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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”.

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.

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?!!

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.

It helps to see other people feeling this way. I am also on tears right now with a sense of relief knowing that it is not just me and I am not these thoughts.

This article really help me. Thank you so much😊
Seems like once I’m feeling better an instructive thought tries to ruin my mood.

I really relate to what you said. It’s like every time I quieted my mind they pop up and ruin it again. I am also guilty of testing to see if they are still there!

The way you are thinking is exactly what I do. It goes on for so long you look for it. It seems a way of life at the moment.

Hi Maddy, I’m also experiencing the same thing and exactly like how you described: checking/testing if the thoughts are still there and feel like this makes it worst.

My thoughts have come on from Paxil withdrawal. While I’m getting over that hump I’m seeing a therapist. It helps and then it seems as soon as I can say “you good girl” my brain says “not so fast...insert scary thought!” It’s NOT fun! But something I know is going to pass. Like everything in life...these feelings are temporary!!!

This is exactly what happens to me, it's like my brain needs to worry about something. My guess is that it has to do with feeling like you don't deserve to be happy, even though it's subconsious - wich is why it feels like it's your brains fault (like the brain is almost seperate from you). I just want you to know that your comment really helped me, even though I don't wish this on anyone - I'm happy that I'm not alone.

Desiree you are so right! It's like you don't deserve to be happy. That brain is trained to scare you. I find that these intrusive thoughts come back to me when I'm over tired, stressed, alone, not taking care of my spiritual side. Thanks to all of you who replied. It nice to know that we are not alone. Practicing not making a big fuss over my scary thoughts is so hard when feeling tired. My heart knows they are not worth my energy but my brain likes to bring them back.

Desiree, it’s like you wrote exactly my thoughts word by word! I have always wondered why my brain has the need to worry all the time. It’s so exhausting and overwhelming.

I know, it really wears you down doesn't it (understatement of the year)? Since we worry about everything it really isn't that weird that our brains makes things up when there's nothing to really be worried about anymore, we have trained the brain to worry I guess. But hey, that must mean that we can also train it to calm down! I believe in all of us <3

It's a relief to know that these bad thoughts dont define who I am and trying to fight them is what makes my anxiety worse. My hope is getting stronger every day. It helps so much to know that I'm not alone. Thank you all for sharing!! There is always a light at the end of the tunnel.

I just have a question about regular anxious/worrying thoughts (not intrusive ones), is it still ok to counteract those with a positive one as cbd suggests? Ultimately what I mean is is the technique for intrusive thoughtS not the same as anxious thoughts like “I’m not gonna feel well today” for example.Thanks so much!

What a great question! Yes, actually, it is not so much what the thought is about as how it feels and acts. And many worry thoughts act just the same way. Worry actually has two parts - the what if makes you anxious , and then typically you try some other thought to comfort yourself or make you less anxious. If one time works, great. But most worry thoughts, especially if you have generalized anxiety, just come right back and you end up in a looping battle between worries and refutations. This happens because temporary relief acts as a negative reinforcer of the worry, treats the worry as important or meaningful or predictive, and you get tangled up in it, losing perspective. So yes, the same attitudes and approaches apply to worries that are not intrusive. Our next book , which Dr Seif and I are writing now , is about compulsive reassurance seeking , and addresses internal as well as external checking and reassurance that works backwards.

I have awful anxiety at the moment due to my almost constant thoughts about if my husband dies before me. He is now 70 and in good health but I keep ‘seeing’ myself all alone (our daughter lives hundreds of miles away) and having to cope with the pain of loss and the loneliness and the anxiety it is causing me is overwhelming. Logically I know I may die first but the anxiety just doesn’t seem to recognise this. Is what I’m experiencing the same as other disturbing thoughts and should I try and apply the same technique as I do for any violent disturbing thoughts?

Live in the moment with your husband. Enjoy what you have now. One day at a time. Have a plan and surround yourself with close friends and family. Your never alone.

My intrusive thought began centered about a horrific dream I had. The more I thought about the content, the worse and more extensive/intrusive/disturbing the thought became to the point I was questioning my memory- as in- what if I committed this terrible act and somehow forgot and have lived my entire life not knowing I did this? It’s been extremely distressing as it goes against everything I’ve ever felt/thought...things I would never want to do. Is this something you hear about? I have been diagnosed with generalized anxiety- but before it was always work or socially related... never anything like this.

I'm consistently frustrated by seeing simultaneous advice to both not engage and to allow/not push out these thoughts. Which one am I supposed to do?

Engaging and allowing them are two different actions.. engagement means to analysis, and listen and debate with the thought. Allowing them simply means to let them be present...I highly recommend you read their book...it's written we'll and has some good techneics

Engaging and allowing them are two different actions.. engagement means to analysis, and listen and debate with the thought. Allowing them simply means to let them be present...I highly recommend you read their book...it's written we'll and has some good techneics