Intrusive Thoughts

Intrusive Thoughts: The Intruders You Want to Kick Out.

Every highly anxious person has to cope with intrusive thoughts. Intrusive thoughts are frightening thoughts about what might happen to you or someone you care about, or what you might do to yourself or another person. They seem to come from outside of your control, and their content feels alien and threatening.

For some people, intrusive thoughts are part and parcel of panic or intense anxiety. In these types of intrusive thoughts, it feels like the thoughts come about as a result of the anxiety, and they function to add more fear to the anxiety you are already experiencing. The intrusive thoughts keep the anxiety going, and maintain the fear-producing spiral. So, for example, you might think, "what if I have a heart attack?" in the midst of an anxiety attack. You are already in the altered state of consciousness that I call anxious thinking, and your thoughts feel likely to happen.

However, there is another class of intrusive thoughts that I call intrusive obsessive thoughts. These thoughts seem to come from out of nowhere, arrive with a distressing whoosh, and cause a great deal of anxiety. The content of intrusive obsessive thoughts almost always focus on sexual or violent images. Here are typical examples of intrusive obsessive thoughts: "Killing someone. Torturing a pet animal. Stabbing a child. Throwing someone (or yourself) out of a window. Jumping onto a train track as the train comes into the station. Molesting a child. Raping someone. Taking off your clothes in public." This is not a complete list, but it gives you a good feeling of the content of these thoughts.

People who experience intrusive obsessive thoughts are afraid that they might commit the acts they picture in their mind. They might imagine hurting someone or committing an act of sexual violation. Intrusive obsessive thoughts can be very explicit, and most people are embarrassed and frightened of them.

There are a number of myths about intrusive obsessive thoughts. The greatest myth is that having thoughts of a sexual or violent nature mean that you want to do the things that come into your mind. This is not true. You do not want to do the things that enter your mind when you have intrusive obsessive thoughts. In fact, the opposite is true. People with intrusive obsessive thoughts are gentle and non-violent.

The problem is that intrusive obsessive thoughts feel so darn threatening. That is because anxious thinking takes over, and the thought—as abhorrent as it might be—seems to have a high probability of occurring. And, you might think, even if the probability is fairly low, the consequences of killing someone, or throwing a child out the window, are so enormous and horrendous, that the thought feels threatening and dangerous.

The Big Answer to Getting Rid of Intrusive Obsessive Thoughts:

Here is what I want you to learn. The content of your thought does not count. It is irrelevant. Your thoughts have no effect on what you will do. A thought—even a very scary thought—is not an impulse. You will not act on your intrusive obsessive thoughts. Your problem is not one of impulse control. You have an anxiety disorder. They are as far apart as chalk and cheese.

Do you want a guarantee? You can't have one. If I said that no one has ever acted on intrusive obsessive thoughts, you might say, "Well, there is always a first time." We all know that there are certain things in life that have a very small probability of occurring, and it makes sense to live our life as if they won't occur. For example, there is a tiny probability that a meteorite will fall out of the sky and hit you as you are reading this. I can't give you a guarantee that it won't happen, but the odds as so infinitesimally small that it makes sense to ignore the possibility. The same reasoning applies to intrusive obsessive thoughts.

You want such reassurances because you are sensitized to the images. That creates anxious thinking—the altered state of reality that makes thoughts feel like they will really happen. The only way to effectively deal with intrusive obsessive thoughts is by reducing your sensitivity to them.

Remember that the content of your thought is irrelevant and you must apply the paradoxical approach to cope with them. If you try to engage your thoughts in any way—such as reasoning with them, pushing them away, altering your behavior to stay away from threatening situations—all these approaches will only serve to make them stronger and more intrusive. As with other forms of anxiety, your job is to do the opposite.

Steps for coping with Intrusive Thoughts

  • Label these thoughts as "intrusive obsessive thoughts."
  • Remind yourself that these thoughts are automatic and you can safely ignore them.
  • Accept and allow the thoughts into your mind. Do not try to push them away.
  • Breathe diaphragmatically until your anxiety starts to go down.
  • Continue whatever you were doing prior to the intrusive thought.

Try Not To:

  • Engage the thoughts in any way.
  • Push the thoughts out of your mind.
  • Try to figure out what your thoughts "mean."
  • Convince yourself that you would never do what the thoughts are saying.
  • Change your behavior so that you avoid the possibility of acting on your thoughts.

Try to:

  • Label your anxiety level and watch it go up and down.
  • Allow the thoughts to remain without hindrance. (They will go away on their own).
  • Focus on managing your anxiety in the present. Diaphragmatic breathing is especially helpful.

This approach can be difficult to apply. But if you can keep applying it for just a few weeks, there is an excellent chance that you will begin to see a decrease in the number and intensity of your intrusive thoughts.

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on Unwanted Intrusive Thoughts

I will be sending out short emails answering questions you ask. Topics include, "Do Intrusive thoughts have to be triggered, or do they come 'out of the blue'?" "What is the difference between a thought and an impulse?" And "Doesn't having a thought about doing something mean that 'deep down' you want to do it?" I welcome you to sign up and ask any other questions you'd like answered.