What are intrusive thoughts?

What are intrusive thoughts?

Intrusive thoughts are unwanted thoughts that can pop into our heads without warning, at any time. They’re often repetitive – with the same kind of thought cropping up again and again – and they can be disturbing or even distressing.

People who have symptoms of anxiety or depression are most likely to have intrusive thoughts, but they can happen to anyone. While harmless in themselves, they can have a negative effect on our quality of life, and sometimes affect the way we behave.

The unwelcome thoughts we have can be in the form of images, sounds, or statements.

Different types of intrusive thoughts

One of the most common types of intrusive thought relates to concerns about safety or risk. These types of thoughts often come in the form of images where a person might imagine driving their car through a crowd of people, harming or killing another person or imagining a loved one fatally injured or dead. New mothers often think about their baby coming to harm. Equally common are blasphemous thoughts or inappropriate thoughts about sex.

Milder forms of intrusive thoughts come in the form of our own critical voice: the one in our heads that tells us things like ‘You’ll never get that job, you’re not good enough’, ‘You’re going to look stupid if you do that’, or ‘They don’t like you and they’re talking about you behind your back’.

If someone has post-traumatic stress disorder (PTSD) they can have intrusive thoughts about the event that caused it – which could be observing or being in an accident or natural disaster, being mugged or raped, or going through a significant life event such as a divorce. Following a traumatic incident, the brain can be hardwired to remind you of it. These reminders, also called flashbacks, might come in the form of sounds or images, and you’ll experience the same physical symptoms you did back then – for example, an elevated heart rate.

Intrusive thoughts are perfectly normal
Having random thoughts is a perfectly natural human phenomenon. They have a practical purpose: keeping us safe by helping us anticipate and prevent problems and dangers, and to plan ahead and remember things we might have forgotten. Our thinking is also what enables humans to be creative, imaginative and innovative.

Intrusive thoughts are often what we call ‘ego dystonic’: they are the opposite of what we actually want and intend to do. They can be shocking and appalling, but most of us know they mean nothing, and we’re able to brush them off. However, some people will fixate on thoughts like this and give them meaning, particularly those with conditions such as Obsessive Compulsive Disorder (OCD). If you think about mowing down some pedestrians, you must be a murderer or a psychopath, right?

The most important thing to remember is that thinking something doesn’t mean you’re capable of doing it. People often feel guilt and shame, and ‘beat themselves up’ about what they’re thinking – but intrusive thoughts do not make you a bad person, or a criminal.

In this way, intrusive thoughts can have a detrimental impact on our mental health. They can be very upsetting, and in some cases can lead to depression, anxiety or OCD. The good news is that they can be successfully managed.

First of all, it’s useful to look at some approaches that are likely to hinder rather than help.

Pushing the thoughts away is not helpful
Some people try to eliminate the thoughts they’re having by blocking them out. This doesn’t work – as we all know, if someone tells you not to picture a pink elephant, you immediately picture a pink elephant! If you try to stop the thoughts from coming, your mind will only feed you more of them automatically, which will reinforce them.

Not only can this cause distress and fear, it can also lead to changes in behaviour – such as avoiding situations, withdrawing from normal day-to-day activities, and ruminating.

Others try to cope with their unwanted thoughts by resorting to compulsive behaviour – for instance, repeatedly checking that the gas is turned off to reassure themselves. This is counterproductive, and only serves to maintain the associated behaviour. It can also develop into an obsession, with someone needing to check the gas several times before they leave the house, believing it will lead to disaster if they don’t.

Acknowledge the thought – and move on
The best strategy for dealing with intrusive thoughts is to consciously recognise what’s happening, and separate the thought from any judgment you’re making about it – and about yourself.

Some people feel that having a thought about something is as bad as doing it, which we refer to as ‘thought/action fusion’. It’s important to recognise that thinking and doing isn’t the same thing at all. Similarly, ‘thought/moral fusion’ is believing that having a certain type of thought makes you a bad person. Again, this is absolutely not the case.

Instead of fighting the thought, or worrying about it, acknowledge it: ‘I’ve had this thought – and that’s all it is, a thought.’ Step back, examine it, and challenge it. Being self-aware and mindful will make it possible to identify what’s really going on, and cope with it better.

Changing behaviour can be difficult. Online cognitive behavioural therapy (CBT) can help you to understand what’s causing your intrusive thoughts, and learn techniques for managing them.

Online CBT is also demonstrated to be a highly effective form of treatment for PTSD and OCD. Your therapist will work together with you to help you understand the causes of both conditions, their symptoms, and how the problem is maintained. You’ll then learn coping strategies to help you reduce the symptoms and reclaim your life.

In an emergency
Call 111 - if you urgently need medical help or advice but it is not a life threatening situation
Call 999 - if you or anyone else is in immediate danger or harm
Call the Samaritans 24 hours a day on 116 123