.
Learning to accept your thoughts
How to learn to accept your thoughts
I use mindfulness and acceptance, and commitment therapy strategies to help you to accept your thought process. You have probably come across this phrase before, ‘accept your thoughts’, so I shall take a second and explain why this is helpful.
Why is this important?
At the moment, if you are suffering, you are not able to accept the thoughts as ‘just a thought.’ You react to them as real or worried that you might act on the thoughts and cause some harm either morally, to yourself or someone else. You probably have developed several ways to cope with your thoughts, including avoiding things or avoiding your thoughts.
Learning to accept your thoughts helps to stop the thought-action fusion.
This is where you believe that thinking about something makes it more likely to happen.
Once you have been taught to accept them, the thoughts shall no longer mean anything to you with practice. The reason why they keep popping into your mind at the moment is that you shine a spotlight on them, trying to figure out what they mean, trying to avoid them and adopting various tactics to make sure you do no harm. Your brain has decided, ‘this is something we need to pay serious attention to.’
Further Reading
Take the thoughts less personally.
You need to be taught that the thoughts do not mean anything about you as a person.
Take the fear out of your thoughts.
Having an emotional reaction to the content of your thoughts keeps the unwanted thought alive in your mind. When you can let the thought come into your mind, and your feelings are not affected, the thoughts start to lose their power.
Stop changing your behaviours.
You might have changed the way you exist in the world to prevent you from causing some sort of harm (concerning your thoughts.) For example,
If you have intrusive thoughts regarding knives, you might have moved the knives in your kitchen, or
If you experience intrusive thoughts regarding children, you might avoid children parties, or are extra careful with how you look at a child or are uncomfortable bathing and dressing children. or
If you have unwanted thoughts regarding your sexuality, you may avoid people, places or things that trigger your thoughts.
You need to learn to stop doing this, as even though the strategies you have developed help you in the short term, they are not effective long term, as they only serve to keep this cycle going.
Cognitive Behavioural Therapy, in addition to mindfulness-based approaches, combined with relaxation training, will help you to achieve this, and all are included in my course.
Examples of Intrusive Thoughts
Disturbing sexual thoughts
These can include thoughts or mental images of violent sexual acts, sex with inappropriate people or things, questioning your own sexual identity or any idea of a sexual nature that cause you distress.
These type of thoughts can be extremely distressing as arousal is usually involved. Even though you have not carried out the act, the idea of it may cause you to feel aroused.
Arousal does not mean that it is true; it is a normal physiological response.
However, most people with these types of thoughts mistakenly believe that this must mean that the thoughts are real if they experience arousal.
Unwanted Thoughts regarding children
These intrusive thoughts or mental images are incredibly distressing as you may have unwanted thoughts that could harm a child somehow. This can include unwanted thoughts that you could cause harm to your child.
These types of thoughts can occur in postpartum depression and are part of mental illness instead of reflecting on you as a person.
Read more on Postpartum OCD and also POCD.
Aggressive thoughts that disturb
These may involve causing harm to yourself or others. Again, these thoughts are distressing as they may include the fear that you may hurt someone, even though you have probably never hurt someone in your life.
It can consist of an impulse to be aggressive to someone verbally or causing physical bodily harm. This does not mean you will carry this out, instead see it as one of the symptoms of OCD.
Religious thoughts that disturb
These include inappropriate sexual thoughts regarding religious people or figures. Swearing during prayer or worship. Strong urges to misbehave during services.
Most people that I work with find it difficult to see these as harmless thoughts. They are more than likely to see them as a sign that something must be wrong with them to have such ideas.
Or even start to believe the thoughts – “Why would I be having them if I haven’t done ……..?” They are just thoughts.
Intrusive Thoughts regarding your sexuality identity
Many people have unwanted intrusive thoughts that make them question their sexual orientation. This is not the same as someone who knows that they are attracted to the same sex. If you have intrusive thoughts regarding your sexual orientation, you still are heterosexual, but you may begin to suffer from doubts due to the beliefs. It is known as Homosexual OCD, and I have a detailed post on HOCD here.
Intrusive Thoughts regarding your relationship
You might find that you obsess about your relationship. If you experience this type of intrusive thought, it has nothing to do with your relationship’s quality or how suitable your partner is for you.
Instead, the thoughts you have about your relationship are to do with the obsessions and compulsion that occur within Relationship OCD.
Involuntary regarding family members
These can include thoughts relating to;
- Kissing members of your own family.
- Sexualised thoughts regarding family members.
- Intrusive images of family members, for example, naked.
- “What if I am attracted to my sister, my brother?” etc.
Intrusive Thoughts about death
This can include being constantly worried about death, which your heart could give up at any given time. It can also include distressing images of death, either you own or someone you care about.
Needing certainty around safety issues
It is normal to worry about your kids and family when they are not with you. Still, you might find that you worry excessively and experience intrusive thoughts and images concerning their safety. These can include
Thinking that they have had an accident when you have no real reason to believe this.
Thinking that they could come to harm or hurt themselves.
These type of thoughts may make you seek reassurance regarding their safety. You might tell people you care about sending a message or calling you when they reach their destination or to message when they are leaving to come home.
OCD and Intrusive Thoughts
Intrusive Thoughts are part of OCD and have both obsessions and compulsions. The obsessions are the unwanted thoughts and images in your head, relating to the particular type of intrusive thoughts you get, and the compulsions are the things you do to try to cope with the thought.
I will give some examples; I have not included HOCD in this list as I have detailed the obsessions and compulsions concerning HOCD here.
Obsessions
Concerning harm
- What if I hurt someone?
- What if I stab someone?
Concerning children?
- What if I hurt my child?
- What if I look at them wrong?
- Am I a paedophile?
Concerning God?
- What if I say something inappropriate?
- Thoughts that you consider offensive and disturbing
Compulsions
The compulsions fall into two categories
Overt
Those that I could see if I were with you, such as removing knives, or avoiding a kid’s birthday party, asking for reassurance, and
Covert
I would not see the things you do that, such as analysing everything inside your head.
Concerning harm
- Moving knives etc. out of your reach
- Analysing your thoughts in your head
- Avoiding people in case you are capable of something bad
Concerning children
- Not changing or undressing your child
- Avoiding being around children
Concerning God
- Avoiding church services
- Penance for your thoughts
Urges and unwanted thoughts
The urges are the same as the thoughts; they are both a symptom in that they fall under the umbrella of obsessions. An urge is an obsession.
Typical urges experienced in OCD and Intrusive Thoughts
- Touch someone inappropriately
- Want to kiss someone? This can include kissing someone that would seem inappropriate, such as members of your own family, members of the same sex (if you are heterosexual)
- to hurt someone that you care about
- To confess to something that you haven’t done
The urges that you get depend on what you hold dear; what you value most. Intrusive Thoughts, including the urges that you get, tend to go after your value base – the things that you would never do.
Urges can also include the urge to carry out a compulsion, e.g., if you get the thought that you could hurt someone else, you might urge to remove all implements that could cause harm.
Or if you falsely believe that you are a bad person and have done something bad, you might have the urge to confess.
Are the urges different from the thoughts?
No, both the urges and the thoughts are, in fact, obsessions.
Examples of how obsessions and compulsions work together in unwanted thoughts
An important point to note before you read the following examples if you recognise yourself in any of the scenarios, that does not mean that you are a bad person; you are having intrusive thoughts. The following article might be useful to read when you finish this page; Am I a bad person for having intrusive thoughts?
Obsessions and compulsions concerning harm
Harm towards others
Example: Sitting in a room and notice the “tie-back” on the curtains and suddenly think “,, I could strangle someone with that.” Thoughts and images relating to this are the obsessions. They usually come about people that you care about and would never want to harm in any way.
To ensure that you never hurt the people you love, you might remove the ‘tie-back from the curtains and store it away. You could also remove anything that is ‘rope-like that could be used to cause harm to others – just in case.
You could also try to reassure yourself by going over all instances in your head, looking for evidence that either you would never hurt the people you care about or are indeed capable of causing harm.
Removing the tie backs and the analysis inside your head are the compulsions. They serve to sort of ‘neutralise” the stressful thoughts you are having, and you carry them out to protect the people you love and make sure you never carry out your thoughts.
Harm towards yourself
Having intrusive thoughts about causing harm to yourself is different from suicidal thoughts. Suicidal thoughts are when the person wishes to end their life. This page is not suitable for you if this is you, and there are a list of contact numbers here.
If you have intrusive thoughts about harm relating to yourself, you could well have a good life and are happy enough and have no intention of wanting it to end, but the thoughts persist.
Example: Standing waiting on a train and think, “I could jump off just as the train approaches.” This is an unwanted intrusive thought about harming yourself. You might start to worry, is there something wrong with me, what type of person am I, that I could do that to my family? These are the obsessions.
If you keep having these thoughts, you might stop using the train, find another mode of transport, or stand well back from the train tracks. These are the compulsions you carry out to keep yourself safe, just if you cannot resist the urge to jump.
Obsessions and compulsions concerning religion.
Example: Unwanted random thoughts such as those mocking God, mocking your religious beliefs, involving the devil, or any form of worship that goes against you and your beliefs. These obsessional thoughts can shake you to your core, and of course, you will do something to try to restore your faith or protect others in your congregation (if you believe the thoughts.)
Stop Intrusive Thoughts from ruining your life
Hopefully the information that I have provided has shown you that are things that you can today to stop intrusive thoughts from controlling your life.
People who are not able to recover are mostly the ones who continue to see their thoughts as being real, or saying something about them as a person. Once you accept that they are just thoughts, albeit it uncomfortable ones, you can then take the next step which is deciding on treatment.
I am not seeing clients online, but I have a self help program that you are welcome to look at.
If you decide that you would like to meet with a therapist in person, look for someone who works with OCD. Undertaking a search for an intrusive thoughts therapist is not worthwhile as remember the thoughts are part of OCD, and I recommend you start your search there.
Should you wish to continue reading my articles, you can find more on the subject here.
Further reading
Diagnostic Manuals
- International Statistical Classification of Diseases and Related Health Problems (11th ed,; ICD-11; World Health Organization, 2019).
- Diagnostic and Statistical Manual of Mental Disorders (5th ed.; DSM-5; American Psychiatric Association, 2013).
