Intrusive Thoughts: What They Are And How To Cope

“Intrusive thoughts are thoughts, images and memories that spontaneously arise in your mind and lead to distress or [may cause] unhelpful behavior,” explains Judith S. Beck, Ph.D., a clinical professor of psychology at the University of Pennsylvania and president of the Beck Institute.

Colette Sachs, an associate therapist at Manhattan Wellness in New York City, says that intrusive thoughts are involuntary; someone can’t control them from coming into their mind.

“They can be uncomfortable, even shocking, and are often contrary to a person’s values or desires,” she says. For example, intrusive thoughts can be unwelcome sexual thoughts or violent thoughts, such as harming yourself or someone else.

“Typically, intrusive thoughts do not have a specific cause,” says Manhattan Wellness senior therapist Lauren Fuchs. Everyone has intrusive thoughts to some degree, adds Dr. Beck.

While everyone deals with occasional intrusive thoughts from time to time, intrusive thoughts that impact daily functioning may be a sign of a mental health condition, such as generalized anxiety disorder or obsessive compulsive disorder (OCD).

Having constant intrusive thoughts on a daily or near-daily basis lasting for longer than six months in the form of worry (such as a loved one getting hurt) is one of the symptoms that may lead to a diagnosis of generalized anxiety disorder. Meanwhile, intrusive thoughts that are repetitive and persistent and in some cases, lead one to perform a ritual or behavior in an attempt to relieve distress associated with the intrusive thought are one of the symptoms that can lead to a diagnosis of OCD.

Past trauma can also cause intrusive thoughts, says Sachs. To her point, research shows people with post traumatic stress disorder (PTSD) can have intrusive thoughts related to the trauma they experienced.

If you believe your intrusive thoughts are tied to a mental health disorder, it’s important to seek proper treatment so that intrusive thoughts do not get in the way of your ability to function in daily life. “If you have a mental health condition and significant intrusive thoughts, you may not be able to overcome the problem on your own,” says Dr. Beck. “A therapist specializing in cognitive behavior therapy can help.”

Many people may feel guilty or ashamed of their intrusive thoughts, even though they occur involuntarily, adds Fuchs. “The energy put toward trying to hide these thoughts from others or trying to control or stop them from coming on can be stressful,” she says. “The presence of intrusive thoughts could also lead to obsessive thought patterns about the origins or reasons behind the intrusive thoughts themselves.”

If you aren’t sure if the thoughts you’re having are intrusive, experts recommend asking yourself these questions:

• Is the thought unwanted? Dr. Beck reiterates that a hallmark of intrusive thoughts is that it’s not one you want to have. For example, if you spontaneously have a thought that makes you happy, that is not an intrusive thought.
• Is the thought out of character for you? Experts say that intrusive thoughts often go against one’s moral beliefs. For example, they may include sexual or violent behavior that the person having the thought would be opposed to actually doing.
• Is it disrupting your peace of mind? If the thought is causing you distress, it is intrusive.
• Is it recurring? Often, intrusive thoughts are recurring, says Sachs. As with the first time the thought occurs, recurring intrusive thoughts are spontaneous, unwanted and disturbing.

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While intrusive thoughts can’t be controlled, you can control how you react when they occur. “The best thing to do is to give the thought a label: ‘That’s just an intrusive thought,’” explains Dr. Beck. “Then, counter any special meaning [such as believing that an intrusive thought about driving your car into oncoming traffic must mean you want to kill yourself] and change where your attention lies; ‘It doesn’t mean anything. I should just focus again on what I’m doing.’” This strategy is much more effective than trying to suppress the thoughts, she says.

Acknowledge the thought without judgment, suggests Sachs. “For example, verbalize ‘I am having an intrusive thought’ when these moments arise,” she says. “This helps to normalize the experience and reduce the anxiety associated with the thought, as well as creating a distinction between the thought and the client’s true self.”

Experts emphasize that you should not judge yourself when an intrusive thought occurs, as there is nothing “wrong” with someone if they have an intrusive thought, even one that goes against their moral values. “These thoughts are exactly that: thoughts,” says Fuchs.

If intrusive thoughts are causing significant distress or are getting in the way of daily functioning, it’s time to see a therapist for help. “Being able to explore these thoughts in a therapeutic space is not only cathartic, but also provides the opportunity to learn about where these thoughts are coming from and develop appropriate strategies to cope with them,” says Sachs. “The goal might not be to eliminate these thoughts completely, but rather learning how to monitor them and effectively manage them in a way that aligns with our well-being and functioning.”

For some people, cognitive behavioral therapy (a psychological treatment that examines one’s thoughts and actions to help them regain a sense of control) can help people with intrusive thoughts cope, says Dr. Beck.

It also bears repeating that, sometimes, intrusive thoughts are a symptom of a mental health disorder, such as generalized anxiety disorder or OCD. For these individuals, treatment may include other types of therapy or prescription medication. For this reason, if you believe your intrusive thoughts may be related to a mental health condition, it’s important to see your health care provider, who can connect you to a psychiatrist or therapist, if needed. Dr. Beck adds that if someone has a mental health condition that could be connected to their intrusive thoughts (such as OCD), working with a mental health provider can help them find ways to cope in every day life, including when intrusive thoughts occur.

If you are having intrusive thoughts that are causing you to worry about your safety or the safety of others, call or text the Sucide and Crisis Lifeline at 988.

“Intrusive thoughts are a common part of the human experience,” Sachs says. “Everyone, at some point, has had a thought that they found disturbing or unwanted. Having an intrusive thought doesn’t make someone a bad person or mean they’re going to act on that thought, and most people do not act on their intrusive thoughts.”

However, if intrusive thoughts are negatively impacting your mental health or getting in the way of your daily life, seeing a therapist can help give you tools for what to do when these thoughts occur.