What are Intrusive Thoughts? How to Identify and Stop Them.
Do you ever have thoughts that make you feel really uncomfortable, even ashamed? Thoughts that seem to come out of nowhere and invade your mind against your will? If so, you may be experiencing intrusive thoughts. Intrusive thoughts are unwanted, recurrent thoughts or images that cause distress or anxiety. The thoughts are hard to control and hard to get rid of. They can be about anything- contamination, mistakes, accidents and more. In this blog post, we will discuss what intrusive thoughts are, how to identify them, and how to stop them from causing distress in your life.
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What is an intrusive thought?
Intrusion is defined as something that is unwelcome or unwanted. Intrusive thoughts are unwelcome and unwanted thoughts that lead to distress. These thoughts can be challenging to identify and understand. The distress is not due to the thought, but the meaning you attach to the intrusive thought. This meaning leads to a sense of fear, doom, or dread. Due to the discomfort the distress causes, you will do an action to help relieve the distress. This could be behavioral or mental. This could be anything from avoidance, reassurance-seeking, or rituals.
Different types of intrusive thoughts
Intrusive thought can be triggered by many different reactions in a person. Reactions are mental or behavioral responses. The response can go in two ways. One thing is to do more to avoid the distress, another is to do less to avoid the distress. A mental response that involves doing more will be getting stuck in a loop of perfectionism. Due to wanting the task you are doing to be perfect you keep working on it. This could lead to not being able to complete a task or finishing it quickly or easily. When you do this, the intrusive thought gets reinforced and leads to more of these thoughts.
It could also be forms of avoidance such as your mind avoiding distress by doing nothing. Instead of doing a challenging task you avoid it and instead watch TV. Sometimes the relationship between the thought and the trigger is clear. Other times it is not a close relationship. The intrusive thought type is characterized by the closeness of the relationship between the trigger and the thought.
When you see the red light of a traffic signal you think, “I should stop driving.” This interpretation of the meaning of a red light is not something you were born with. Through years of observation, you learned when a signal light is red you stop driving. It becomes ingrained. You no longer have to tell yourself the light is red, I need to stop my vehicle, or apply the brake. These three steps happen with little to no effort on your part and with lightning speed.
Intrusive thoughts are similar. They initially are learned. Over time the brain is able to make the connection with little to no effort on your part. The thoughts move through your mind without you recognizing them. These thoughts are based upon past experiences.
Here are some examples of intrusive thoughts:
A person who is triggered by a thought that has little to do with the actual situation. One day John is at work and his co-worker asked him if he watches the show Dancing with The Stars. His first thoughts are, “I am bad at dancing. I don’t want to make a fool of myself in front of everyone.” This is an example of an event that has little relationship with John's dancing. This mention of dancing triggered negative thoughts about himself. His response was to demean his friend for watching a dancing show. Theirfor avoiding his distressing thought.
A person who is triggered by a thought which has a direct relationship to the situation. For example, an adult puts a child on their lap and has an image of themself dropping the child. This thought can trigger a response of guilt, fear, or shame about being unsafe. A person may then refuse to hold the young child for fear of injuring them. This is a form of avoidance.
A person who is triggered by a thought that has some relationship to the situation. John and his brother are watching a football game. As a player makes a touch down his brother gets up to high-five him in celebration. His first thoughts are, “I suck at dancing. I don’t want to make a fool of myself in front of everyone.” This is an example of an unrelated negative thought entering Johns’s mind. This thought has little relationship to the situation but it causes him to avoid celebrating.
Themes of Intrusive Thoughts
Intrusive negative thoughts can fall into groups. Some of the common groups are contamination, mistakes, accidents.
Contamination fear is common. Many people fear germs and something being dirty. When faced with a situation you feel is unclean, you can begin to feel disgusted. The feeling of disgust is triggered by a thought such as, “Touching that dirty cloth will make me sick.” The thought of being sick is what causes the fear.
Mistakes can be a source of stress and anxiety in many people’s lives. Mistake intrusive thoughts are usually interpreted to mean you have done something wrong. These mistakes can be anything from making a mistake while driving, forgetting an appointment, or performing poorly at work.
Fear of making mistakes is common. When doing a task such as presenting in front of a group. You may have many negative thoughts running through your mind such as, “I don’t want to mess this up.” “I’m not good enough.” “Everyone is going to judge me.” These thoughts can lead you to feel shame and guilt.
Fear of an accident occurring can also lead to intrusive thoughts. When driving, you may have an image of yourself crashing into another car. This fear can lead to intrusive thoughts such as, “What if I lose control of the wheel?” These thoughts can cause anxiety and make it difficult to concentrate on the task at hand.
Intrusive Thoughts and Anxiety
Anxiety is the expectation of a future threat. A threat to your physical or emotional safety. Intrusive thoughts are distressing. These thoughts make you feel unsafe due to the belief that something bad is going to happen. This is distressing due to your fear of not being able to be in control or prevent the bad thing from happening.
Intrusive thoughts lead to anxiety when they are persistent and excessive. Excessive refers to a person overestimating the chance of a bad situation happening. There is a small chance people will laugh at John when he celebrates a football touchdown. Persistent refers to his intrusive thought that has been occurring for a long time.
These intrusive thoughts that lead to anxiety can result in physical manifestations. John began to feel the tightening of his muscle when anything related to dancing is mentioned. He will also become more vigilant and sensitive to dancing comments. He may refuse to celebrate a touchdown made by his favorite team. He may become silent when someone mentions dance shows.
Obsessive thoughts versus intrusive thoughts
Obsessive thoughts and intrusive thoughts are similar and can be easily confused. They are both distressing. But how are they different?
There are some theories that obsessive thoughts occur without a triggering event. This means a person experiences a thought that is unrelated to the situation. Intrusive thoughts, however, are usually related to the situation. Obsessive thoughts are more related to activities. Such as fear of hitting a person with your car, leaving a stove on, forgetting to lock your home door, ect…. Intrusive thoughts occur following a triggering event. For example, John may see a commercial for a dance show and then begin to have thoughts about dancing. These thoughts about dancing are the cause of the intrusive thought. One theory suggests that intrusive thoughts are caused by suppressed memories or traumas. They also tend to be thoughts about who you are as a person. Such as, "I am stupid", "I am lazy", "I am forgetful", ect….
The line between obsessive thoughts and intrusive thoughts is not as clear as this section makes it seem. Individuals with anxiety tend to have both obsessive thoughts and intrusive thoughts.
What causes intrusive thoughts
There has been a lot of research and theories about the cause of intrusive thoughts. There are biological and psychological and genetic theories. Even with the many theories, it is not clear why some people struggle with them more than others.
Biological theories suggest that intrusive thoughts come from the amygdala. The amygdala is a small structure in the brain responsible for fear and arousal. It may be possible that individuals with anxiety have an overactive amygdala causing persistent and excessive intrusive thoughts to occur.
Psychological theories suggest that events such as trauma, neglect, abuse, and life stressors can cause intrusive thoughts to occur. These events may have triggered the amygdala causing an overactive response.
Stop suppressing intrusive thoughts
It can be hard to stop suppressing intrusive thoughts. Suppression involves not allowing yourself to become aware of the thought. Instead, thought and their consequences become feared. To prevent emotional discomfort a mental or physical activity is done to get rid of the thought. The problem becomes just because it is not actively being thought of it does not mean it is not the back of your mind. When this happens it can lead to emotional discomfort.
The first step is to identify your emotional discomfort. Journaling about bothersome experiences in your life can help you acknowledge that you have negative thoughts. You can then spend time trying to identify your thoughts. When you are able to identify them you can then spend time trying to understand them and challenge their validity. After identifying recurrent, intrusive thoughts you can begin to work on challenging them.
These steps may seem overwhelming and hard. But allowing yourself to explore your thoughts can help take their power away. It also makes them less scary and more manageable.
How to identify intrusive thoughts
Cognitive-behavioral therapy has been the treatment of choice for treating intrusive thoughts. One key component of the therapy is identifying cognitions also known as thoughts. Journaling can be a good way to being to identify intrusive thoughts.
The starting point for journaling is where does discomfort begin. When you notice yourself feeling anxious or depressed this is the point to begin writing about your experiences. After identifying situations that lead to destress you can then begin to question what you may have been thinking during the time of stress.
How to treat/stop intrusive thoughts
There are two main evidence-based treatment options for intrusive thoughts. The first is medication-based. Using antidepressants as first-line treatment for intrusive thoughts can be very helpful. Selective serotonin reuptake inhibitors (SSRIs) is the class of medications used most often. The second evidence-based treatment option is Cognitive-Behavioral Therapy.
The goal of cognitive-behavioral therapy for intrusive thoughts is to teach you how your thoughts, feelings, and behaviors are connected. These connections can be identified by journaling about your experiences. The goal is to help you to understand how your thoughts might be causing your anxiety or distress. You are working toward understanding the relationships between thoughts, feelings, and behaviors.
Intrusive thoughts are unwelcome and unwanted thoughts that appear in your mind. They can be images, words, or ideas that you don’t want to think about. It is important to know what an intrusive thought looks like so it can be identified when one appears. Intrusive thoughts can be distressing and cause stress. It is important to know when intrusive thoughts are occurring, why they are occurring, and how to stop them.
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Citation:
Lack CW. Obsessive-compulsive disorder: Evidence-based treatments and future directions for research. World J Psychiatry. 2012;2(6):86-90. doi:10.5498/wjp.v2.i6.86
“Obsessive-Compulsive Disorder.” National Institute of Mental Health, U.S. Department of Health and Human Services, https://www.nimh.nih.gov/health/topics/obsessive-compulsive-disorder-ocd.
Simon D, Adler N, Kaufmann C, Kathmann N. Amygdala hyperactivation during symptom provocation in obsessive-compulsive disorder and its modulation by distraction. Neuroimage Clin. 2014;4:549-557. Published 2014 Mar 26. doi:10.1016/j.nicl.2014.03.011
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