Intrusive Thoughts: What They Are and How to Manage Them

Apr 28, 2021

Intrusive thoughts, sometimes a feature of anxiety disorders, OCD and PTSD, are more common than many people think
Therapist Nicola Williams offers six tips for managing intrusive thoughts
We have therapists and counsellors who specialise in anxiety and OCD available to support you – find yours here

Have you ever been in a shop and suddenly had the unexpected urge to knock all the items off the shelves? What about imagining yourself randomly insulting a stranger, or shouting something rude in public?

What are intrusive thoughts?

We experience thousands of thoughts per day, and often we are not even consciously aware of their content. Intrusive thoughts however are those thoughts (and images) that unexpectedly pop into our minds and are distressing enough for us to take notice of them.

Although particularly common in anxiety disorders, OCD and PTSD, most people will experience them at some time, even without any other symptoms of poor mental health. In fact, studies have shown that up to 94% of the population have these thoughts at some point.

When do they become a problem?

Intrusive thoughts are harmless; however, they can feel distressing if we attribute meaning or significance to them, particularly if their content is at odds with our personal beliefs or values. A religious person who has blasphemous thoughts and then believes this makes them a ‘bad person’ will have a tendency to experience more guilt and shame than a non-religious person, or a religious person who understands that these thoughts are meaningless and hold no value. They can therefore become problematic if we believe the thoughts say something about us as a person, we become overly focused on them, and change our behaviour as a result.

An example of this may be a new mother who suddenly has an intrusive thought of harming her child. This can trigger a perception of herself as a bad mother, fear that having the thought may mean she will act on it (even though she can think of nothing worse), and subsequent avoidance (perhaps refusing to spend time alone with her baby, or not picking her up in case she drops her).

Unfortunately, most of the time we keep these thoughts to ourselves. Many people fear that they will be judged, perceived as ‘odd’, or even dangerous. Lack of communication then perpetuates the belief that intrusive thoughts are uncommon, and that other people will not understand. There is often the concern that ‘thinking it’ must mean that deep down we must either want to do it, or that we are at risk of doing it, triggering feelings of confusion, anxiety, or shame, and the unspoken cycle continues. This is particularly true if the thoughts are of a sexual or violent nature.

Some of the more common intrusive thoughts experienced within ‘non-clinical subjects’:

Did I leave an electrical appliance on, that could cause a fire?
Did I leave the door unlocked?
Imagining people naked when talking to them
Having the urge to say something rude, or insulting, to a friend, or a stranger

The following intrusive thoughts are less likely to be spoken about, but are also among the most common:

While driving – running the car off the road, swerving into oncoming traffic, or running over a pedestrian or animal
Sexual thoughts – including an impulse to engage in indecent exposure or masturbate in public
An impulse to harm themself or someone else when seeing or holding a sharp object such as a knife

(Note: Remember, an intrusive thought differs from a true desire to do something. Generally, intrusive thoughts are, by definition, things we don’t want to do, with this incongruence inducing the typical fear and distress associated with them).

So, what can we do to help us cope with these intrusive thoughts?

1. Don’t try and suppress or push away the thought

Have you ever tried not to think of something? There is a well-known experiment that shows how this just doesn’t work. Try not to think about a pink elephant! In fact, think about anything at all but do not think about that pink elephant…push him out of your mind! How did that work? The reality is that saying ‘don’t think about…’ is actually making you think about it even more.

2. Instead of pushing the thought away, accept it

And recognise it for what it is, just a thought. Thoughts are vastly different to reality. They are not a sign of intent, or a reflection on you as a person. They are simply random words and images which are not worth more than a brief acknowledgement.

3. Create some distance

Defusion is a technique that allows us to create a distance between us and the thought. When you notice a distressing thought, STOP, STEP BACK, and OBSERVE. Say ‘I am having the thought that…’, perhaps followed by ‘I am noticing that I am having the thought that…’.

Be curious to the experience, to the fact that your mind can come up with such random ideas and suppositions. Another way of defusing from thoughts is to say them in a silly voice or sing them to the tune of a song. This may feel difficult at first but with practice it can make a world of difference to the attachment we place on them.

4. Don’t change your behaviour

Doing so can reinforce the belief that it was only this change in behaviour that stopped you acting on the thought, and that your mind is doing a good job by ‘warning you’. Therefore, what is your mind going to do? It is going to keep on doing what it thinks is keeping you safe. Exposure, or facing the fear, even if done in a gradual way, will prove that the warning was unfounded.

5. Use distraction or re-focussing techniques

There is a difference between pushing away thoughts, and doing something else that will, in turn, take attention away from them. Do something you enjoy, a hobby or interest. Sing, do a puzzle, or go for a walk and notice the world around you. Practice mindfulness, or grounding techniques, which help bring your attention to the present moment, and away from your internal mind.

6. Seek professional help

Finally, if you are still struggling after putting these techniques into practice, are experiencing symptoms that concern you, or are worsening over time, you may benefit from counselling or therapy. If so, spend some time researching which approach you feel will benefit you, and never feel obliged to work with the first professional you speak to. It’s important to find someone you feel you can connect with, and a good therapist will be happy to answer any questions you may have and will understand if you want to ‘shop around’ before you come to a decision.

Nicola Williams is a verified welldoing.org therapist in Bridgend and online