OCD Intrusive Thoughts: Why They Happen And how To Deal With Them

Intrusive thoughts are unwanted images, thoughts, impulses, sensations, or urges that pop into your head spontaneously, often causing distress or anxiety.

These thoughts are commonly associated with unpleasant themes such as harm or causing accidents, sexual behaviors, making mistakes, anxiety about relationships, or fear of contamination.

Such themes generally provoke emotional distress, especially when they are perceived as being out of character or against the person’s respective values.

Intrusive thoughts are often at the root of the OCD experience. Having intrusive thoughts does not mean you have OCD, but if you find yourself trying to suppress these unwanted thoughts and fears with compulsions (behaviors or rituals used to try and prevent a dreaded situation from happening) this can be a sign of OCD.

How to know if you have OCD-related intrusive thoughts?

To understand intrusive thoughts, it is important to recognize that they are a normal part of the human experience and do not necessarily reflect a person’s true desires or intentions

Intrusive thoughts on their own aren’t a mental health issue. The primary difference between intrusive thoughts that occur in the presence of anxiety and those that do not is the way these thoughts are classified.

Those with diagnosed clinical OCD are more likely to judge their thoughts as bad, immoral, and dangerous and are more likely to feel guilt or shame surrounding these thoughts. Thinking ‘this is a bad thought’ creates urges to immediately try to fix it.

They are also more likely to try to restrain these thoughts and prevent the feared potential consequences from occurring. This thought process tends to intensify the strength of the intrusive thought and can lead to more serious implications. 

What characterizes an intrusive thought as a component of OCD is how much emotional distress these thoughts cause and whether or not you try to neutralize these thoughts through compulsions. 

For someone with OCD,  it can feel impossible to let these thoughts go, no matter how irrational they seem. This is what leads someone to engage in compulsions to alleviate intrusive thoughts. 

People without clinical anxiety or OCD, on the other hand, are more likely to dismiss their thoughts as out-of-character and go on about their day. They do not let the thoughts impede on their daily life, and they tend to not ruminate on the deeper meanings of the thoughts.

Common Obsessions of Intrusive Thoughts OCD

There are several different types of intrusive thoughts. Some common themes include:

  • Violent or aggressive acts, specifically causing harm against yourself or other people
  • Fear of germs, infections, or contamination
  • Self doubts about doing tasks wrong or leaving tasks unfinished
  • Fear or committing a sin, blasphemous behavior, or being an immoral person
  • Participating in sexual acts or behaviors
  • Embarrassing yourself in public 
  • Fear of something terrible happening 

Common Compulsion of Intrusive Thoughts OCD

Compulsions are the behaviors or actions in which a person may engage to neutralize and reduce the anxiety caused by their intrusive thinking. Examples of common compulsions include: 

  • Constantly repeating a ritual or behavior
  • Checking on yourself and others in order to ensure no harm has been done
  • Continually thinking or ruminating about the intrusive thoughts
  • Seeking reassurance or validation from others
  • Having an intense need to perform a task “just right”
  • Avoiding objects, places, or people that can trigger one’s intrusive thoughts

Do OCD thoughts mean anything?

People who experience intrusive thoughts tend to become worried about what they might mean. They may have a difficult time realizing their thoughts are just thoughts.

The presence (or absence) of intrusive thoughts isn’t a good marker of well-being. It’s about our attitude towards them and how we respond. Thoughts aren’t facts and don’t always require a response. We have limited control over what thoughts enter our heads. But we do have a choice about whether to act on them.

While these sensations, ideas, memories, urges, and images might be disturbing and distressing, they more often they have no particular meaning. If the individual does not have any desire or intention of acting on the thoughts, then they should not worry about any deeper meaning.

Unfortunately, it is easy for someone with OCD to attempt to fight these thoughts and protect against them, and the harder a person fights them, the stronger they get. 

It is important to remember that these thoughts are not predictions of the future and they are not reality.

For someone with OCD, intrusive thoughts can feel nearly impossible to ignore, and the mind can become completely absorbed by these obsessions. The pain and distress we experience are not the intrusive thoughts themselves, but rather the amount of power we give these thoughts.

What causes intrusive thoughts?

Intrusive thoughts might not have a “cause.” They can happen randomly and just pop into your head. Just as easily as they wander into your brain, they exit and leave no lasting impression. 

However, with OCD, intrusive thoughts occur when an individual does not complete a particular behavior or habit (compulsion). A person with OCD will often try to suppress or stop their unwanted thoughts (obsessions) through rituals or repetitive behaviors.

This usually leads to a vicious cycle that involves repeating these particular behaviors or habits over and over to suppress the obsessions, which then just reinforces the obsessive thinking.

Why do OCD thoughts seem so real?

Individuals who suffer from OCD tend to have a need for certainty and perfection. They want to know for sure that whatever we are having intrusive thoughts about will never happen, or is completely false.

However, it is impossible to know absolutely for certain that what we fear has no meaning behind it or will never happen. That is what makes these thoughts so distressing for people with OCD. 

While people without OCD might have the same thoughts, images, and urges, they do not attribute any meaning to them and our brain often just filters them out as unnecessary or faulty information.

They are able to dismiss them and move on. But unfortunately for people who do suffer from OCD, they become filled with fear and intense anxiety and get stuck on these thoughts and attribute meaning to them.

Treatment: Managing intrusive thoughts by stopping compulsive behaviors

In the presence of anxiety and Obsessive-Compulsive Disorders, we should not try to suppress our intrusive thoughts. Rather, these thoughts should be examined, confronted, and worked through.

We might wish that we could never experience an intrusive thought again, but that is impossible. Instead, the goal of treatment is to learn to accept the thoughts and let them flow through your mind as though they’re any other thought. 

Exposure Response Prevention (ERP), a type of Cognitive Behavior Therapy, is the most common treatment option for OCD. ERP involves deliberately exposing oneself to intrusive thoughts, objects, and situations that make you anxious, and then preventing yourself from engaging in compulsive actions in reaction to these thoughts.

Over time, the hope is that you will become less sensitive to the things that once caused you great anxiety — including intrusive thoughts. 

In some cases, meditation can also be used to treat OCD. Mindfulness meditation, practicing yoga, taking walks outside, and other forms of self-care can also be beneficial ways to infuse your life with more positivity.

Can OCD intrusive thoughts change?

Yes, both compulsions and obsessions can change with time. The underlying emotions and fears tend to remain the same, but one’s age, culture, and life experiences can affect the themes of intrusive thoughts. The compulsive behaviors used to reduce anxiety can also shift.

It is important to note, though, that the types of OCD symptoms one has tend to remain fairly consistent over time. For example, if someone has a fear of germs, infections, or contamination early in life, it is unlikely they will develop a fear of committing a sin or blasphemous behavior later in life.

While the themes of the intrusive thoughts remain the same, the OCD symptoms can shift within the same symptom type.

So, for someone with a contamination-related obsession, they might have a strong urge to wash their hands or frequently shower at a young age, but later in life, they might shower less, but instead use a very specific process or ritual for washing themselves.

Will OCD intrusive thoughts ever go away?

Unfortunately, it is impossible for anyone to completely get rid of intrusive thoughts because no matter how hard you try to push them away, they will continue to make their way back into your consciousness.

However, the obsessions and compulsions associated with OCD can be mitigated with proper treatment. You might continue to have intrusive thoughts, but this does not mean they have to turn into an obsession.

THINK recovery looks likeREALLY recovery looks like
Never having or being bothered by intrusive thoughtsHaving intrusive thoughts but being
able to respond
Linear recoveryOccasional lapses/relapse
Never having obsessionsLiving a fulfilling life despite what OCD says
Finding the miracle answerComfortable never gaining certainty
Source: https://www.firstpsychology.co.uk/files/1-Understanding-ocd-booklet.pdf

Are intrusive thoughts normal?

Intrusive thoughts are far more common than typically believed. While intrusive thoughts are predominantly associated with obsessive-compulsive disorder (OCD) or amongst the symptoms of other anxiety disorders, having an intrusive thought once in a while is a normal part of life.

In fact, research has found that over 90% of the population experiences intrusive thoughts (Abramowitz, Deacon, & Whiteside, 2019). 

While everyone has intrusive thoughts from time to time, if these thoughts are happening often, causing significant concern, or interfering with your daily life, it is important to seek professional help.

Intrusive thoughts are usually nothing to worry about, but if you feel guilt or shame about your intrusive thoughts or feel like you need to control them, you might be experiencing something more serious.

Sources

Abramowitz, J. S., Deacon, B. J., & Whiteside, S. P. (2019). Exposure therapy for anxiety: Principles and practice. Guilford Publications.

Beaman, C. P., & Williams, T. I. (2010). Earworms (stuck song syndrome): Towards a natural history of intrusive thoughts. British journal of psychology101(4), 637-653.

Julien, D., O’Connor, K. P., & Aardema, F. (2007). Intrusive thoughts, obsessions, and appraisals in obsessive–compulsive disorder: A critical review. Clinical Psychology Review27(3), 366-383.

Najmi, S., Riemann, B. C., & Wegner, D. M. (2009). Managing unwanted intrusive thoughts in obsessive–compulsive disorder: Relative effectiveness of suppression, focused distraction, and acceptance. Behaviour research and therapy47(6), 494-503.

Seli, P., Risko, E. F., Purdon, C., & Smilek, D. (2017). Intrusive thoughts: Linking spontaneous mind wandering and OCD symptomatology. Psychological research81, 392-398.

Saul Mcleod, PhD

BSc (Hons) Psychology, MRes, PhD, University of Manchester

Educator, Researcher

Saul Mcleod, Ph.D., is a qualified psychology teacher with over 18 years experience of working in further and higher education.

Julia Simkus

Research Assistant at Princeton University

Undergraduate at Princeton University

Julia Simkus is a Psychology student at Princeton University. She will graduate in May of 2023 and go on to pursue her doctorate in Clinical Psychology.