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What are Intrusive Thoughts?

One hallmark feature of OCD and other anxiety disorders are intrusive thoughts. These are unwanted and automatically-appearing thoughts that are unwanted, taboo, distressing, confusing and otherwise distress-inducing. Examples include: "what if I am gay?", "What if I drive my car off this bridge right now?", and thoughts about harming another person. Intrusive thoughts can also come in the form of pictures: your child lying in a pool of blood, yourself committing suicide, or yourself or a family member in a sexual act. If you are reading this right now you are likely able to conjure some of these images. Interestingly, some may stand out to you and cause you distress, while others may pass right through your mind without a second glance.

The field of OCD treatment has categorized these thoughts into distinct clusters:

1) Harm Thoughts

2) Sexual Thoughts

3) Religious Thoughts

4) Contamination Thoughts

5) Relationship Thoughts, and more




What is interesting is that no matter the content of the thought, the process by which it hooks you and gets you stuck worrying or obsessing is much the same. The thought will arise, tell you that it is important and MUST be thought about now, and demand some amount of attention. As it draws in your attention, the details in the thought only become more clear and consume more attention. These thoughts create a black hole where they bring in your attention and try to suck your whole day in with them.


How can you keep going about your day in spite of an intrusive thought? Well, let's think about the thoughts listed at the beginning of this article. As I mentioned, you likely had a visceral reaction to one or more of those thoughts, while others did not capture your attention. That is interesting, because it could be argued that any thought is the "worst" of the bunch up there. What did you do with the thoughts that did not bring in your attention? You saw them, acknowledged them, and chose to move on and allow your brain to take in new information. In that simple and immediate act, you sent your brain a message: "this thought is not important, move along now." Think of the difference between that and the thought you recoiled from; the thought that made you cringe? Did you treat that cringe-worthy thought as if it were unimportant? Likely no, your recoil and internal conversation about the thought sent your brain a message about how that thought was meaningful, and as a result your brain brought it up again.


Part of OCD treatment is being able to recognize and acknowledge all intrusive thoughts while choosing to treat them as if they are not important and moving on with your day. This may not "fix" the thought and will likely not make it go away forever, but wouldn't it be better to see it and move on than get fixated on it for an entire day? If you would like more practice with this please feel free to reach out to me - intrusive thoughts do not get to boss you around any longer!


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