Intrusive Thoughts

What if I lose control and drive off the road? What if I want to hurt someone?  How can I be sure that I actually love my partner? What if that heart palpitation is a heart attack this time? I may have left the stove on and the house burning down will be all my fault.

The term “intrusive thought” often gets thrown around, but for those struggling with anxiety and especially OCD, these thoughts can be extremely distressing. According to Harvard Health, intrusive thoughts are unwanted, disturbing thoughts or images that pop into your mind without warning. Intrusive thoughts may be violent, sexual or repetitive; they are often ego dystonic and shame inducing. Everyone gets intrusive thoughts, but if you have OCD, often times, they become “stuck” due to the fear of uncertainty that they could be true or that they could mean something about you as a person. These thoughts can trigger compulsions or avoidance behaviors in an attempt to stop the thoughts and related distress. However, the more we try to push our intrusive thoughts away, the “stickier” they become. If I tell you NOT to think of a purple cat, what is the first thing that comes to your mind? 

When we treat intrusive thoughts as something we need to be rid of, it makes them more likely to return and teaches the brain that they are in fact harmful. This is why it is so important to learn “response prevention”, a skill used in Exposure and Response Prevention (ERP) therapy. By not engaging in the compulsions that follow intrusive thoughts and sitting with uncertainty, new learning happens in the brain. Over time, these intrusive thoughts should become less distressing, and compulsions may not feel necessary. 

If we can accept intrusive thoughts for what they are, just thoughts (which are firing neurotransmitters in the brain) we can learn to not take them so seriously and maybe even laugh at them too! Also, remember that thoughts are not facts, so we can acknowledge them without assigning meaning. It’s not the thought itself, but rather the meaning you assign to it that’s keeping you stuck. The next time you experience an intrusive thought, try to welcome it. Let it come, then let it go.