Intrusive Thoughts in OCD: Everything You Need To Know

Within OCD, intrusive thoughts fall under the category of obsessions. Those who suffer from obsessive-compulsive disorder, are plagued by unrelenting and highly distressing intrusive thoughts that play on their fears.

These unwanted thoughts are experienced by everyone, including non-OCD sufferers.

But when these invasive and repetitive thoughts take over and begin to limit our ability to enjoy and experience day-to-day life to the fullest, this is when they become a problem.

These intrusive thoughts feel so real and provoke such high levels of uncertainty and anxiety, that we feel a sense of urgency to try and regain a sense of control.

This drives sufferers to engage in physical or mental compulsions (ritualistic behaviors) to alleviate that sense of uncertainty, if only for a short while.

However, by engaging in those compulsive behaviors, they find themselves trapped in the OCD cycle which strengthens and thrives every time we seek temporary relief.

The good news is, OCD is highly treatable and you can change your relationship and response to intrusive thoughts so they no longer dictate how you choose to live.

In this article, we’re going to help you understand the ins and outs of intrusive thoughts and explore how you can take your life back from them!

What are intrusive thoughts?

Intrusive thoughts are unwanted, distressing, and recurrent thoughts and images that appear in a person’s mind without their control or consent. 

They can be violent, sexual, or blasphemous in nature and can cause feelings of shame, guilt, and anxiety. 

Everyone experiences intrusive thoughts from time to time, for those who do not suffer from OCD, these thoughts are quickly dismissed as some strange, out-of-the-box thinking – Woah! Where did that come from? Never mind, I’ll just carry on.

Non-OCD sufferers may recognize these thoughts but are quick to shake them off and carry on with their daily life.

Those with OCD feel tortured by these intrusive thoughts. They can feel all-consuming and make it incredibly difficult to focus on anything other than the thoughts themselves. The reason these intrusive thoughts are so painful within this mental health disorder is that OCD is egodystonic in nature.

This means that those intrusive thoughts go against our values and the very nature of who we’ve always believed ourselves to be.

They challenge our self-concept and bring into question our sense of identity.

In addition to this, they play on our need for certainty. Humans naturally seek certainty to feel safe. Our brains try to protect us from perceived danger by sounding the alarm when it suspects that something isn’t quite right.

This is why OCD is also known as the doubting disorder.

These intrusive thoughts become the source of perceived threat because they’re shocking, or disturbing, or we fear the potential consequence of what might happen if we simply ignore them.

Our brain recognizes these thoughts and responds, “Nope, something isn’t right here! Better look into that. What does it mean? Why would you think this way? Don’t let this slide!”

In reality, our brains are just trying to protect us.

Unfortunately, in the case of OCD, they have misfired and are protecting us from something that is of no real danger.

Intrusive thoughts can look like:

• What if thoughts: 

What if ABC happens?

What if you want ABC to happen?

• Doubt thoughts

Are you sure you want to do that?

Maybe you’re going to *insert fear*

• Demands

Do it!

You have to…

You need to…

You want to…

• Self-criticism Thoughts

Because you did ABC, you are awful

You’re horrible because…

You like this

• Questions that mimic curiosity

Is this why…?

I wonder if…

Intrusive thought examples within OCD subtypes

Obsessive-Compulsive Disorder (OCD) can present itself in different subtypes, each with their own set of intrusive thoughts. 

Here are some examples of intrusive thoughts in different OCD subtypes:

1. Contamination OCD: Fear of germs or getting sick, leading to excessive cleaning, hand-washing, or avoidance of certain places or objects. Intrusive thoughts may include imagining contracting a deadly disease or being contaminated by something dirty.

2. Checking OCD: Fear of harming oneself or others due to negligence or oversight, leading to compulsive checking behaviors. Intrusive thoughts may include imagining leaving a door unlocked or a stove on, causing harm to oneself or others.

3. Harm OCD: Fear of causing harm to oneself or others, leading to compulsive behaviors such as avoidance or seeking reassurance. Intrusive thoughts may include imagining hurting someone, being responsible for a terrible accident, or committing a violent act.

4. Sexual OCD: Fear of acting out sexually or having inappropriate sexual thoughts, leading to compulsive behaviors such as avoidance or seeking reassurance. Intrusive thoughts may include imagining engaging in taboo sexual acts or having inappropriate sexual thoughts about family members or children.

5. Religious OCD: Obsessive thoughts related to religion or morality, leading to compulsive behaviors such as excessive prayer or avoiding religious activities. Intrusive thoughts may include imagining committing blasphemy or having impure thoughts about religious figures.

Symptoms and signs of intrusive thoughts

It’s important to understand that everyone experiences intrusive thoughts.

What we want to recognize is whether or not these intrusive thoughts are diminishing your quality of life and contributing to the OCD cycle.

The signs and symptoms of intrusive thoughts can vary from person to person depending on their specific OCD theme, but some common experiences include:

1. Unwanted and repetitive thoughts, images, or urges that are difficult to control or dismiss.

2. Feelings of anxiety, fear, guilt, shame, or disgust associated with the intrusive thoughts.

3. Persistent and distressing mental images or memories that intrude into daily activities or conversations.

4. Attempts to suppress or avoid intrusive thoughts, which can lead to increased anxiety and stress.

5. Compulsive behaviors or rituals that are performed in an attempt to neutralize or alleviate the anxiety associated with intrusive thoughts.

6. Difficulty concentrating, sleeping, or completing daily activities due to intrusive thoughts.

7. Feeling a sense of shame or embarrassment about the content of the intrusive thoughts, which can lead to social isolation or avoidance of certain situations.

8. Fear that you will snap and lose control.

Is it normal to have intrusive thoughts?

According to a study published in the Journal of Obsessive-Compulsive and Related Disorders (2015), 94% of the general population reports having intrusive thoughts at some point in their lives. 

However, for some individuals, intrusive thoughts can become distressing and interfere with their daily functioning, leading to mental health concerns such as anxiety, depression, and obsessive-compulsive disorder (OCD).

It’s important to note that not all individuals who experience intrusive thoughts have OCD or a mental health disorder.

Furthermore, it’s important to distinguish between “normal” intrusive thoughts and clinically significant ones that cause distress and impairment. Intrusive thoughts that persistently interfere with daily activities, cause significant distress, or are associated with compulsive behaviors may warrant a mental health evaluation and treatment.

In summary, intrusive thoughts are a common experience, and it is normal to experience them. 

It is our relationship and response to those thoughts that will signify whether or not they are a greater problem that needs to be addressed.

Why do we have intrusive thoughts?

The exact cause of intrusive thoughts is not fully understood, but research suggests that they may be related to several factors, including:

1. Evolutionary Adaptation: Some researchers believe intrusive thoughts may be a normal and adaptive response to perceived threats, allowing individuals to anticipate and avoid potential dangers.

2. Cognitive Factors: Certain cognitive processes, such as attentional bias, memory recall, and response inhibition, may play a role in the development and persistence of intrusive thoughts.

3. Mental Health Disorders: Intrusive thoughts are a common symptom of mental health disorders such as OCD, generalized anxiety disorder (GAD), and post-traumatic stress disorder (PTSD).

4. Brain Chemistry: Studies have shown that imbalances in certain neurotransmitters, such as serotonin and dopamine, may contribute to the development of intrusive thoughts.

5. Past Trauma: Traumatic experiences, such as abuse or violence, can increase the likelihood of experiencing intrusive thoughts as the brain tries to process and make sense of the trauma.

Despite the urge you may have to understand why you’re experiencing these intrusive thoughts, the truth is that this type of rumination can become a compulsive behavior in and of itself.

And those compulsive behaviors only strengthen OCD’s hold.

The reality is, when clients come to us they have this same desire to find the why but we quickly educate them to see that we don’t need to know the why or the root cause…

We can work together to manage these intrusive thoughts so you can continue to live and thrive on your terms.

Why do intrusive thoughts feel so real?

Something our clients often ask is, why do my intrusive thoughts feel so real?

And the answer is that it is a real process that’s happening inside the mind and the body.⁠

These thoughts are perceived as threats that fire off our anxious response.⁠ In our bodies, we feel uneasy and on edge.⁠

Our mind is screaming – you need to do something about this! Don’t leave this alone!⁠

The reason it feels so real is that our response to these intrusive thoughts is the same as if we faced a real threat, even though there isn’t one.⁠

Within particular OCD subtypes, this can be particularly difficult to accept. Suicidal OCD intrusive thoughts for example; when these intrusive thoughts about taking your own life feel so real it’s easy to not want to take the risk and simply let them be.

The potential consequence of those thoughts becoming a reality are too frightening, so it’s understandable that those within these subtypes feel compelled to avoid those outcomes at all costs.

This is why OCD can often feel like you’re going crazy. All of these fears happen inside the mind and you may begin down a self-critical spiral of believing you shouldn’t have these thoughts, they aren’t normal, and there must be something wrong.

The irony is, it’s that very thinking that gives these thoughts the attention they need to further thrive.

Common misconceptions about intrusive thoughts

Here are some of the most common misconceptions about intrusive thoughts that we face within our clients and online communities (and what we want you to know instead!):

1. Your thoughts are a direct reflection of who you are

Often people with OCD think you are your thoughts.

You are not your thoughts.

We often give our thoughts more validity and weight than we should. But, especially for those suffering from OCD, it’s detrimental to sit with the belief that you are your thoughts.

Our brains are complex things.

And nothing is this black and white.

If you find yourself plagued with intrusive thoughts or images that make you feel as though you’re a bad person (as this is something we often see within our clients), just remember…

You are so much more than your thoughts.

2. Having an intrusive thought means you’re more likely to act

A common myth surrounding intrusive thoughts is that they may lead to action, or should we say, sufferers may believe that having the thought means they are more likely to act on it.

This simply isn’t true.

Just because you think a thought does not mean you will take action on it. Despite how it may feel sometimes, you are in control.

3. Intrusive thoughts are a problem in and of themselves

The irony is that intrusive thoughts are not a problem until our brains see them as a problem.

Everyone has intrusive thoughts – even those who do not suffer from OCD or another mental health condition.

But they become a problem when our brain sees them as a perceived threat, a problem that needs to be solved. We then give them more of our attention and focus, and this allows them to thrive and feed our OCD.

The truth is, you can experience intrusive thoughts without them being a problem or negatively impacting your life. This is what OCD treatment can help you achieve.

4. The goal of therapy is to stop intrusive thoughts

Following on from the last point, many clients ask us how they can stop their intrusive thoughts, but this is not the goal of therapy.

You cannot stop your thoughts, intrusive or otherwise.

And it’s in trying to fight, stop, and wrestle with them that we make those symptoms of OCD worse. 

When you first begin therapy with a qualified mental health professional, they will begin with psychoeducation so you can understand the function of your thoughts and how to approach them in a way that is helpful rather than disruptive.

As you probably have already experienced, the more you try to stop thoughts, the more you have them.

As an experiment, you could try not to have a specific thought. You will find the act of trying not to have the thought is having the thought and makes you have more of them.

How do intrusive thoughts and OCD affect quality of life?

Intrusive thoughts and OCD can have a significant impact on a person’s quality of life. 

Here are some ways they can affect daily functioning:

1. Interference with daily activities: Intrusive thoughts and OCD can interfere with a person’s ability to concentrate, work, study, or engage in leisure activities.

2. Relationship problems: The distress caused by intrusive thoughts and OCD can impact a person’s relationships with family, friends, and romantic partners.

3. Avoidance behaviors: Some people may avoid situations or activities that trigger their intrusive thoughts or compulsions, which can lead to social isolation and impaired functioning.

4. Emotional distress: Intrusive thoughts and OCD can cause intense feelings of anxiety, fear, shame, guilt, or disgust, which can be distressing and affect mood and overall well-being.

5. Sleep disturbances: Intrusive thoughts can make it difficult to fall asleep or stay asleep, which can impact sleep quality and overall health.

6. Decreased quality of life: The negative impact of intrusive thoughts and OCD on daily functioning, relationships, and emotional well-being can lead to a decreased quality of life.

When living with OCD, these intrusive thoughts bring daily turmoil and life can feel as though it’s shrinking.

But with the right support, you can regain control and live according to your values rather than your fears. And you can widen your physical and emotional experiences again and live life how you choose to live it – and not let OCD dictate your decisions.

Treatment for OCD intrusive thoughts

The most effective treatment for managing OCD intrusive thoughts is exposure and response prevention therapy, ERP.

This proven behavioral methodology teaches you how to tolerate the uncertainty and anxiety following those intrusive thoughts, without needing to engage in compulsions.

When you begin treatment with a qualified specialist, they will start by providing education and knowledge about the different components of OCD so that you feel equipped to engage in the treatment.

ERP is often complemented by other modalities such as ACT (acceptance and commitment therapy) and Mindfulness. You will be given these tools to help support you as you move through the treatment plan.

You will then work together to create a hierarchy of exposures that you can begin working through. These exposures will be done at your own pace and you will never be asked to do anything that you don’t feel achievable.

Through ERP, you will learn healthy ways to cope with those intrusive thoughts and the anxiety that accompanies them. Over time, the anxiety decreases and those intuitive thoughts become far less problematic.

1:1 Private Therapy

Starting OCD treatment can seem daunting.

When our clients come to us, there’s often a high degree of hesitation and skepticism. After all, facing your fears probably doesn’t seem like a lot of fun, so how do you know if it’s worth it?

Well, our team of highly qualified mental health professionals is trained to the highest standards and offers a warm and compassionate approach to therapy.

Clients come to us afraid and doubtful.

They know they can’t carry on living this way but they just aren’t sure that recovery is possible for them. We quickly show them that it is!

When you come to us, you’ll be met with an elite team of licensed OCD specialists who are invested in your recovery.

You’ll be met without judgment and you won’t be asked to do anything that you don’t feel you can manage.

We’re going to work on this together.

A life where intrusive thoughts don’t rule every waking hour of our day is not as far away as you might think.

If you’re interested to see how we can support you and you’re based in California or Arizona, please submit an initial intake form here.

We would be honored to assist your OCD recovery.

Online self-study program

If private therapy isn’t currently an option for you, OCD specialist Kimberley Quinlan has created an affordable online program called ERP SCHOOL that is accessible to everyone.

You will learn the exact tools and techniques given to those in a private therapy setting, and you will understand how to apply them to your specific intrusive thoughts and compulsions.

By the end of the program, you will have the knowledge and understanding to stop letting your intrusive thoughts ruin your life and resist the urge to do compulsions that keep you trapped in the OCD Cycle.

Join ERP SCHOOL here.

Intrusive thoughts FAQs

Are intrusive thoughts a mental disorder?

Intrusive thoughts are not a mental disorder in and of themselves.

They are typically a symptom of other mental health conditions such as OCD, depression, or anxiety disorders.

Intrusive thoughts are typically harmless, but if you find that they invade your mind and steal the majority of your time, energy, and attention… it is worth reaching out to a qualified mental health professional who can offer an official evaluation, diagnosis, and treatment plan, if necessary.

Do intrusive thoughts mean anything?

Intrusive thoughts are not an indication of your character or sanity.

The reality is, sometimes our thoughts are truly meaningless, irrelevant, and unimportant – no matter how attention-grabbing they may seem.

How do I stop intrusive thoughts?

You cannot stop intrusive thoughts.

But you can change your relationship with them and how you respond to them. Every effort to fight, stop, wrestle with, or suppress these thoughts only gives them the attention they need to thrive.

The aim is to notice them, allow them, and carry on with your day as normal.

What if my intrusive thoughts are real?

Intrusive thoughts can feel very real, but thoughts are just thoughts.

Just because you think it in your mind and feel a physiological response in your body, does not mean it is true.

This type of rumination can become a mental compulsion in and of itself. If you feel trapped in a spiral of trying to ‘figure them out’, please speak to a medical professional who can support you through a relevant diagnosis and treatment plan.