Exposure · 6 minute read

Intrusive thoughts

Sudden, unwanted thoughts and images, sometimes shocking ones, are something almost everyone has. Here's why they stick, and what helps.

Key takeaways

Almost everyone gets sudden, unwanted thoughts of harm, sex, blasphemy or embarrassment. Having one says nothing about what you want.
What makes a thought stick is the meaning you give it ("this says I'm dangerous"), and the more you fight it, the more it comes back.
Name it, let it be there, skip the checking and reassurance, and carry on with what you were doing.

If intrusive thoughts take up a lot of your day, a doctor or a therapist who knows OCD can help, and treatment works well. If you ever want to act on a thought, or feel unsafe, get help straight away.

Out of nowhere

You're standing on a subway platform and a picture flashes into your head of jumping, or of pushing someone. You're holding a baby and imagine dropping them. You're in a quiet meeting and think of shouting something obscene. Then comes the horror: why would I think that? What does it say about me?

These are intrusive thoughts: sudden, unwanted thoughts, images or urges that seem to come out of nowhere.

Almost everyone has them

In 1978 the psychologists Stanley Rachman and Padmal de Silva asked ordinary people, with no mental health problems, about unwanted thoughts. Most had them, and their content was strikingly similar to the obsessions of people with OCD: harm, contamination, sex, blasphemy, embarrassment. The difference was how often the thoughts came, and how much they upset people.

In 2014 a team led by Adam Radomsky asked students in 13 countries across six continents. More than nine in ten had had at least one unwanted intrusive thought in the previous three months.

Why some stick

The thought itself isn't the problem. What makes it stick is the meaning we give it: "having this thought means I'm dangerous", "means I secretly want it", "means I'm a bad person". That meaning makes the thought feel urgent, so it gets attention, so it comes back.

Intrusive thoughts tend to be about what matters most to you. A loving parent gets thoughts of harming their child. A kind person gets thoughts of cruelty. That's why they're so upsetting, and it's also the clue: the horror you feel is a sign the thought goes against who you are.

Pushing them away backfires. Trying hard not to think something tends to bring it back more often, which is why arguing with the thought or forcing it out rarely works for long.

Question 1 of 2

Which of these responses keep an intrusive thought sticky, and which let it pass?

"Why would I think that? Maybe deep down I want to."
"That's an intrusive thought. Minds do this."
Asking a friend, "You don't think I'd ever do that, do you?"
Letting the thought sit there while you finish your coffee

0 of 4 sorted

After having a baby

Unwanted thoughts of harm coming to a baby, including thoughts of causing it, are very common in new parents. In a 2008 study by Nichole Fairbrother and Sheila Woody, most new mothers reported them. They reflect how much you care and how alert you are to danger, not a hidden wish.

If they come many times a day, cause a lot of distress, or lead to lots of checking or avoiding time with your baby, that can be perinatal OCD. It's treatable, and a doctor, midwife or nurse is a good first person to tell.

What tends to help

When one arrives

Name it
"That's an intrusive thought." Naming it puts a little space between you and it.
Let it be there
Don't argue with it, analyze it or push it away. Let it come and go in its own time.
Skip the rituals
Checking, seeking reassurance or doing something to cancel the thought keeps the loop going. Delay the ritual can help.
Carry on
Keep doing what you were doing, with the thought along for the ride.

Question 2 of 2

Sam is waiting for a train and gets a sudden image of pushing a stranger onto the tracks. Sam feels sick at the thought. What's most helpful?

Sources and further reading

Finish the lesson

0 of 2 questions done. Answer the rest to finish.