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  • Intrusive Thoughts: What are they?

    I was in an OCD-specific internet forum the other day and someone stated they had been diagnosed with OCD, but still did not understand what intrusive thoughts were. So, what are intrusive thoughts?

    Intrusive thoughts are sudden unwanted thoughts, images, or ideas that can be explicit and are often distressing to the individual. These thoughts do not lead to action. People experiencing intrusive thoughts often find them shameful, shocking, and disturbing. The thoughts have no bearing on reality or the person’s desires.

    Although almost everyone experiences intrusive thoughts at times, (ever had the urge to trip a running person?) however, many individuals that struggle with OCD, PTSD, anxiety, or depression become hyper-focused on the thoughts which can lead to distress in the individual as well as compulsions in some in order to manage the anxiety they are experiencing from the intrusive thought.

    The most common types of intrusive thoughts are sexual, violent, or religious in nature – which is what causes the distress in the individual. For example, a common sexual intrusive thought might be a sudden fear that one might be sexually attracted to children, which is often termed Pedophilia OCD (or merely POCD). Similarly, instead of the thought of being attracted to children, one might have a sudden image pop into their mind of a similarly explicit nature. I believe it bears repeating that these thoughts do not have any basis in reality or the individual’s desires. The individual usually finds these thoughts very distressing and upsetting – which reveals the individual’s true underlying values. If you are having distressing thoughts it does not mean you are a horrible person, it merely means it’s time to seek help with treatment.

    Many people experience distressing intrusive thoughts regularly and are unaware they can be a symptom of OCD, PTSD, anxiety, or depression. Likely the shame and stigma of these thoughts lead many individuals to keep them secret – fearing they are secretly a horrible person or really do desire to cause others harm. It can be panic-evoking and debilitating, but there is treatment for people experiencing these disturbing thoughts.

    The gold standard for treating obsessions and compulsions in individuals with OCD is an evidence-based type of Cognitive Behavioral Therapy (CBT) called Exposure and Response Prevention (ERP). ERP involves incrementally exposing the individual to a feared stimulus in a safe environment and helping the individual to prevent any responses or rituals.

    Quick Tips:

    ·     Remember: A thought is a thought, it’s not an action. Thinking about something does not necessarily lead to doing it.

    ·     What you resist, persists. Don’t resist your intrusive thoughts. If you have one, let it come and acknowledge to yourself that you’re having a distressing intrusive thought. The more quickly you realize what is happening, name the emotions and thoughts you are having and accept what’s happening, the more quickly they will dissipate.

    ·     Try to resist engaging in any compulsions or rituals. Compulsions and rituals can frequently come with intrusive thoughts. If you have compulsions, try not to engage with them. When you use a compulsion, it will temporarily bring comfort and relief, but it reinforces the behavior and leads to further anxiety in the future. More on compulsions in the future!

    If your thoughts are causing you distress or you are experiencing anxiety – I would be happy to work with you to find a treatment plan that works for you. Please contact me at [email protected]