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Steps to overcome intrusive thoughts


This page is to help you overcome intrusive thoughts, by coming to terms with the thoughts as opposed to stopping them.

Can you stop intrusive thoughts?

In a word, no, but there are things you can do to overcome them. It’s only semantics, technically you cannot really stop intrusive thoughts, but you cannot stop any type of thought from occurring. You might have heard of the pink elephant experiment. If not, try this.

Do not think of pink elephants, that’s all you have to do. Do not think about their trunk, whether it is a blush pink, baby pink or bright pink, do not think of their big pink ears. Stop reading this for a second and start your test for about 15 seconds and do not think of pink elephants.

I’m guessing the very first thought you had was of a pink elephant. That’s normal. No matter how hard you tried not to think of pink elephants, the thought or image would still come. That’s just how your mind works. It’s near impossible to stop a thought from coming, but the key is, just like the pink elephant, is for the thought not to bother you, for it to be neutral. Thinking about pink elephants is neutral and you will forget about it quickly and will not subject it to the screening and analysis that you reserve for your intrusive thoughts, which paradoxically only serves the strengthen the thought.

The question should be, not how do I stop intrusive thoughts, but what do I need to do to overcome them?

How to overcome intrusive thoughts

Before explaining more formal therapy options, I shall start by discussing things you can try by yourself to help with your thoughts.

It follows a stepped-care approach to treatment where you start with the least intensive intervention, such as self-help, before moving to counselling with a licensed mental health professional.

Psycho-educational

Do not give time to the thought; label and move on

If you analyse your thoughts, wondering why you have them or what it says about you as a person, there are models of therapy that will help you stop doing this.

Why do you need to stop doing this?

Thoughts need energy to survive. Acceptance and Commitment Therapy works well by teaching you to label the thought and move on.

You can do this right now, although it takes practice. Next time you have an intrusive thought, label it just as a thought and move your attention away rather than dedicate time to it. Try it now.

Decide on your label. You can use a label such as.

  • there’s an intrusive thought
  • It’s just a thought

For example, if your intrusive thought is that you are going to shout out something really bad during your Church service, rather than trying to stop the thought or analyse it, tell yourself;

I am having an intrusive thought

Do not try to stop the thought

Don’t push the thought away; this does not work. The more you tell yourself to stop thinking about something, the more likely you will think about it. Try this for yourself. Don’t think about your favourite food for one minute. This might be desserts, pie, steak, whatever it is, do not think about it.

Did you notice an increase in saliva? If you did, not only did you think about the thought, but you changed your physiology, as your body is now preparing for food!

Keep labelling; there’s a thought, and move on.

Accept your thoughts

If you are suffering, you cannot accept intrusive thoughts as ‘just a thought.’ You react to them as accurate or worried that you might act on the thoughts and cause harm to yourself or someone else. You 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. They keep popping into your mind because you shine a spotlight on them, trying to figure out what they mean, trying to avoid them, and adopting various tactics to ensure you do no harm. Your brain has decided, ‘this is something we need to pay serious attention to.’ Learning to label them and move on helps to stop this.

Stop doing things differently.

You might have changed the way you exist in the world to prevent yourself from causing some harm (concerning your thoughts.) For example,

If you have intrusive thoughts regarding knives, you might have moved the blades in your kitchen, or

If you experience intrusive thoughts regarding children, you might avoid children’s parties, be extra careful with how you look at a child or be 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.

It would be best if you learned 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 keep this cycle going.

Cognitive Behavioural Therapy, besides mindfulness-based approaches, combined with relaxation training, will help you achieve this.

Know the difference between thoughts and reality

There is a stark contrast between I will stand up and shout something obscene in Church right now, and I am worried I might say something blasphemous.

The first thought contains action, something you will do now, whereas the second is the worry, and doubt. Reality-based action thought. I am going to punch that person. Doubt I am worried I might hurt someone.

Understanding doubt and reality is crucial in overcoming unwanted intrusive thoughts. Once you can see the difference, it becomes easier to accept that you need to work with doubt instead of the content of the thought.

Worrying that you might do something or have done something in the past and cannot remember it is not the same as actually doing it.

People with intrusive thoughts go out of their way, carrying out elaborate compulsions to ensure they never act on the thought.

For example

People with obsessive thoughts or Pure O may not know they carry out compulsions. The following examples will highlight some of the compulsions you may do and need to work on to end intrusive thoughts.

People with HOCD may check themselves to ensure their sexual preference has not changed. This checking is carried out to ease the distress caused by internal thought and is a compulsion.

Someone with Harm OCD may remove objects they fear might hurt someone. This compulsive act is carried out to prevent a feared consequence.

Trust your senses

I shall start with a more classic OCD example to explain how to start trusting your judgment.

A person with OCD may lock their front door, repeatedly pull the handle, unlock and relock and stare at the door for a long time before feeling able to walk away.

The doubt that characterizes OCD makes locking up very difficult for the person; they cannot trust their actions and sight.

In non-OCD tasks, they rely on their senses; for example, if a person has just put a plate in the cupboard and walked away and I ask where the plate is, they will answer in the closet as they can trust their actions and their sight that they saw the plate in the cupboard.

If I ask two people about their romantic preference, one may state; that they are, for example, heterosexual, and if I inquire how they know, they can trust their judgment to answer the question.

However, if the person has Sexual orientation themed OCD, they will not be able to trust their decision as they are plagued with doubt caused by OCD.

People with HOCD may no longer trust their judgement and check to see if they are attracted to members of the same sex or opposite sex and if they are lesbian or gay.

If you have been heterosexual or in a same-sex relationship, your sexual identity should be a given; it is a fact based on reality.

The doubt caused by intrusive thoughts conflicts with reality.

Do not overuse your senses.

In the example above, where the person repeatedly locks the door and stares at it, to overcome the obsessive thought that the door might not be locked, they have to relearn to trust their senses, and they do that by using the following.

Lock the door and look at the action of turning the key, and walk away. It can be challenging to begin with, as doubt will create high anxiety levels.

Resist walking back to check the door, as this will reinforce the pattern that checking makes you feel more relaxed and reassured.

Therapy for intrusive thoughts


Psychoeducation. Arm yourself with information
If you are ready to start therapy, I appreciate that this may be daunting, as you may feel deep shame and fear regarding discussing your thoughts. For that reason, I have included articles on MoodSmith to make the process as transparent as possible.

Start by reading this introductory series.

Treatments that help

Cognitive behavioural therapy CBT
CBT is well-researched and remains one of the most influential models of therapy as noted by Healthline is used to manage intrusive thoughts

to help with the intrusive thoughts of OCD. Intrusive thoughts are maintained through fear, avoidance and compulsions, and CBT addresses this pattern.

The person with intrusive thoughts is systematically encouraged to explore their thoughts instead of avoiding them. The tenet of CBT is to help the person change their thought processes and behaviours to ones that will break the cycle of OCD.

Read more on CBT here.

Exposure and Response Prevention ERP
Exposure and response prevention is a gold standard, according to Abramowitz, 199610

in the model, you are exposed to your intrusive thoughts without ritualising. Ritualising is where you perform the compulsion, such as assurance seeking.

You can read more about ERP and how it helps intrusive thoughts here.