What To Do With Your Intrusive Thoughts

Intrusive thoughts can be upsetting to those who experience them. Knowing more about intrusive thoughts, however, might put you at ease the next time they happen. We’ve answered your questions about intrusive thoughts so you can better understand what they are and how to manage them.

What are intrusive thoughts?

Intrusive thoughts are uncomfortable, unanticipated thoughts that seemingly arise out of nowhere and can cause distress. They might have a violent or sexual nature, and they might also be absurd or ridiculous. More commonly, they may cause shame and confusion, as intrusive thoughts often directly contradict the true intentions and values of the person experiencing them.

People who regularly experience disturbing intrusive thoughts may fixate on the meaning of the thought, and fear that it reflects their moral character. Intrusive thoughts could leave you asking yourself, “I don’t actually want to do those horrible things I’m thinking about… Do I?” Intrusive thoughts can be confusing because they often aren’t connected to reality. Sometimes, intrusive thoughts have roots in mental health conditions like obsessive compulsive disorder (OCD) or post-traumatic stress disorder (PTSD). Other times, however, they are random.

Are intrusive thoughts normal?

Intrusive thoughts are normal and happen to nearly everyone at some point in their lives. With such complex brains, it’s no wonder that we sometimes end up thinking about things that are seemingly random. Many people have experienced a fleeting thought about doing something that they don’t actually want to do, like jumping off the top of a building, or pushing someone else in front of a train. Many people will recognize the thought as bizarre, take no action, and quickly put it out of their minds without fear.

However, intrusive thoughts can become a concern for individuals who experience them regularly, and feel very distressed or distracted when they occur. These people might benefit from using additional coping mechanisms to mitigate intrusive thoughts, and seeking the support of a mental health professional.

While it's important to know that intrusive thoughts are normal, it’s also important to understand that they don’t always have meaning. No matter the content of your intrusive thoughts, they don’t make you a bad person.

What kind of intrusive thoughts are there?

People have intrusive thoughts across a wide range of topics or situations. Most intrusive thoughts begin with “What if?” The intrusive thoughts that can cause people concern might involve one of these themes:

• Disturbing, violent imagery
• Sexual behaviors that you find unappealing
• Germs and contagion
• Catastrophes, like a natural disaster or a freak accident
• Taking action that would cause emotional or physical harm to yourself or others
• Taking action that would violate your personal religious beliefs

One way to tell if your thought is an intrusive thought is if it gives you pause. With so many thoughts going through our minds each day, we might not notice what we’re thinking about until it’s particularly salient. If you’re noticing your thoughts because they’re distressing, or if these distressing thoughts feel hard to control, then they may be intrusive thoughts. Those who are distressed by their intrusive thoughts may ruminate on the thought, meaning that they think about it repeatedly and attempt to find meaning in its occurrence. This rumination can make the intrusive thought feel like it’s occurring more frequently, which can elevate distress.

What can trigger intrusive thoughts?

Many intrusive thoughts have no trigger and no source. They simply arise at random times and then go away. However, some people find that when they’re particularly stressed out, they’re more prone to experience and ruminate on intrusive thoughts. Others see patterns in their intrusive thoughts as related to past traumatic experiences, or related to a mental health condition like anxiety or OCD.

There might also be biological factors behind intrusive thoughts. The brain relies on its neural pathways, so if these pathways become disrupted by an accident or disease, an individual might see an increase in intrusive thoughts. People can also see more frequent intrusive thoughts when their hormones change, or when they start new medications.

Intrusive thoughts can also be triggered by major life events or natural development, like going through puberty or menopause. If your intrusive thoughts are increasing in frequency or causing you more distress, it’s always best to see a healthcare professional to make sure that there’s no physical reason behind their escalation.

What are examples of intrusive thoughts?

Intrusive thoughts, by nature, can be anything. However, based on the themes shared above, there are some common intrusive thoughts that people say are most upsetting:

• “Look how high up this bridge is. What if I throw my phone off the side of it and watch it fall into the water?”
• “I wonder what it would be like to have sex with him.”
• “I remember turning the kettle off, but what if I accidentally turned it back without knowing, and it burns the whole house down?”
• “What would happen if I punched the stranger on the subway right now?”
• “I bet that God is so disappointed in me. I’m such a sinner.”
• “I know my tests came back normal, but what if I actually have cancer, and they missed it?.”
• “Remember when he broke up with me? And what he said about me? I can still hear his voice saying it.”
• “It’s really quiet right now. I should yell and scare everyone.”
• “What if I jump in front of this train?”

If you experience many intrusive thoughts about hurting yourself or someone else, it might be the time to start working with a mental health professional. While you may never intend to act on those thoughts, they can still be scary to have.

You might also want to reach out for help  when you can’t stop thinking about your intrusive thoughts. Intrusive thoughts can be stubborn — the more you try to stop thinking about them, the more you’re thinking about them. This can be emotionally exhausting and lead to feeling frustrated and disappointed.

What are intrusive thoughts a sign of?

While intrusive thoughts can be random and often have no meaning, their frequency and magnitude can be signs of a mental health condition.

What mental health conditions could be associated with intrusive thoughts?

• OCD — Completing certain compulsions to avoid engaging with your intrusive thoughts can be a sign of OCD. These compulsions can be physical behaviors or mental rituals. OCD has several thought-based symptoms which often cause discomfort for those who experience them. If your intrusive thoughts have to do with food or eating behaviors, this could also be a sign of an eating disorder.
• PTSD — If your intrusive thoughts often occur in the same situation or setting, that could be a sign that you’re particularly reactive to those specific triggers. Depending on your history, this could be related to PTSD or past trauma.
• Anxiety — You might immediately jump into self-criticism and worry about what other people would think  after you experience an intrusive thought, or ruminate on why you had that thought. If you find yourself unable to let go of an intrusive thought, it might be a sign of anxiety.

While intrusive thoughts can be related to mental health concerns, your intrusive thoughts might simply be a sign that you have an active brain. There’s only so much you can learn from your own research; the best way to fully understand what you’re going through is to seek support and assessment by a qualified mental health professional.

How can I manage intrusive thoughts?

Intrusive thought management looks different for everyone, however there are a few generalizable techniques that are effective in avoiding a negative reaction. Because they can happen out of nowhere, it’s very difficult to prevent them. However, you can learn to manage how you react to them.

Therapy tools for managing intrusive thoughts

The first step in managing intrusive thoughts is to acknowledge that you’re having them. The next time you find yourself experiencing an intrusive thought, try thinking to yourself or saying aloud, “This is an intrusive thought.” Being explicit that you’re having an intrusive thought can make it less scary — you now know what you’re dealing with, and you know that you can manage your reaction. You might also say to yourself, “It’s just a thought. Nothing more.”

You may benefit from the “Leaves on a stream” visualization, a popular cognitive defusion tool from Acceptance and Commitment Therapy (ACT). This exercise involves the following steps:

• Visualize your mind as a running river or stream.
• Imagine your thoughts are falling leaves.
• Imagine that one of the leaves falls into the water.
• Label the leaf as the intrusive thought that you’re currently experiencing, and watch as the river slowly carries it away.
• Repeat this process for any thoughts you’re experiencing – both the intrusive thought itself, the judgments you have about the thought, and any other thoughts that occur to you in the moment. Continue to visualize the leaves slowly floating away.

Avoid trying to figure out what your intrusive thoughts mean or whether or not you actually want to act on those thoughts — see if you can distract yourself by focusing on something else. Lastly, try not to judge yourself. Intrusive thoughts happen to everyone, and they’re nothing to be ashamed of — you aren’t a bad person for occasionally and randomly thinking bad things.

How can a therapist help with intrusive thoughts?

Therapists can help you notice your thought patterns, both the adaptive ones and the maladaptive ones. Knowing your patterns can be helpful in working through your thoughts, and a therapist can give you a different perspective to consider.

Therapists can also treat you for underlying mental health conditions, like anxiety or OCD. They can provide you with the skills you need to manage your symptoms, and to cope with the distress that arises with intrusive thoughts. They can also help you understand when your intrusive thoughts become dangerous, like if you’re thinking of hurting yourself.

Many therapists are trained in evidence-based therapy modalities that center around thoughts or thought patterns, like cognitive behavioral therapy (CBT) and acceptance and commitment therapy (ACT). A therapist can help you see the connection between what you’re thinking and how you’re feeling.

Lastly, a therapist can help you manage your stress levels and take care of yourself. If you find that you’re more likely to experience an intrusive thought when you’re overwhelmed, a therapist can be a good sounding board for ways to destress and to incorporate relaxation into your regular routines.