Intrusive Thoughts

What are Intrusive Thoughts?

Intrusive thoughts are ideas, images, or urges that are typically unwanted, and can make you feel uneasy or disturbed. There are three critical parts of an intrusive thought.

  1. The Thought: This is the initial intrusive thought - it can come at random, or be triggered by something. Everyone has intrusive thoughts, and it is a common misconception that we control our thoughts. In reality, we do not control what thoughts come, but we do control our response to these thoughts. You may notice this is similar to the avoidance cycle, we do not control the trigger, but we do control the action we take afterwards.
  2. The Understanding: If you believe you control your thoughts, then you might feel guilty or frustrated that you have intrusive thoughts. This makes sense, because why would we be causing ourselves discomfort? If this is your belief, then you would probably focus your energy on stopping the thoughts in the first place. But this will not work, because we do not control our thoughts. In fact, attempting to suppress a thought often causes it to occur more. So, we must shift our understanding - know that we do not control our thoughts. Now, if you believe that we don't control our initial thoughts, which is true, then that too can be scary and frustrating, but, by knowing we don't control the trigger, we can shift our focus to what we do in response.
  3. The Response: We accept that we don't control incoming intrusive thoughts, and they are not our fault - what we do control is how we respond. This lesson will go over ways to respond to intrusive thoughts.

Why Do We Have Them?

We have random thoughts all the time - happy, sad, funny, gross, and more. Can you remember all the thoughts you had today? What about the last hour? You likely only remember the thoughts that were significant. Now, if you suffer from anxiety or contamination OCD, then a triggering thought will cause discomfort, which is significant. Of course, we want to avoid this discomfort, so we begin to monitor for what caused it. As we monitor, we get better at recognizing negative thoughts. We notice them sooner and more often, which causes discomfort, so we monitor more. This is the negative feedback cycle of intrusive thoughts.

The first step in addressing intrusive thoughts is to understand you do not control them, they are not your fault. Release yourself of the pressure of controlling your thoughts. Instead, we will focus on what to do after intrusive thoughts come. Just like the avoidance cycle, by focusing on what we control, and practicing discomfort, we will unlearn these negative feedback cycles.

Breaking the Cycle

We've established that we don't control our random thoughts. That means we know we will have negative, gross, and unwanted thoughts occasionally come. What can we do in response?

Avoidance

The first thing is to stop avoidance and safety behavior. Avoidance reinforces the connection in our brain that believes the trigger was actually dangerous, and the next time the trigger is present the brain will trigger even more discomfort to achieve avoidance again. Treat intrusive thoughts like other exposure activities - sit in the discomfort. It will come and pass, and the negative cycle will reduce over time

Recognize and Accept

Practice recognizing and accepting your intrusive thoughts. Say out loud, or mentally repeat the following phrases:

'I am having an intrusive thought'
'I don't control this thought, but I control my response'
'I will let this thought pass over me'
'I will sit in the discomfort'

Practice Discomfort

Apply the same skills you have built practicing exposure to intrusive thoughts. Ask yourself 'What about this thought is uncomfortable?'. Describe the thought out loud, or write about the thought on a piece of paper. By accepting the thought and practicing discomfort, your brain will understand the thought itself is not dangerous, and the discomfort response will reduce.

Summary

1. We don't control our thoughts. Intrusive thoughts are not your fault.

2. Thoughts that cause discomfort are more likely to be noticed. The more discomfort they cause, the more we will monitor for them. By monitoring more, we will notice more. This is the negative feedback cycle that can cause more intrusive thoughts.

3. To break the cycle we must look for where we have control in the cycle. We cannot avoid triggers or random thoughts. Avoidance, distraction, rituals, and safety behaviors reinforce to our brain that the thought was dangerous. We must break this cycle by facing the discomfort, instead of giving it power.

4. Just like breaking the avoidance cycle, by facing discomfort we teach our brain to unlearn the faulty connection, and over time discomfort will reduce, and monitoring will reduce.