Intrusive thoughts: why they happen and how to stop fearing them

Everyone has intrusive thoughts

Research has found that most people experience unwanted, odd or disturbing thoughts from time to time: "What if I pushed someone onto the tracks?", "What if I shouted something in the masjid?" For most people these thoughts pass without much notice.

When they become a problem

For people with OCD or anxiety, intrusive thoughts feel meaningful and dangerous. The thought "What if I hurt my baby?" leads to terror, then to checking, avoiding or seeking reassurance. The more you fight a thought, the more it sticks.

Common themes

• Harm: hurting a child, partner or yourself
• Sexual thoughts that go against your values
• Religious and blasphemous thoughts
• Relationship doubts: "Do I really love my spouse?"
• Fear of losing control or going mad

Thoughts are not intentions

The key fact: having a thought does not mean you want it, believe it or will act on it. People with harm-related intrusive thoughts are extremely unlikely to act on them, because the thoughts horrify them. The distress is the clue that the thought goes against who you are.

Why trying to stop them backfires

Try not to think of a white elephant. You just did. Pushing thoughts away, arguing with them or replacing them with "good" thoughts keeps them coming back.

What helps

• Name it: "This is an intrusive thought. It is OCD or anxiety talking."
• Let it be there: do not argue, analyse or push it away.
• Carry on: keep doing what you were doing.
• Drop rituals: reduce checking, confessing and reassurance seeking.

Getting professional help

If intrusive thoughts are taking up a lot of time, stopping you from being with your children, or making you avoid prayer, CBT with ERP can help. Telling a professional about your thoughts may feel terrifying, but they understand intrusive thoughts well and will not judge you. See ERP therapy.

Questions people ask

Are intrusive thoughts normal?

Yes. Most people have unwanted or strange thoughts sometimes. They become a problem when they cause intense distress and lead to rituals or avoidance.

Do intrusive thoughts mean I want to do those things?

No. Intrusive thoughts are unwanted, and the distress they cause shows they go against your values.

Will I act on my intrusive thoughts?

People with harm-related intrusive thoughts in OCD are very unlikely to act on them. The fear itself reflects that you do not want to.

How do I stop intrusive thoughts?

Paradoxically, by not trying to stop them. Notice the thought, label it, let it stay without engaging, and carry on with what you were doing.

Can new mothers have intrusive thoughts about their baby?

Yes, it is very common after birth. These thoughts are distressing but do not mean you will harm your baby. Talk to a professional.

Are intrusive thoughts a sign of OCD?

They can be, if they are frequent, very distressing and lead to compulsions. They also occur with anxiety and depression.

Should I tell a therapist about my intrusive thoughts?

Yes. Professionals who treat OCD hear these thoughts often and understand them. Sharing them is part of getting better.

Why do I get blasphemous thoughts during prayer?

Intrusive thoughts often target what matters most to you. During prayer, religious thoughts become the target. It is a known feature of religious OCD.

Can intrusive thoughts be treated?

Yes. CBT with exposure and response prevention is very effective for intrusive thoughts linked to OCD.

What is relationship OCD?

A form of OCD involving constant doubts about whether you love your partner or are in the right relationship, with checking and reassurance seeking.