If you’ve ever had a strange or disturbing thought pop into your head—something violent, taboo, or just plain weird—you’re not alone. These kinds of thoughts are known as intrusive thoughts, and they’re more common than you might think. For many people, they come and go without much impact. However, for others, intrusive thoughts can persist, causing distress and raising questions like: Why am I having these thoughts? Does it mean something about me?
According to one study, nearly 94% of participants experienced at least one intrusive thought within the past three months, making it quite normal to have these thoughts.
Keep reading to learn why these thoughts happen, when they may be a sign of something more—like obsessive-compulsive disorder (OCD)—and how you can find relief through evidence-based treatments.
What are intrusive thoughts in OCD?
Intrusive thoughts are unwanted, distressing mental images, urges, feelings, or sensations that repeatedly enter your mind. In the context of OCD, they’re not just occasional—these thoughts become consistent, anxiety-provoking, and often feel out of alignment with your values.
People with OCD experience these thoughts as obsessions, which lead to compulsions—physical or mental behaviors meant to reduce the distress from obsessions or prevent a feared outcome. For example, someone who has a sudden thought about harming a loved one may compulsively avoid knives or seek reassurance that they’re a good person.
Are intrusive thoughts normal?
Yes. Intrusive thoughts are a normal part of the human experience. Most people have occasional random or disturbing thoughts, such as picturing themselves shooting during a quiet meeting or imagining something bad happening to a loved one.
The difference is that people with OCD get stuck on these thoughts. They interpret them as dangerous or meaningful, and their efforts to “get rid of them” only make them more frequent and distressing. This is often referred to as thought-action-fusion—the belief that having a thought is the same as acting on it.
Common types of intrusive thoughts
Intrusive thoughts can focus on nearly any topic, but they often involve fears that are especially distressing because they go against a person’s core values or sense of identity.
Some common themes include:
- Harming others
- Sexual thoughts about inappropriate people or situations
- Fears about being a bad person
- Doubts about one’s sexual orientation
- Worries about relationship compatibility
- Obsessions about religion or blasphemy
These thoughts are typically ego-dystonic, meaning they feel wrong, disturbing, or out of character. People who experience them often ask, Why would I think something like that?—and the anxiety that question creates can become overwhelming.
What causes intrusive thoughts?
The exact cause of intrusive thoughts is not fully understood—it’s believed that a combination of biological, psychological, and environmental factors contributes to their development.
While unwanted thoughts occur spontaneously, various factors can increase their frequency and intensity, including stress, illness, lack of sleep, and significant life changes (e.g., having a baby).
Why do intrusive thoughts stick?
Intrusive thoughts persist because the brain reacts to perceived danger in a particular way. When a thought feels threatening, your brain responds with anxiety—even if there’s no real risk. That anxiety makes the thought feel more important or urgent, which causes you to pay more attention to it.
Trying to push the thought away or neutralize it with a mental or physical compulsion often backfires. In fact, research shows that thought suppression actually increases the frequency of the thought over time, reinforcing the OCD cycle.
How to respond to intrusive thoughts
The most effective response to intrusive thoughts isn’t to challenge or suppress them—it’s to accept them without judgment.
Mental health professionals often recommend the following methods:
- Label the thought as intrusive
- Acknowledge it without trying to make it go away
- Remind yourself that thoughts are not facts
- Avoid engaging in compulsions
- Let the thought pass in its own time
This approach can reduce the power that intrusive thoughts hold over you.
Can intrusive thoughts be treated?
Yes. There are effective treatments for people whose intrusive thoughts cause distress or interfere with daily life. The most proven approach is exposure and response prevention (ERP) therapy. ERP is a specialized form of cognitive behavioral therapy (CBT) proven to be effective for OCD. General CBT, if not tailored for OCD, can sometimes be unhelpful or even worsen symptoms.
In ERP, a therapist helps you gradually face the thoughts or situations you fear without using compulsions to cope. Over time, this helps your brain learn that the thoughts are not dangerous and that you can tolerate uncertainty.
Studies show that ERP therapy is highly effective, with 80% of people with OCD experiencing a significant reduction in their symptoms.
Other approaches that may help include:
- Medication (typically SSRIs)
- Mindfulness-based strategies
- Acceptance and commitment therapy (ACT)
These are typically done in combination with ERP therapy, depending on the individual’s needs.
Severe, treatment-resistant OCD may benefit from the following therapies:
- Intensive outpatient programs (IOPs)
- Partial hospital programs (PHPs)
- Residential treatment centers (RTCs)
- Transcranial magnetic stimulation (TMS)
- Deep brain stimulation (DBS)
- Gamma knife radiosurgery (GKRS)
Find the right OCD therapist for you
All our therapists are licensed and trained in exposure and response prevention therapy (ERP), the gold standard treatment for OCD.
When to seek help
Everyone has odd or uncomfortable thoughts sometimes—but if they’re showing up frequently, causing distress, or interfering with your ability to function, it’s best to speak with a mental health professional—preferably someone with specialized training in OCD.
Bottom line
If intrusive thoughts are disrupting your life or making you question your character, you’re not alone. These thoughts are common, treatable, and say nothing about who you are. With the right support, you can learn to live with uncertainty and stop intrusive thoughts from controlling your life.
Key takeaways
- Intrusive thoughts are common, but they can feel especially distressing when they conflict with your values.
- Trying to suppress or control intrusive thoughts usually makes them worse.
- Exposure and response prevention (ERP) therapy—alongside other therapeutic approaches—is the most effective treatment for intrusive thoughts.
