None of us can escape intrusive thoughts, the random and usually off-putting musings that include visions of shoving your hand through the center of a beautifully decorated cake or a bridge collapsing at the very moment you’re driving over it.
Intrusive thoughts, which you don't intend to think, can come to mind at strange and undesired times. And they give you pause because you know not to act on them, perhaps because they're outlandish or outright they're dangerous. As unwanted as they are, it’s possible to stop intrusive thoughts.
What are intrusive thoughts?
“Intrusive thoughts are spontaneous, unwanted thoughts that we have that are usually unpleasant in some way,” says Ayanna Abrams, Ph.D., a clinical psychologist and founder and executive director of Ascension Behavioral Health. “They can be memories, images, thoughts about the future, maybe even an urge, and usually result in at least brief emotional distress because they can be distracting or disruptive.”
Intrusive thoughts can pop into your mind and fade, or they can stick around for hours or days, adds Patrice Berry, Psy.D., a psychologist and founder of Four Rivers Psychological Services. “The ones that are normally more troubling are the ones that play on repeat. They’re the ones that a person has difficulty shifting their attention away from,” says Berry.
Intrusive thoughts are different from ideas you might have when dwelling on something, Berry stresses. It’s typically intrusive if it’s something you can control and know would have a poor outcome, like snatching an ice cream cone from someone’s hand.
Depending on what comes to mind, you might feel shame or guilt about your intrusive thoughts, but “thoughts are just thoughts,” says Berry. It’s typically only concerning when you find yourself feeling compelled to act on them.
Why do they happen?
They’re typically random, but intrusive thoughts can be brought on by triggers, says Berry.
“Intrusive thoughts can be about day-to-day stress, result from low self-esteem, feeling like an imposter in a work setting, having a fight with a friend,” says Abrams. Stress and lack of sleep are popular reasons for your mind showing you images you’d rather do without.
“But (they) can also be symptomatic of an anxiety disorder, a depressive episode or a common symptom of obsessive-compulsive disorder (OCD) or an eating disorder,” Abrams adds.
Who has intrusive thoughts?
Everyone has them, but some people have a harder time shaking these thoughts, Berry points out. People with obsessive-compulsive disorder (OCD), anxiety, trauma or depression are likely to experience intrusive thoughts more often, and they’ll likely have them persist longer than most. Their intrusive thoughts often make it difficult to function, says Berry.
Are all intrusive thoughts bad?
Not necessarily. Some intrusive thoughts are mild, like a vision of shutting a door in someone’s face. Is it rude? Yes, but it probably won’t bring about any danger.
That said, most intrusive thoughts have an element of risk to them, whether it’s dangerous or socially unacceptable. “The themes (of intrusive thoughts) sometimes are sexual or violent,” Berry explains. You might also envision something bad happening to you or someone else.
Some examples Abrams offers include picturing yourself tripping over something, dropping a baby, failing at something, no one showing up to your birthday party or getting a concerning phone call about a loved one in the middle of the night.
How do you stop intrusive thoughts?
Sleep
Lack of sleep makes it harder to think clearly, says Berry. Tired people “tend to be more irritable or on edge in general,” she adds.
To optimize your sleep routine, focus on better sleep hygiene, such as going to sleep and waking up at the same times each day and getting between seven and nine hours a night.
If you are struggling with intrusive thoughts when trying to fall asleep, Abrams recommends getting a noise machine that plays calming white or brown noise, or listening to a boring podcast or music to drown them out.
Progressive muscle relaxation
Berry also suggests progressive muscle relaxation (PMR), where you tense and release the muscles throughout your body, according to the Cleveland Clinic. Start at one end of your body and squeeze your muscles for five seconds one after the other until you get to the muscles on the other end.
As you squeeze, visualize the tightened muscle, exhale, and then relax that muscle for 10 seconds, visualize the relaxed muscle and move on to the next, says Cleveland Clinic. For example, you might scrunch your toes, your thighs, followed by your abs, your fingers, your shoulders, and then your eyes.
The idea is that by tightening and relaxing your body, piece by piece, it calms the nervous system and brings on mental relaxation, too.
Deep breathing, yoga and meditation
Stress is a major culprit for intrusive thoughts. So, Berry suggests calming activities that’ll help center you and keep your mind from racing. She encourages deep-breathing exercises, like belly breathing where you inhale slowly for four seconds, hold the breath for four seconds and exhale for four seconds or longer.
Yoga includes breathing techniques, such as lion’s breath breathing, where you inhale and exhale while sticking out your tongue and making an “haaa” sound.
You can also try meditation, even when your mind is racing. Try meditating while walking in nature or writing down the things you’re grateful for.
Don’t push your thoughts away. Instead, be mindful
“Thoughts are not things,” says Abrams. They can’t harm you.
But “how you respond to them is very important, based on (whether) you’re judging them as ‘good,’ ‘bad,’ ‘right’ or ‘wrong,’” she says. “When we appraise our thoughts as negative, we usually try to push them away, which can have the opposite effect, and make them stick for longer and create even more distress.”
So, Abrams says to practice mindfulness. This will help you “come back to your center and reminds you of what is real and accessible."
Focus on your breath, your body and your surroundings, Abrams says. You’ll feel your mind shift from your thoughts to what’s right in front of you, bringing you to the present.
Thought diffusion, says Abrams, means resisting fighting off your unwanted thoughts. Instead, “allow it to come and go and build the skills to tolerate them — this paradoxically can help decrease them,” she adds.
Do this by noticing the thought and naming it. “I am having a thought that I wish I wasn’t having,” you might tell yourself. This practice creates distance between you and the thought.
“The important underlying goal here is not trying to change the thought, or penalize or judge yourself negatively for having the intrusive thought.” Then you can move forward with options, says Abrams.
- Do I want to investigate this thought process?
- Is now a good time to reflect, or am I busy with something that I want to be present for?
- Can I distract myself in this moment?
- Do I ride this one out by sitting still for three to five minutes and breathe deeply?
- Maybe I can do a visualization exercise and picture myself somewhere peaceful for a few minutes, then get back to this task.
“Over time, building up what therapists call your ‘distress tolerance’ skills can help you to accept that sometimes you have intrusive thoughts and that you are and will be OK,” says Abrams.
Turn to healthy distraction
Shift your attention to something else when you notice intrusive thoughts. “Focusing on a task or thought that is pleasant or engaging, like a game on your phone, calling a friend, turning on the TV,” is sometimes all you need to shake the bad thoughts off, says Abrams.
Externalize your thoughts
Abrams recommends journaling or dumping your thoughts into a notes app on your phone because it will allow you to put distance between you and the thoughts, especially if you’re not ready to talk about them.
“I’ll oftentimes recommend that clients journal, pull out their notes app throughout the day or use voice notes to briefly process what they are thinking, and we can reflect on it afterward,” says Abrams.
Exposure and response prevention
This treatment, also known as ERP, is something you can do with a therapist and is typically recommended for those who have OCD. “It helps you confront your relationship with uncertainty and control —allowing more practice in regulating your nervous system when the spontaneous thoughts arrive,” says Abrams.
This practice involves calculated exposure to the things that set off your intrusive thoughts over time, according to the Mayo Clinic, allowing you to manage the triggers that set off unwanted thoughts, compulsions and obsessions.
Cognitive behavioral therapy
“Cognitive behavioral therapy is an evidence-based treatment modality that centers how your thoughts and behaviors impact each other and essentially shifting how you think about things in order to change how you respond to things,” Abrams explains.
CBT might help you be less critical of yourself. The shame, isolation and anxiety people might develop because of intrusive thoughts can be harmful. “This modality can help with a practice of non-judgment, can help you stay curious about your thoughts instead of critical, can help you to remember that these are a common experience in the safety of a relationship with a mental health professional so that you know you’re not alone,” says Abrams.
“These techniques do take sustained practice though, so giving yourself lots of compassion for the time it may take, is also important.”
Aryelle Siclait
Health Reporter/Editor
