Obsessive compulsive disorder - OCD treatment and therapy from NOCD

Do I have OCD or just intrusive thoughts? An OCD specialist explains

By Dr. Keara Valentine

Oct 27, 20235 minute read

Reviewed byPatrick McGrath, PhD

how do you know if your intrusive thoughts are from OCD?

First things first: Yes, it’s true that intrusive thoughts are a part of obsessive-compulsive disorder (OCD). And as a therapist and specialist in this particular mental health disorder, I can help you find out if there’s a reason to be concerned about your intrusive thoughts. 

That said, it’s important to know that almost everyone experiences unpleasant thoughts they would rather not have. When they happen, you’re left to wonder, “where did that come from?”—especially when the nature of the thoughts is entirely out of character. Maybe it’s a thought about driving off a cliff, or doing something sexual or harmful in nature

If you have no desire to act on them, and they’re not interfering with your daily life, intrusive thoughts usually aren’t concerning as they don’t have any particular meaning.

On the other hand, when your intrusive thoughts aren’t just a blip in your day, but something that takes up a lot of your attention, there could be a reason to investigate further. 

Let’s dig in so you can get the answers you need.

What is an intrusive thought?

Intrusive thoughts, images, and urges are mental experiences that are unpleasant or distressing, happen against your will, and do not align with your true feelings or values. They can be brief, fleeting thoughts such as “What if I drop this vase of flowers?” or more distressing ones like “What if I drop my baby out of my arms?” or “I’ll be contaminated if I touch this door handle with my bare hand!” 

There’s really no topic that’s off-limits for intrusive thoughts. Some examples include:

When the intrusive thought leaves your mind as quickly as it comes, there’s typically nothing to worry about. But for people with OCD, it’s more complicated. People with OCD may experience intrusive thoughts more often and may become more worried by them than people without OCD. 

What’s more, when intrusive thoughts are a part of OCD, the thoughts latch onto your mind, and you often fear they won’t cease until you can find a way to relieve yourself of the distress that they cause. The thoughts can lead you to spiral and draw conclusions that are baseless. For instance, after an intrusive thought about dropping your child, you might think: What if I really am a bad mother? What if Child Protective Services takes my baby away? Generally speaking, intrusive thoughts in OCD center around something that matters deeply to you where the consequences are devastating, which is partially why they can feel so alarming.

How intrusive thoughts lead to compulsions 

When you have OCD, intrusive thoughts become distressing to the point where you feel you must find a way to eradicate them through taking action. Here’s where compulsions come into play. 

Let’s take a step back to define what OCD actually is. OCD is a mental health disorder that occurs when a person gets caught in a cycle of obsessions and compulsions. Obsessions are unwanted, intrusive thoughts, images, or urges that trigger distressing feelings. Compulsions are behaviors (including both mental and physical actions) that an individual engages in to attempt to get rid of the obsessions and/or alleviate distress.

There are many types of compulsions. One common compulsion is reassurance-seeking. For example, you might find yourself spending hours on Google trying to figure out how to know whether you’re a good mother, or asking your partner if you’re a good parent. Unfortunately, the nature of compulsions is that they only bring temporary relief.

What characterizes an intrusive thought as a component of OCD is how much emotional distress these thoughts cause you and whether you try to neutralize these thoughts via compulsions. 

How do you treat intrusive thoughts from OCD?

Even if it might seem like these intrusive thoughts will always be running your life, fortunately, there are treatment options available. I’ve personally seen countless people get the appropriate kind of therapy and live a life free from the grip of OCD and intrusive thoughts. The key is to know exactly what’s effective for the treatment of OCD, since not all therapy is interchangeable.  

For OCD, you need Exposure Response Prevention (ERP), a type of therapy that can help you face the thoughts that cause you the most distress without trying to escape from them by performing a compulsion. Dozens of clinical studies have demonstrated the effectiveness of ERP.  Over time, what happens is that the intrusive thoughts don’t have the same power over you, as ERP helps to drastically alleviate the distress caused by these thoughts.

If you’re ready to take the power away from your intrusive thoughts and live life on our own terms, specialized care is accessible to you. I strongly recommend learning more about NOCD’s evidence-based approach to OCD treatment, with a broad network of OCD specialists. I’ve seen so many people get their lives back from OCD—and you can, too.

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