What Are Intrusive Thoughts?

The Team at Upper East Side Psychology
7 hours ago
6 min read

Introduction

You can be having a completely normal day when your brain suddenly throws out a thought that stops you in your tracks.

It may be violent, sexual, religious, embarrassing, or just deeply unsettling. The thought passes quickly, but the fear can stick around: What did that mean? Why did I think that? Does this say something about me?

Intrusive thoughts can feel frightening, confusing, or upsetting, especially when they seem completely out of character. The good news is that having an intrusive thought does not mean you want it to happen, agree with it, or are likely to act on it.

This blog will help explain what intrusive thoughts are, why they can feel so alarming, and how therapy can help you respond to them with less fear and shame.

What are Intrusive Thoughts?

Definition of Intrusive Thoughts

Intrusive thoughts are unwanted thoughts, images, urges, memories, or impulses that enter the mind unexpectedly. They often feel disturbing, inappropriate, or inconsistent with a person's values. They can occur occasionally or become repetitive and distressing.

Why Intrusive Thoughts Feel So Disturbing

The content of unwanted intrusive thoughts tends to be socially unacceptable, violent, or sexual. They feel so disturbing because when people experience them, they often become afraid that they might commit the acts they picture in their minds. Furthermore, they fear that the thoughts mean something about themselves. This creates feelings of shame, embarrassment, and disgust.

Are Intrusive Thoughts Normal?

Research estimates that over six million people in the United States are troubled by intrusive thoughts (Bilodeau, 2024). Sometimes intrusive thoughts are associated with a mental health disorder, such as obsessive-compulsive disorder or post-traumatic stress disorder.

Other times, they are triggered by stress, anxiety, or even biological factors such as hormone shifts (Bilodeau, 2024). Many people who experience these thoughts do not have a mental health disorder.

Common Types of Intrusive Thoughts

Harm-related thoughts
- Thinking about hurting yourself or someone else
- Violent images or scenarios
Sexual thoughts
- Unwanted sexual thoughts or images
- Thoughts that feel inappropriate or distressing
- Fear that thoughts reflect hidden desires.
Negative thoughts and self-talk
- Feelings of guilt, shame, and unworthiness
- Fixating on past mistakes

Why Intrusive Thoughts Happen

Stress and anxiety are typically the most common factors that trigger intrusive thoughts. But also, sometimes the brain simply creates “junk thoughts” that are completely irrelevant, unimportant aspects of our stream of consciousness (Seif and Winston, 2018).

When a thought feels disturbing, a person may try to push it away, analyze it, or seek reassurance that it does not mean anything. This response is understandable, but it can unintentionally make the thought feel more important. The more urgently someone tries to get rid of the thought, the more the mind may return to it. On the other hand, if you choose to completely ignore the thought, it dissipates more easily and gets washed away in the flow of consciousness (Seif and Winston, 2018).

In reality, an intrusive thought is not an impulse. Having a disturbing thought does not mean you actually want to act on it. For many people, the work is not learning how to control every thought, but learning how to respond with less fear and urgency when the thought appears.

Intrusive Thoughts and OCD

Intrusive thoughts do not automatically mean someone has obsessive-compulsive disorder, or OCD. However, intrusive thoughts are a core feature of OCD.

OCD is a long-lasting disorder that can involve obsessions, compulsions, or both. Obsessions are recurring thoughts, urges, or mental images that feel intrusive, unwanted, and anxiety-provoking. Compulsions are repetitive behaviors a person feels driven to do, often in response to an obsession.

Common obsessions can include fears about contamination, losing control, forgetting something, harming oneself or others, or having unwanted taboo thoughts involving sex, religion, or harm.

Common compulsions can include repeated checking, excessive cleaning, arranging items in a specific way, counting, praying, or silently repeating words.

The difference is not simply whether someone has an unwanted thought. Many people have unwanted thoughts from time to time. In OCD, the thoughts or behaviors are usually difficult to control, take up significant time, cause distress, or interfere with daily life.

How to Respond to Intrusive Thoughts

Identifying Intrusive Thoughts

A helpful first step is learning to recognize an intrusive thought when it appears. Ask yourself:

Is this thought unusual for me?
Is this thought bothersome?
Is this thought hard to control?

An intrusive thought is usually very different from your typical thoughts, disturbing, and repetitive.

Once you recognize the thought as intrusive, try labeling it gently and without judgment: This is an intrusive thought. It is not something I chose, and it does not reflect what I really believe or want to do.

What to do

When intrusive thoughts show up, the goal is not to argue with them or force them away. In fact, trying too hard to get rid of the thought can make it feel even stronger. Instead, it may be helpful to:

Accept and allow the thoughts in your mind
Remind yourself that thoughts are not actions
Allow time to pass; there is no urgency
Expect the thoughts to come back again
Continue what you were doing prior to the thought while still allowing the stress or anxiety to be present

Seeking Help

Intrusive thoughts are common, but support can be helpful when they begin to interfere with daily life.

It may be time to seek help if intrusive thoughts are causing significant distress, taking up a lot of mental energy, disrupting sleep, affecting work or relationships, or leading to avoidance. It may also be helpful to seek support if the thoughts are connected to repeated checking, reassurance-seeking, or compulsive behaviors.

How Therapy Can Can Help

Intrusive thoughts can feel isolating, especially when the content feels embarrassing, frightening, or hard to say out loud. Therapy can offer a space to understand what is happening without judgment and learn how to respond differently. Further, research indicates that intrusive thoughts typically respond well to therapy (Bilodeau, 2024).

Cognitive Behavioral Therapy (CBT)

Cognitive Behavioral Therapy, or CBT, is one approach that can help people manage intrusive thoughts. CBT can help clients notice patterns in how they respond to unwanted thoughts and learn new ways to relate to them.

This process can help individuals shift some of their general thought patterns, which in turn enables them to better manage these thoughts when they do occur (Bilodeau, 2024).

Exposure and Response Prevention (ERP) Therapy

When intrusive thoughts are part of obsessive-compulsive disorder, or OCD, therapy may also include Exposure and Response Prevention, often called ERP.

ERP helps people gradually face feared thoughts, images, or situations while practicing not engaging in the compulsive response. Over time, this can help reduce the power of the obsession and make the anxiety feel more manageable.

At Upper East Side Psychology, ERP therapy is offered for children, adolescents, and adults navigating OCD symptoms, including intrusive thoughts and compulsive behaviors.

Q&A

Are intrusive thoughts normal?

Yes. Almost everyone experiences unwanted or disturbing thoughts from time to time. Having an intrusive thought does not mean you agree with it, want it to happen, or are likely to act on it.

Why are intrusive thoughts so hard to ignore?

Intrusive thoughts often feel hard to ignore because they create anxiety. When someone tries to push the thought away, analyze it, or seek reassurance, the thought can start to feel more important. This can make it harder to let the thought pass.

Can intrusive thoughts be a sign of OCD?

Intrusive thoughts do not automatically mean someone has OCD. In OCD, intrusive thoughts are often repetitive, distressing, and connected to compulsions, such as checking, cleaning, avoiding, counting, or seeking reassurance.

Can therapy help with intrusive thoughts?

Yes. Therapy can help people understand intrusive thoughts, reduce fear and shame, and learn healthier ways to respond. Approaches such as CBT may help shift unhelpful thought patterns, while ERP may be especially helpful when intrusive thoughts are connected to OCD.

Final Thoughts

If intrusive thoughts, anxiety, or OCD symptoms are interfering with your daily life, therapy can help. The clinicians at Upper East Side Psychology provide evidence-based treatment for anxiety, OCD, intrusive thoughts, and related concerns using approaches such as ERP, CBT, and ACT.

Schedule your free 15-minute consultation today:

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