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by Martin Seif, PhD and Sally Winston, PsyD

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/

ADAA invites you to view Dr. Seif and Dr. Winston's corresponding free webinar, Overcoming Intrusive Thoughts.


About the Authors

SeifWinston.PNGDr. 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.

Just want to express my gratitude for this article. Whenever I begin to feel overwhelmed with my intrusive thoughts and anxiety I read this artice and remind myself I’m not alone.

Same! This releaved my anxiety within the first few sentences. I was feeling so alone and ashamed. I couldn’t handle my bad thoughts anymore so I googled and found this—then burst into tears, being releaved to have found out I’m not alone and that I’m not a monster for thinking such f**ked up things.

Same here nicole. My thoughts took me as far is the mental health institution. But articles like this help put everything into perspective. Ive read others but some kind of traumatized me.

I thought that I was going mad and would not share my thoughts with anyone. On certain occasions they felt overwhelming and I assumed i must be some some of freak now after reading your comment I feel the same as you that it is a normal process that certain people go through and that makes me feel a lot better and reassured that such feelings will now pass.

Oh Nicole. I actually started crying even more when I read your comment, because that was my exact same reaction. It's good to know one is not alone, and that we all have each other's backs.

This all of a sudden happened to me this past year. July 4th, 2018 my life changed forever. I’ve been struggling with it every day since. The things that constantly run through my head keep me awake at night. I know these thoughts aren’t things I would ever do so I don’t know what triggered this in me. I’m searching for relief daily, I can’t keep living like this. I don’t like where my mind is and I just don’t understand how it just popped up on me so suddenly. If anyone can see this I’d love to talk to you. Life is getting progressively harder to live. Do I seek medical attention or cope with it? Coping with it does not work... I’m running out of options and just need direction

You're not alone. I understand entirely how you feel, trapped within your own mind. I'm no expert by any means, but if you feel something is wrong enough to get help, it can't hurt.

Yeh isn’t it interesting our choice of words, “Trapped” in our own minds, but that is how it feels it’s bizarre really, but comforting that lots of other humans experience similar things hopefully a really quick solution will be discovered soon.

Hi Ross, I wondered if you have had help/advice yet and how you are now?

Yeah I got sudden onset ocd 10 years ago, it gets easier when you get the right treatment and medication. I still live with it but I just ignore it as much as possible and live around it. Some people have diabetes, some are in a wheelchair, I have ocd. I really enjoy life and love having a good laugh, I learned that you can’t take everything seriously lol. What I do know is that it is triggered and worsened by stress so when I get it I know I need to relax myself, resting and mindfulness, meditation helps, then I get distracted then I forget about it. Hope this helps X

Please speak to a licensed psychologist. I had these exact feelings six months ago. My mom had died, I had moved once again to a new city where I knew no one. I was suffering PTSD and had no idea. Suddenly I started having horrible thoughts and considered running away or...worse. they caused me to have my first full-fledged panic attacks. I found a psychologist who helped me work through the weird thoughts. The thing about them is that they don't mean anything about you or your wants and desires. In fact they are like a magnification of your worst fear. Please find someone you can unload these thoughts on. They won't commit you or call the police. Thoughts are not a crime, and chances are you won't be the first of their patients with this issue. Please don't lose hope. Give counseling a chance.

Thanks for sharing that. It really resonated with me what you said about a magnification of your worst fear. I couldn't understand why I kept getting these thoughts as I knew they weren't what I wanted and in actual fact if these thoughts were to come to reality, I would be devastated. Thanks so much for your post. It gives me hope to think I can overcome my situation.

Ross I’ve being going through the same thing your going through for over 9 years and I still wonder what is going on in my life. From the time that I had my last child I’ve being having sleeping disorder that not even sleeping pills would handle, during my pregnancy I told my doctor that I was not having any sleep so he recommend me to read and so I did, but the following doctors appointment I had I told him that I still couldn’t sleep after reading and he just said I should read some more and there I went reading more and more but still didn’t work so I just give up, it’s like what I am doing right now will come back at me when I ready to go to sleep, so if any one can help with my issue I will greatly appreciated

Linda Born

February 10, 2019

In reply to by Emin

I have thoughts that I'm going to die along with anxiety. I feel horrible and like going to hospital at times. how can I make them stop?!!

I completely understand how you feel Linda. I've been struggling with thoughts for about a year and a half. I'm definitely not a doctor or anything of that sort, but what helps me the most is to read stories and websites like these to make me feel like I'm not just loosing my mind. When I have a thought I try my best to keep calm and just let it go in one ear and out the other. If we put to much thought on trying to push it away or worry constantly about it the thought will only be more reoccurring and stronger. I know this is a lot to take in and it won't be immediate unfortunately. But it does get easier when you are able to see the thought as junk. That's all it is is junk. It's not you! The thoughts are of things that don't represent you and what your true value is. You are so much better than any thought that comes into your head. When you have the thoughts try to stay calm and say that's just junk and it's not me. And as crazy and weird as it might be even laughing at the thought will take its power away. I know this is very wordy, but I hope this helps and I will be praying for you everyday:)

Hi Ross,

I can pinpoint the exact day mine started as well - May 4th, 2018. I suggest getting help from a Cognitive Behavioural Therapist and possibly going on some anti-anxiety medication. Lexapro helped me for many years, but now it doesn’t. I have heard Anafranil works well for intrusive thoughts. Lately, I have been doing exposure therapy where I repeat the thought over and over for 10-20 mins a day to reduce its power. That seems to work okay. I record my anxiety level on paper before, during and after the exercise. Hope this all helps.

I feel you. I suffer ftom them as well, and they bring me to tears, cause I never would do the things That is running through my mind. I am always in situations where I can be just driving. And I will have the thought. What If I just hit the people walking. I know 100 percent I wouldnt. But the thoughts are always popping up. They all started out out of the blue. And the give me anxiety and took me through deep depression. Seeing Im not alone Is a total relief, and I am finding new coping mechanisms.

I read somewhere that and Inositol helps to alleviate the thoughts. I also read inositol is depleted by caffeine. You may have more unwanted thoughts after a lot of caffeine. I hope this helps you.

I think what helps most is a combination of this sort of mindfulness work, but also integrative psychiatry which for me is self help in getting proper diet and nutrients that are deficient or low in an ocd and other disorders brain. Research ocd vitamin deficiency..Iron,Calcium, Vit D, B vitamins, C helps a lot for panic like just eat a kiwi or apple or whatever you can along side chicken, avoid sugar, non organic dairy, gluten, etc. You have to see what works best for you.

My life forever changed on June 6th 2006. I was 14 and in the middle of playing a video game when the thought of me possibly being gay popped into my mind in a flash and gave me my first panic attack that literally lasted 3 months. I had never heard of the word anxiety, let alone experienced it.

Sorry if this appears to be long, but maybe if I tell you my story, you'll understand your own a little better.

I literally thought I was losing my mind. From the moment I woke up, to the exact minute I'd go to sleep: panic. Sleeping was the only way I could escape. I knew many people, even in my family, who were very much against homosexuality. And that's exactly why I had these intrusive thoughts. Therefore I never said anything. I suffered in silence for 3 months until I told my mom and realized she had the same problem. When she was 14, she thought she was going to hell. Her aunt raised her to fear God in every aspect and it tormented her for years.

I had also gotten to the point where I was too afraid to touch knives because I was afraid I might hurt somebody with them. My mind knows *exactly how to torment me in the worst ways imaginable.

Now Im 27, still straight (lol), and still get these unwanted thoughts from time to time. No warning at all. For all of you that have this problem, you are not alone. If you have nobody to talk to, now you do. Send me an email and we'll hash this out. It's amazing how your mind can try to convince you of something that's so untrue and far from reality. I knew I was straight, but I had another side of thinking (not a voice) that worked very hard to convince me otherwise. It was relentless.

Here's the best part: It starts to go away. You begin to develop a tolerance to it. You start to understand yourself all too well and understand they are nothing but unwanted thoughts you sadly can't control. Even without medication, the severity starts to subside. Your intrusive thinking may change over time, but human beings have a remarkable way of adapting to anything. Now I rarely get them, unless I'm highly stressed. Eventually it becomes nothing but a nuisance you'll begin to shrug off.

6/6/06 was the first day I had ever contemplated suicide. Sadly, one little thought traumatized me to the point where I was never the same happy kid ever again.

earth2derek@gmail.com

Amazing- you post was really helpful. I constantly have scary thoughts about my cognitive health because of these random thoughts... I’d think about how easy it would be to deliberately swerve and hit an oncoming car with my kids in my car, 100% aware of what I was doing- then I’d have more thoughts like that, which made me worry I’d become a schizophrenic (I have a cousin who is).. but after passing the age where schizophrenia is typically diagnosed, I was relieved that I didn’t have any problems.

Then I shifted to worrying I was having early onset Alzheimer’s (my grandpa had Alzheimer’s) any time I’d forget or misplace something. So now, I’m battling keeping my thoughts about Alzheimer’s at bay, when all I can think about is how I keep having mental hiccups.. but it’s just my thoughts are causing the mental hiccups!

I’d probably be back to my old self if I could stop being so sensitive to every thought, action, and feeling I have.

Hi Im am 34 years old and starting having some intrusive thoughts that started causing major anxiety and feeling of going crazy. These came out of nowhere, I have been having a hard time coping and its disrupting my life til now.. Thanks for sharing your story. I truly feel I am not alone

Hi Ross, my son (34 years old) has had OCD for 4 years now- came on suddenly and was crippling- he missed a year of work. He saw a psychologist and did lots of reading to gain insight into his condition. This what saved him- insight about what he has. He also tried anti depressants as prescribed- did not work at all. Now he takes clonazepam for anxiety ( small dose 3 times a day), which helps. And this week is starting CBD oil. Several of his coworkers use it with success, so he is very hopeful. Couldn’t get a doc to prescribe it, so is buying it on his own. Every day is a struggle, but he finds that keeping busy often keeps the thoughts to a minimum. I hope you have family and friends to talk to - this is VERY important!

I would urge anyone who has ocd/ anxiety etc not to take cbd. Over time it can lead to psychosis, schizophrenia etc. everyone talks about how wonderful it is but only for seizures and cancer. It has been proven to exacerbate mental health issues. I myself have ocd, anxiety and depression for over 20 years and have been told by very good doctors as well as my own research not to take cannabis

Hi Lauren, can you post the research you have found on that. Because I would love to see it. There are pages of research on CBD helping psychosis. That THC in the form of smoking pot for years can cause psychosis. So if I am missing something that is research that has shown CBD causing psychosis I would like to read it. Thanks

Look ...i have the same thing and in my heart of hearts I know these thoughts are not my own thoughts there not something I enjoy they bring me so much torture. I saw a post online on another site that helped me a lot. It said plain and simple a thought is a thought and a desire is a desire ! None of us desire these thoughts were so scared to think them, and that actually makes us think them ! Then since we are people who take these subjects seriously it’s a major deal and our brains go on high alert. What I would like to know is how to re assure ourselves that we can relax and let them go

Ross, the same thing happened to me and I found out after many years it was OCD! Some honesty with trusted family members and docs led to a RX for Prozac and a totally normal life back! Don't let anxiety disorders control you, there is so much help available and you're not alone! No one admits these things so then we feel alone and scared. It's comforting to read the facts, you're not alone! Sorry this has happened to you!!

You’re definitely not alone! Keep on striving, I’m a young person in my early 20’s and have been dealing with this for a couple of years now. I find that it goes away when I don’t force it away, the less I fight it the better it is. You can get through it and you will! Think of it almost as a “phase” that will go away. However if it is causing you overwhelming distress then please speak to someone about it. Remember you are loved and this problem does not change that!

So sorry your're feeling this way. Try looking up Dr.Barry McDonagh and his approach, he deals with anxiety and panic attacks but his step by step program is amazing when it comes to irrational thinking. You can find the PDF version online for free.

Here is my theory

Every time you have an unwanted thought, it causes an anxiety response. So, your brain thinks , something threatening or dangerous has happened, so the next thing it does is fire the thought back at you to see if it gets the same reaction and so on. So what to do ?
You must accept the thoughts however terrible the are, even try to humour yourself with them. Soon your brain will realise that they contain no threat. And will give up re sending them. The more you fight them the more you loose.

Just like Ross mentioned, these intrusive thoughts just happened to me for the first time in 56 years just a month ago and I thought I was going crazy. I couldn't imagine how i could have such thoughts and went thru days and hours of struggle trying to figure it out and trying to keep them from popping into my head. Not easy. For me, I got into some books by Dr. Caroline Leaf, a brain researcher for 30 years, who is also a Christian like me and I got her app called the 21 Day Brain Detox and it has helped me tremendously because it brings together Christian faith with proven scientific principles on the brain. Really it is my turning completely and totally to my Lord and His Word and my trusting in Him that has mostly been responsible for the progress I've made but her app helped put it into steps that I do everyday. I'm still getting occasional thoughts but not nearly like they were and my reaction to them is not nearly as catastrophic as it was. I know what all of you are going through.

I have suffered with anxiety for many years and the intrusive thoughts. I tried everything. Vitamins, a good diet, exercise, and the list goes on. I thought that as a Christian, I shouldn't be having these thoughts and that I must not be a good enough person. I also didn't think I should take meds but that I could cure it by reading up on it and trying the different things offered as I read many, many, books on this malady and did the appropriate things like a good diet, exercise, mindfulness, vitamins, and the list went on. I finally found out, which might be difficult to believe, that I had a definite serotonin deficiency which I found out, runs in my family. And I was not only suffering with that, but had many, many allergies to foods, and also pollen, etc. I also noticed that Benadryl helped me. So, the doctor put me on Tofranil of which I take 35mg a day which is a small dose but it helps. I would try to stop the medication several times because I really didn't want to take it but I always had to go back on it. Also, reading all the literature made me more anxious. I feel that the Tofranil also helped me a little with my allergies because I believe it has an ingredient that does that also. This is what helped me and I suffered many, many, many years of coping and trying to help myself because my religion at that time seemed to say that if I was a good enough Christian, I wouldn't need meds but that was simply so false and I am embarrassed to say I believed it at the time and that is why I would stop my Tofranil (Imipramine) but within a short time would have to start back on it because nothing I did would stop these thoughts. It's so important to go to a counselor or someone who deals with your anxiety problems to get the correct diagnosis and if you need medication, take it and don't berate yourself for having to do so. Also, I have to get this med compounded as I am so sensitive to additives, dyes, chemicals. I still do not eat foods with dyes, chemicals, additives and do not eat sugar or false sugar and try to eat organic and never eat out in a restaurant. And I exercise, practice relaxation techniques, pray, etc. and try to stay in shape. 5'3" and weight 130

Hi!

What did your doctor say about taking Benadryl for your anxiety?

I too am going through this again.ive been told this is usual for anxieyy and depression.it always scares me and i havent reached the thereapeutic dose on my mefs yet.it eill happen it jas .any times before.see your gp dont do this alone.get well soon

I totally understand you. Anxiety runs in my family and depression. I to have obsessive intrusive scary thoughts. It happens when I get stressed. You are not alone.

life has been hard this past week, thoughts i’ve never even thought about before popped into my head. things that i know aren’t true kept on taking up my thoughts, my anxiety has got so worse to the point where i actually started to believe those things like how i don’t love my boyfriend or we aren’t going to get better in the relationship, like i have a thing for my friend which i’ve never even thought about before. like i’m **** myself up constantly and i’m so incompetent and i went to my boyfriend about this and he’s been so supportive. these thoughts are making me so sick i haven’t eaten that well , it’s gotten so bad that i’m doubting that this is what’s going on with me when i know that this is the truth and it’s just my anxiety****with me , it’s like it’s telling me that i’ll never get better and i’m going to stay like this forever... i need help too

I've been dealing with the same crap. Weeks on and off of obsessing over the intrusive thoughts, which started in February after I had my first panic attack. It launched me into a week of extreme panic where I was trying to grapple with all the uncertainties in my life, just causing me more anxiety. Before I had the panic attack I was a go-with-the-flow kind of gal. I'm learning to accept uncertainty, and when intrusive thoughts come in strong, I think to myself - it's just a thought, let it be. I don't try to push it out, but I don't try to focus on it or give it more worth either. My anxiety has gotten better, but I still think the thoughts quite frequently, but I'm less reactive to them. It's becoming easier to live in the moment again. Since this started it has put a lot of stress on my relationship with my boyfriend of almost two years (because I have intrusive thoughts about my sexuality and relationship commitment)- we've ridden the waves together. It does get better! Let your boyfriend know what you are going through, it doesn't help to hold it in. Help him understand that they are obsessive thoughts and don't reflect how you actually feel when you are in the present. I have started to see therapists too, hoping they can give me more tools to cope with and master my thoughts. For me it comes in waves (I've had two exceptionally bad ones since February lasting 3ish weeks) where I feel like I must do something drastic to solve the anxiety/stop the thoughts. Then I learned about OCD, and realized I was experiencing it, which has given me some peace. It's very difficult to "get out of your head" and I relate very well to the comments describing the feeling of being trapped in your own mind. I can't iterate enough though - it does get better! I downloaded the Calm app since my anxiety started, and the guided meditations although hard to get into at first have helped me lessen my reactivity to my thoughts. Hope this helps!