Intrusive Thoughts: What They Are, How they are linked to Anxiety and OCD and How to Take Control

What is an Intrusive Thought?

Intrusive thoughts are those unexpected, often distressing thoughts that seem to pop into your mind out of nowhere. These thoughts can be alarming and typically involve themes that are contrary to your values or worries related to things that matter deeply to you. For instance, a person who values kindness may suddenly think of harming a loved one, or someone who values fidelity might be troubled by thoughts of infidelity. The content of these thoughts is typically unsettling and may seem completely out of character, which only heightens the distress they cause.

Are Intrusive Thoughts Normal?

Yes, experiencing intrusive thoughts is normal. Most people encounter them from time to time and quickly dismiss them as unusual or irrelevant. The problem arises when individuals start to fixate on these thoughts or attribute undue significance to them—a phenomenon known as thought-action fusion. This is when a person starts to believe that having a thought is just as bad as acting on it, or thinking ‘I’ve had a thought so maybe it means it’s true’ which can lead to anxiety, repeated checking behaviors, seeking reassurance, or trying to disprove the thought. Ironically, these attempts to suppress or eliminate the thought can make it more persistent, leading to a cycle where the thought becomes increasingly “sticky” in the mind. The underlying issue with intrusive thoughts is often rooted in a need for certainty. People may feel compelled to achieve absolute certainty over things they can never fully control, leading to heightened distress and ongoing mental struggles.

What is Intrusive Thought Disorder?

While intrusive thoughts themselves are not classified as a disorder, they can be a symptom of various mental health conditions if they become frequent, intense, and significantly disruptive to daily life. Such conditions include Obsessive-Compulsive Disorder (OCD), Post-Traumatic Stress Disorder (PTSD), Generalised Anxiety Disorder (GAD), Depression, Social Anxiety Disorder, and Panic Disorder.

How Are Intrusive Thoughts Linked to OCD?

Intrusive thoughts are a hallmark feature of Obsessive-Compulsive Disorder (OCD). In OCD, these thoughts, or obsessions, become persistent and unwanted, causing significant anxiety or distress. Common obsessions in OCD might involve fears of harming oneself or others, contamination, unwanted sexual thoughts, or an overwhelming need for order and symmetry.

People with OCD often feel driven to neutralise the anxiety caused by these thoughts through repetitive behaviours, known as compulsions. For example, someone who fears contamination may engage in compulsive hand-washing, or someone worried about causing harm may repeatedly check to ensure they haven’t accidentally harmed anyone. These compulsive behaviours, whether physical or mental, are an attempt to reduce the anxiety associated with the intrusive thoughts.

A crucial aspect of OCD is the misinterpretation of these intrusive thoughts. While most people can dismiss them as meaningless, someone with OCD may view them as dangerous or indicative of their true intentions. This misinterpretation intensifies the distress and leads to compulsive behaviours designed to alleviate the anxiety, disprove the thought, or eliminate it altogether.

How Are Intrusive Thoughts Linked to Anxiety?

Intrusive thoughts and anxiety are closely intertwined. These thoughts can both trigger and be a symptom of anxiety disorders. The emotional response they provoke, of fear, doubt and anxiety, is often strong, particularly which makes them difficult to ignore or dismiss. The content of intrusive thoughts usually involves distressing or anxiety-inducing themes, such as concerns about safety, health, morality, or social interactions. For instance, a person might have an intrusive thought about contracting a severe illness, which then triggers anxiety about their health.

The disturbing nature of the thought can cause a person to worry about its implications, leading to a cycle where the thought triggers anxiety, and the anxiety makes the thought more persistent. When someone is anxious, they are often hyper-aware of their thoughts and bodily sensations, which can make intrusive thoughts seem even more significant. This heightened focus can lead to catastrophic thinking, where the person imagines the worst-case scenario based on the intrusive thought, further intensifying their anxiety.

How to Manage Intrusive Thoughts

Getting rid of intrusive thoughts can be challenging, as the more you try to force them away, the more persistent they may become. Be aware that ‘talking therapy’ or counselling can often make things worse rather than better. Often it requires working with a clinical psychologist trained in scientifically supported treatments for anxiety and OCD. The good news is with the right strategies these challenges can readily be turned around.

Instead of attempting to eliminate the intrusive thoughts, effective strategies focus on managing these thoughts and reducing their impact.

1. Recognise and Label the Thought: Acknowledge the thought as just a thought, not a reflection of reality or your intentions. Label it as intrusive to remind yourself that it is unwanted and involuntary.

2. Practice Mindfulness: Observe your thoughts without judgment. Mindfulness helps you focus on the present moment, reducing the power of intrusive thoughts.

3. Cognitive Restructuring: Challenge the thought by examining its validity and reframe it with a more balanced perspective.

4. Exposure and Response Prevention (ERP): Gradually expose yourself to the thought without engaging in compulsive behaviors. This therapeutic approach helps reduce the anxiety associated with the thought over time. Understanding worry and the nature of this mental compulsion can be a helpful part of this process.

5. Acceptance Based Therapies: Accept the thought without letting it control your behaviour. Focus on actions that align with your values.

6. Seek Professional Help: A therapist trained in Cognitive-Behavioural Therapy (CBT) and specifically treatments for anxiety and OCD can provide structured guidance. Medication may also be an option for reducing the frequency and intensity of intrusive thoughts alongside working with a psychologist.

While intrusive thoughts can be distressing, they are a normal part of human experience. By understanding their nature and using strategies like mindfulness, values-based interventions, and therapy, you can manage these thoughts effectively. If intrusive thoughts are significantly impacting your life, seeking help from a mental health professional is a positive step toward regaining control over your emotional wellbeing.

Written by Dr Jodie Lowinger from The Anxiety Clinic.

The Anxiety Clinic team is deeply committed to helping families manage emotional and behavioural challenges and to enhance happiness, resilience and wellbeing. They are a warm and friendly team of clinical and registered psychologists, offering online therapy across Australia and in-person therapy from their light and comfortable practice rooms in Bondi Junction. 

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