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What is OCDRelated Symptoms & ConditionsWhy are my intrusive thoughts so disturbing? Advice from an expert

Why are my intrusive thoughts so disturbing? Advice from an expert

7 min read
Elle Warren

By Elle Warren

Reviewed by April Kilduff, MA, LCPC

Nov 13, 2023

It’s scary to feel like you don’t have control over your own brain. It can be terrifying to have thoughts that couldn’t be more opposed to who we are, what we value, and what we believe.

Everyone has intrusive thoughts, and they are often disturbing in nature. Basically, that’s why they’re called “intrusive.” It might feel like an isolating experience, but you couldn’t be less alone in it—they’re universal experiences.

If you’re like me, you have a difficult time determining what thoughts “mean something” and what thoughts don’t. When you have disturbing intrusive thoughts, you find yourself asking, “Is something wrong with me? Who even am I? Why did I think that just now?”

If that sounds familiar, keep reading for an explanation of intrusive thoughts, why they’re disturbing, when they’re a sign of an underlying mental health condition, and how you can get help if they’re causing distress. 

What are intrusive thoughts and why are they so disturbing?

Intrusive thoughts are a phenomenon that everyone experiences. Regardless of age, gender, and where someone lives in the world, intrusive thoughts are universal.

Intrusive thoughts—which can also take shape as mental images, urges, sensations, or feelings—are unwanted and out of alignment with who we are. They are what’s called “ego-dystonic,” meaning they’re “out of sync” with our true desires, values, and beliefs, as April Kilduff, MA, LCPC, LMHC, a specialist in OCD and anxiety disorders, puts it.

“It’s this ego-dystonic nature that makes intrusive thoughts so disturbing.” In other words, the very nature of intrusive thoughts is that they don’t represent us

Intrusive thoughts can occur for a variety of reasons, or for no reason at all. Kilduff notes that sometimes “our brain puts bizarre things together and spits them back out at us.”

For example, you could be holding a hammer to nail something in the wall, and see your cat down by your feet. You might think, I could smash my cat’s skull in with this hammer. You don’t want to do that, of course—you never, ever would—but your brain just made an association.

Moreover, Kilduff says, “our brains have the tendency to look for threats and worst case scenarios because their number one job is to keep us alive.” Therefore, it presents us with extreme situations that could, theoretically, threaten us—no matter how improbable or untrue they really are. 

The content of intrusive thoughts can be just about anything, but they are often taboo, inappropriate, or uncomfortable. Some common themes of intrusive thoughts that people may find disturbing include:

Most people are able to move on from intrusive thoughts. They recognize the thought as strange and untrue to them and move on with their day. However, in the case of some mental health conditions, people feel unable to move on from intrusive thoughts, finding them distressing or worrying that they’re meaningful—if that’s why you’re reading this article, it’s important to learn more about what you’re dealing with.

Are distressing intrusive thoughts indicative of a mental health condition?

While intrusive thoughts on their own are not indicative of a mental health condition, since everyone has them, the way you respond to them can indicate a couple different conditions.

Obsessive-compulsive disorder (OCD) is marked by an intense intolerance of intrusive thoughts. OCD sufferers are deeply distressed by intrusive thoughts and feel anxiety, fear, panic, and/or shame in the face of them.

In order to try to relieve themselves of those intense, uncomfortable feelings, they perform compulsions. Compulsions are any physical behavior or mental action done in response to an intrusive thought. They’re done in an attempt to reduce distress or keep an unwanted outcome from occurring.

Ultimately, though, compulsions just lead to more frequent intrusive thoughts. Compulsions train the brain to view intrusive thoughts as threats to be taken extremely seriously, but they aren’t actually dangerous—and compulsions do nothing to keep them from coming back. Because intrusive thoughts will always happen, one can never perform enough compulsions.

Here are some examples of common compulsions:

  • Physical compulsions:
  • Mental compulsions:
    • Rumination. This happens when you turn something over and over in your mind, even for hours a day, often to “think your way out” of intrusive thoughts and the feelings they bring.
    • Reassurance-seeking from yourself. For example, repeatedly thinking I would never do anything violent. I am a good person.
    • Thought replacement. For example, after thinking what if I push someone down the stairs? you might intentionally think I should do something nice for them.
    • Mental reviewing. This happens when you go through prior experiences and situations with a fine-toothed comb to look for proof that intrusive thoughts are or are not true. 

There’s another set of conditions that may have a difficult time moving on from intrusive thoughts: anxiety disorders. This umbrella term includes generalized anxiety disorder (GAD), specific phobias, social anxiety, and panic disorder.

Someone with GAD, for example, might have an intrusive thought like, What if my child gets hurt at school? that they will then worry about constantly, making themselves “sick with worry,” Kilduff says. Unlike OCD, though, they do not perform compulsions.

However, people with anxiety disorders may engage in other “safety behaviors” that are similar to some compulsions, Kilduff explains; namely, avoidance and distraction. Someone with social anxiety may avoid social situations, for example, while someone with a phobia of spiders is likely to avoid places and situations where they are likely to encounter a spider. Someone with GAD may also distract themselves to get a break from their nearly constant worries all day.

A licensed mental health professional can help you determine which condition you’re experiencing, so there’s no need to get too caught up in figuring it out on your own. The best course of treatment will often be the same for both OCD and anxiety disorders.

Can you get help for disturbing intrusive thoughts?

Since everyone has intrusive thoughts, they don’t on their own indicate a problem that needs solving. However, since you’re reading this article and likely concerned about the meaning of your thoughts, that may be a sign you’re ready for help—more specifically, help taking the power away from your intrusive thoughts when they do occur.

The good news is that OCD and anxiety disorders are both highly treatable conditions. The first-line treatment for both is exposure and response-prevention therapy (ERP). ERP has two components: gradually, intentionally confronting the places, situations, people, thoughts, sensations, and feelings that trigger your intrusive thoughts; and then resisting the urge to engage in compulsions or safety behaviors in response. 

First, you and your therapist will discuss the nature of your intrusive thoughts and what triggers them. If you experience a more taboo or disturbing theme of intrusive thoughts, you might feel hesitant to share them with your therapist.

Rest assured: your therapist is there to help you, and they’ve heard it all! You can’t tell them any intrusive thought that will make them worry about your character or sanity. They have an intricate understanding of the ego-dystonic nature of intrusive thoughts.

Throughout the process of ERP, you will get comfortable with being uncomfortable and uncertain. Maybe that sounds impossible right now, but I assure you that it’s not. Again, these conditions are highly treatable—and you are no exception. 

Where you can go for help with disturbing intrusive thoughts

While everyone experiences intrusive thoughts, it may be time to seek help if you find that your intrusive thoughts are particularly distressing and interfering with your life. 

NOCD has hundreds of therapists who have received specialized, intensive training in OCD and anxiety disorders, and who have extensive experience helping people learn to conquer OCD, no matter how disturbing or taboo their intrusive thoughts may be.

If you’re interested in learning to manage your intrusive thoughts and take away their influence over your life, I strongly recommend learning more about NOCD’s accessible, evidence-based approach to treatment for OCD and anxiety disorders.

NOCD Therapists specialize in treating OCD

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Taylor Newendorp

Taylor Newendorp

Network Clinical Training Director

I started as a therapist over 14 years ago, working in different mental health environments. Many people with OCD that weren't being treated for it crossed my path and weren't getting better. I decided that I wanted to help people with OCD, so I became an OCD therapist, and eventually, a clinical supervisor. I treated people using Exposure and Response Prevention (ERP) and saw people get better day in and day out. I continue to use ERP because nothing is more effective in treating OCD.

Gary Vandalfsen

Gary Vandalfsen

Licensed Therapist, Psychologist

I’ve been practicing as a licensed therapist for over twenty five years. My main area of focus is OCD with specialized training in Exposure and Response Prevention therapy. I use ERP to treat people with all types of OCD themes, including aggressive, taboo, and a range of other unique types.

Madina Alam

Madina Alam

Director of Therapist Engagement

When I started treating OCD, I quickly realized how much this type of work means to me because I had to learn how to be okay with discomfort and uncertainty myself. I’ve been practicing as a licensed therapist since 2016. My graduate work is in mental health counseling, and I use Exposure and Response Prevention (ERP) therapy because it’s the gold standard of OCD treatment.

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