Unwanted Intrusive Thoughts

Unwanted intrusive thoughts are stuck thoughts that cause great distress. They seem to come from out of nowhere, arrive with a whoosh, and cause a great deal of anxiety. The content of unwanted intrusive thoughts often focuses on sexual or violent or socially unacceptable images. People who experience unwanted intrusive thoughts are afraid that they might commit the acts they picture in their mind. They also fear that the thoughts mean something terrible about them. Some unwanted intrusive thoughts consist of repetitive doubts about relationships, decisions small and large, sexual orientation or identity, intrusions of thoughts about safety, religion, death or worries about questions that cannot be answered with certainty. Some are just weird thoughts that make no apparent sense. Unwanted Intrusive thoughts can be very explicit, and many people are ashamed and worried about them, and therefore keep them secret.

There are many myths about unwanted intrusive thoughts. One of the most distressing is that having such thoughts mean that you unconsciously want to do the things that come into your mind. This is simply not true, and, in fact, the opposite is true. It is the effort people use to fight the thought that makes it stick and fuels its return. People fight thoughts because the content seems alien, unacceptable, and at odds with who they are. So, people with violent unwanted intrusive thoughts are gentle people. People who have unwanted intrusive thoughts about suicide love life. And those who have thoughts of yelling blasphemies in church value their religious life.  A second myth is that every thought we have is worth examining. In truth, these thoughts are not messages, red flags, signals or warnings--despite how they feel.

The problem for people who have these thoughts--and one estimate is that more than 6 million people in the United States are troubled by them-- is that unwanted intrusive thoughts feel so threatening. That is because anxious thinking takes over, and the thought—as abhorrent as it might be—seems to have power it does not.  People tend to try desperately and urgently to get rid of the thoughts, which, paradoxically, fuels their intensity. The harder they try to suppress or distract or substitute thoughts, the stickier the thought becomes.

People who are bothered by intrusive thoughts need to learn a new relationship to their thoughts--that sometimes the content of thoughts are irrelevant and unimportant. That everyone has occasional weird, bizarre, socially improper and violent thoughts. Our brains sometimes create junk thoughts, and these thoughts are just part of the flotsam and jetsam of our stream of consciousness.  Junk thoughts are meaningless. If you don’t pay attention or get involved with them, they dissipate and get washed away in the flow of consciousness.

In reality, a thought—even a very scary thought—is not an impulse. The problem is not one of impulse control- it is over control. They are at opposite ends of the continuum.  However, sufferers get bluffed by their anxiety, and become desperate for reassurance. However, reassurance only works temporarily, and people can become reassurance junkies. The only way to effectively deal with intrusive obsessive thoughts is by reducing one’s sensitivity to them. Not by being reassured that it won’t happen or is not true.

Unwanted intrusive thoughts are reinforced by getting entangled with them, worrying about them, struggling against them, trying to reason them away. They are also made stronger by trying to avoid them. Leave the thoughts alone, treat them as if they are not even interesting, and they will eventually fade into the background.

Here are steps for changing your attitude and overcoming Unwanted Intrusive Thoughts

• Label these thoughts as "intrusive thoughts."
• Remind yourself that these thoughts are automatic and not up to you.
• Accept and allow the thoughts into your mind. Do not try to push them away.
• Float, and practice allowing time to pass.
• Remember that less is more. Pause. Give yourself time. There is no urgency. 
• Expect the thoughts to come back again
• Continue whatever you were doing prior to the intrusive thought while allowing the anxiety to be present.

Try Not To:

• Engage with the thoughts in any way.
• Push the thoughts out of your mind.
• Try to figure out what your thoughts "mean."
• Check to see if this is “working” to get rid of the thoughts

This approach can be difficult to apply. But for anyone who keeps applying it for just a few weeks, there is an excellent chance that they will see a decrease in the frequency and intensity of the unwanted intrusive thoughts.

Our book is “Overcoming Unwanted Intrusive Thoughts”. Selected in March 2019 as an Association for Behavioral and Cognitive Therapies Self-Help Book Recommendation - an honor bestowed on outstanding self-help books that are consistent with cognitive behavioral therapy (CBT) principles and that incorporate scientifically tested strategies for overcoming mental health difficulties.

Get the Spanish version of the book "Guía para superar los pensamientos atemorizantes, obsesivos o inquietantes" here. 

To sign up for a free e-newsletter that answers questions about intrusive thoughts, please visit this webpage: http://www.drmartinseif.com/

Additional Resources

• ADAA invites you to view Dr. Seif and Dr. Winston's corresponding free webinar, Overcoming Intrusive Thoughts.
• Check out this helpful video by professional graphic designer and animator J. Nordby on how he overcame his struggles with intrusive thoughts. 

Dr. Winston and Dr. Seif In The News: 

• What a Sticky Mind Means
• Unwanted Intrusive Thoughts: How to Overcome Sticky, Frightening, Obsessive, or Disturbing Thoughts, PsychologyToday.com, July, 2019

About the Authors

Dr. Winston and Dr. Seif are both Founding Clinical Fellows of ADAA. They are co-authors of the books “What Every Therapist Needs to Know About Anxiety Disorders” and “Overcoming Unwanted Intrusive Thoughts” 

Dr. Sally Winston is a clinical psychologist and co-director of the Anxiety and Stress Disorders Institute of Maryland. She is nationally recognized for her expertise in the treatment of anxiety disorders. Dr. Winston has been active with ADAA for over 30 years. She has served as chair of the ADAA Clinical Advisory Board and was the first recipient of the ADAA Jerilyn Ross Clinician Advocate Award.

Dr. Martin Seif is a master clinician who has spent the last thirty years developing innovative and highly successful treatment methods for anxiety disorders. He helped found ADAA and has served on its Board of Directors and Clinical Advisory Board. Dr. Seif has offices in Manhattan, NY and Greenwich, CT. For the last 18 years, he has been Associate Director of the Anxiety and Phobia Treatment Center for White Plains Hospital Center. He also trains therapists and psychiatric residents at New York-Presbyterian Hospital.