Intrusive Thoughts is another phrase for the obsessions that exist within Obsessive-Compulsive Disorder. The Latin root of the word ‘obsessed’ means to besiege. If you are suffering from Intrusive Thoughts, you are surrounded by distressing thoughts, which you eventually obsess about. They effectively become intruders in your everyday life.
Article last reviewed by Dr Elaine Ryan 24 June 2021
The following image might illustrate this better. The thoughts initially do not belong to you but are catapulted into your thought stream. What you do with them next depends on whether they become unwelcome intruders in your life.
If you can bat them away or ignore them, they will never take hold of your mind. If you worry about the thoughts or believe in them, these thoughts may intrude on your daily life.
Estimated reading time: 8 minutes
Table of contents
- What causes intrusive thoughts?
- Who gets intrusive thoughts?
- Will they ever go away?
- Do I need to see a Doctor?
- How are they diagnosed?
- Examples of Intrusive Thoughts
- Disturbing sexual thoughts
- Unwanted Thoughts regarding children
- Aggressive thoughts that disturb
- Religious thoughts that disturb
- Intrusive Thoughts regarding your sexuality identity
- Intrusive Thoughts regarding your relationship
- Intrusive Thoughts about death
- Needing certainty around safety issues
What causes intrusive thoughts?
Most people I work with wish to know why they have intrusive thoughts. I want to begin by stating that they do not reflect on you as a person.
Random thoughts bombard everyone’s mind all the time. We all get them; I get them.
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; how you react to it is a problem.
In the paragraph above, what thought grabbed your attention most?
- Random thought one living room better without curtains
- Random thought two large trees would be suitable 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!
You could quickly think, the second thought could lead to harm, or it suggests something about you as a person. This judgment makes random thoughts more likely to stick in your mind and become intrusive or obsessive.
A random thought that becomes intrusive is one that was so disturbing; you could not ignore it. Like an unexpected visitor who calls to your home and becomes an unwelcome guest.
If someone calls to your home and you choose not to answer, they don’t get in. If, however, you open the door and they overstay their welcome and take over your home. It’s hard to not only get them out of your mind but also out of your home.
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?
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.
Will they ever go away?
As I mentioned above, we all have random thoughts every day. Thoughts that become obsessive or intrusive that cause you distress can go away with the proper treatment. Learning not to react to the thought as if it is true deprives it of attention, and it loses its power. You are less likely to think it, or if you do, it does not disturb or frighten you anymore.
What treatments are available for intrusive thoughts?
If you are ready to start treatment, the most successful treatments include Cognitive Behavioural Therapy; CBT and Exposure Response Prevention; ERP.
You can start with self help, or meet with a licensed mental health professional for face to face therapy.
Do I need to see a Doctor?
It is advisable to meet with your doctor or a licensed mental health professional to get a correct diagnosis. Getting a diagnosis and understanding why the thoughts occur can be the basis of a treatment plan.
How are they diagnosed?
Suppose you meet with a mental health professional. In that case, 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; ICD1.1
- 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.
Now that we have covered what intrusive thoughts are, I shall give you some examples of the types of unwelcome thoughts that can become obsessive.
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 sexual idea that cause you distress.
These types of thoughts can be distressing, as arousal is 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 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 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.
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 comprise an impulse to be aggressive to someone or causing physical harm. This does not mean you will carry this out, instead see it as one symptom 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 sign that something must be wrong with them to have such ideas.
Or even 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. Suppose you have intrusive thoughts regarding your sexual orientation. In that case, you still are heterosexual, but you may suffer from doubts because of 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. Suppose you experience this type of intrusive thought. In that case, 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 worried about death, which your heart could give up. 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 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 types 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.
Any random thought can become intrusive, if it disturbs you or you change how you react based on the content of the thought. Having a good understanding of what is happening puts you in control and ready to take steps to overcome the intrusive thought.
Should you wish to continue reading my articles, you can find more on the subject here.
- 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).