The best way I can think to explain intrusive thoughts, is through a personal example. As a child, my family would regularly attend church on a Sunday morning. Whilst sat in the pews, listening to the service, I would often have the most distressing and peculiar thought pop into my mind! I’d think, what if I stood up, made a loud noise to get everyone’s attention and pulled my trousers down, exposing my manhood to everyone in attendance.
This thought would be accompanied by a racing heart, sweating, and a feeling of heat rising up through my body, coming out through my throat! I’d start to panic inside; What did this thought mean? Why was I having this thought? This was the last thing I wanted to do, so why was I thinking it?
Intrusive thoughts are images and ideas that come into our minds uninvited. We have little control over them and everyone experiences them. They can be distressing and come in a variety of forms. So what is the difference between someone who has intrusive thoughts with OCD vs without? The answer is that people with OCD often assume their intrusive thoughts and dreams mean something. They may question whether they are having the thought because they want to act on it or whether it says something unacceptable about them. As a result, they get anxious and try to get rid of the thoughts. However, the more they fight them, the more sticky and frequent they can become, and the problem gets worse. If you’d like support from an OCD therapist, our blog how long do OCD flare-ups last explains what patterns are common, and OCD and Dreams looks at why dreams can feel so convincing.
Intrusive thoughts are unwanted thoughts, images or impulses that can enter the mind without invitation.
Experiencing an intrusive thought does not, by itself, show that you want to act on it or that it reflects your character.
In OCD, the distress often comes from the meaning attached to the thought and the need to work out why it appeared.
Trying to suppress, analyse or remove an intrusive thought can make you notice it more frequently.
Checking, reassurance seeking and mental review may provide temporary relief while keeping the thought feeling important.
CBT helps you change how you interpret and respond to intrusive thoughts rather than trying to control every thought that enters your mind.
Intrusive thoughts can be extremely uncomfortable and when problems develop, it is not uncommon for people to feel hopeless. Fortunately, Cognitive Behavioural Therapy (CBT) is an evidence-based treatment, which is very effective in helping people to overcome OCD. Here are some concepts and techniques, which will help you understand how it works:
A study by Purdon and Clark (1993) took a pool of 293 individuals, none of which had OCD, and asked them what intrusive thoughts they experienced. The results were very interesting. For example, 48% of females and 60% of males had thoughts of ‘having sex with an unacceptable person’. The headline is that intrusive thoughts are normal. We need to accept that they are just thoughts. If you’d like to explore the wider picture, our blog Biological Explanations for OCD looks at the factors that can influence OCD symptoms.
If I tell you not to think of a pink elephant, what happens? That’s right, you think of a pink elephant. This is an example of how thought suppression doesn’t actually work. The more we try not to think of something, the more we think of it. Another strategy is to accept that we will have these thoughts, observe them and wait for them to go away on their own accord.
Accepting your intrusive thoughts will probably also mean feeling anxious, distressed and/or uncomfortable. Have faith: the more you experience these feelings, the less intense they will become. It is a scientific rule that if nothing bad happens and you sit with your anxiety for a prolonged period of time, it will decrease over time. You need to face your fears and tell yourself, ‘I can cope!’
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Intrusive thoughts can be distressing and worrying. However, they do not hold meaning. Thoughts are just thoughts. If you find yourself struggling with problems related to the topics discussed in today’s blog, consider contacting us at NOSA to get an assessment. You can explore our therapy services, and if you’re looking for more focused support, our specialist OCD clinic may be a good fit. We can make treatment recommendations and help you overcome these problems. CBT is an effective therapy for OCD and help is out there if you need it.
Looking for more insights into CBT and how it can help? Explore our client journeys to see real experiences of those who have benefitted from therapy. For further reading, visit our blogs, where we cover a range of mental health topics. If you have any questions, our FAQ page provides helpful answers about therapy, treatment options, and more.
If you’re a practitioner looking to develop your skills, we also offer CBT supervision training and CBT training and teaching.
Yes. Unwanted or unexpected thoughts are a common part of human experience. What often causes difficulty in OCD is not simply having the thought, but interpreting it as important, dangerous or revealing.
No. An intrusive thought can feel upsetting precisely because it conflicts with your values or intentions. The presence of a thought is not the same as a wish, plan or action.
OCD can create a strong need to understand why a thought appeared and what it might mean. Anxiety can then make the thought feel more believable or urgent, even though emotional intensity is not proof that the thought is true.
Trying hard not to think about something can make your attention return to it more often. Analysing, checking or pushing the thought away may also teach the mind that it is important and needs further attention.
CBT helps you understand the cycle between the intrusive thought, the meaning attached to it, anxiety and the responses used to feel safer. Treatment may include learning to allow uncertainty and reducing compulsions such as checking, reassurance seeking or mental review.
This page is for general information and education. It is not personalised advice, diagnosis, or a substitute for professional assessment.
NOSA CBT offers evidence-based therapy for OCD, hoarding help, phobias, health anxiety, social anxiety, PTSD, panic disorder, and generalised anxiety disorder. We also provide a specialist OCD clinic, professional CBT supervision training, and CBT training and teaching for mental health professionals.
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