By Steven Booth, Co-Founder, Elevation Behavioral Health

We have all experienced unwanted involuntary thoughts that upset us. These are not like ordinary thoughts that flow through the mind during the day. Instead, intrusive thoughts are highly distressing. When intrusive thoughts plague us it can result in the symptoms of anxiety.

Sometimes intrusive thoughts are associated with obsessive-compulsive disorder (OCD). In fact, for someone with OCD, the intrusive thoughts are what drive the compulsive behaviors. The thoughts are so upsetting that the individual with OCD will attempt to diminish the potency of the disturbing thoughts. This can turn into a pattern of obsessive thoughts followed by compulsive actions. Learning how to overcome OCD-related intrusive thoughts becomes an integral goal in managing this mental health disorder.

Whether the intrusive thoughts are related to anxiety or OCD, either way they are very frustrating and disrupting to your daily life. Learning techniques to stop intrusive thoughts can help bring these under control and improve functioning.

What Causes Intrusive Thoughts?

It is not yet fully understood why people have undesired thoughts that invade their consciousness. Often, these random thoughts that intrude on our otherwise peaceful day will keep tapping away demanding our attention. Other times, the thoughts, though disturbing, are fleeting and leave us as quickly as they arrived.

There are a few potential causes for the onslaught of intrusive thoughts. These include:

• PTSD. Someone who has prolonged symptoms of stress after experiencing a trauma will be plagued by intrusive thoughts. The thoughts are usually related to the event itself, such as undesired memories.
• OCD. OCD usually has intrusive obsessive thoughts that drive the compulsive actions. The thoughts are so upsetting that the person will engage in ritualistic compulsive behaviors as a way of mitigating the stress the thoughts cause.
• Medical issues. Intrusive thoughts can be a symptom of a health condition, such as Parkinson’s disease, dementia, or a brain injury.

Are Intrusive Thoughts the Same as Ruminations?

Intrusive thoughts may seem to be the same as ruminating thoughts, but the two actually bear distinct differences. Where an intrusive thought is usually random and fleeting, ruminations the ongoing mulling over of the upsetting thoughts. Instead of noticing the intrusive thought and then choosing to ignore it or dismiss it, ruminating involves embracing the thought and chewing on them for long periods of time. Rumination is a type of coping mechanism to help process a disturbing event by reviewing the event over and over in your mind.

OCD and Intrusive Thoughts

The most common source of intrusive thoughts occurs among those who struggle with OCD. The intrusive thought is often related to a core value, such as religious beliefs or ethical issues, and involves a disturbing scenario that goes against what the person believes in. These thoughts might involve things of a sexual nature, thoughts of harming a loved one, or blasphemous thoughts that are in opposition to their core faith beliefs.

Because these intrusive thoughts are so destabilizing, the person with OCD will begin to fear the thoughts, which only makes the thoughts more pervasive. They begin to adapt compulsive behaviors to help diffuse the stress that the obsessive intrusive thoughts cause them.

Types of Intrusive Thoughts

There are different types of OCD-related thought intrusions. These include:

• Sexual intrusive thoughts. Disturbing thoughts that involve taboo sexual imagery, inappropriate sexual thoughts, or violent sexual acts.
• Religious intrusive thoughts. Obsessing about possibly sinning against God, scrupulosity, doubting faith beliefs, or blasphemous thoughts.
• Harming intrusive thoughts. Undesired thoughts of harming a loved one, such as a spouse, a parent, a child, or self.
• Responsibility intrusive thoughts. Irrational acceptance of the blame for certain acts committed that was not the fault of the person.
• Existential intrusive thoughts. Anxious thoughts that question the reason for existence, the purpose of life, or the reality of self.

Each of these types of intrusive thoughts will drive a corresponding compulsive action.

Exposure and Response Prevention

One of the targeted treatment methods for helping someone with OCD-related intrusive thoughts is an intervention called exposure and response prevention, or ERP. ERP is a type of cognitive behavioral therapy that helps the person face the disturbing thoughts head, but in small stages. Slowly they are encouraged to disengage from the compulsive actions that would typically follow the intrusive thought.

By stating their thoughts out loud with an ERP therapist, the power of the thoughts is greatly diminished. As Dr. Debra Kissen, a Clinical Fellow at the Anxiety Depression Association of America states, “The same intrusive thoughts that feel so real, all powerful and self-defining when swirling around in your head will disintegrate when said out loud.” The thoughts have far more power when they are held captive inside your mind, but when shared with someone they lose their impact.

In ERP the intrusive thought is exposed, and then the decision to not engage in the compulsive behaviors is the response prevention. The person makes a decision to no longer give in to the compulsions. During the first few weeks of ERP the therapist will guide the person through the steps of exposure and non-response. Eventually, the individuals will be equipped to conduct ERP themselves.

How to Stop Intrusive Thoughts

There are some effective techniques for managing intrusive thoughts when they appear. Consider these tips:

1. Do not fear the thoughts. While natural to want to avoid or ignore the thought, that can make it a reaction based in fear. Instead, try to accept the thought, realize that it is an obsessive irrational thought, and remind yourself that it will soon pass.
2. Practice self-care. Intrusive thoughts are related to anxiety or OCD, so learning methods to help promote relaxation can be helpful when the thoughts occur. Practice mindfulness and deep breathing to calm yourself down when the thoughts occur.
3. Seek help from a therapist. A therapist can work with you through the ERP therapy and other therapies, like CBT, which can help you make changes in how you respond to the thought triggers. They can also refer you to a psychiatrist who can prescribe antidepressants or anti-anxiety medications.

Don’t let random intrusive thoughts impact your quality of life. There are ways to manage these thought obsessions, which will improve all areas of daily functioning.

About the Author

Steven Booth is the CEO and Founder of Elevation Behavioral Health in Agoura Hills, CA. Steven earned his B.A. from the University of California, Santa Barbara in Economics. Before helping to co-found Elevation Behavioral Health, Steven worked in both private and public accounting. Like many others, Steven has seen firsthand the destruction that addiction can inflict on family and friends. He has also witnessed the extraordinary changes that can be made when addicts receive the necessary treatment. His passion is providing outstanding mental health care through his facility, and improving the quality of life of clients.