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by Martin Seif, PhD and Sally Winston, PsyD

On-Demand Webinar with ADAA members Drs. Kissen and Greene - What Are Intrusive Thoughts and How Can You Deal with Them?

Read the Q&A Blog Post About Intrusive Thoughts and How to Deal with Them Blog Post by Drs. Kissen and Greene.

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

Dr. Winston and Dr. Seif In The News: 


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.

I've had intrusive thoughts of blasphemy and all that of God and jesus, saying Jesus isn't real when I know he is and to god, I've been a Christian since I was 8 years old and I'm 20 now. Please help me, now I'm thinking I'm going to hell for it.

Don't worry about them that is the worst thing you can do. You know instinctively that they don't hold meaning so allow them to float in then out as just 'junk' thought.

When I was in middle school I had the exact same thing happen to me where I had these blasphemous thoughts and they would constantly haunt me every day, but I frequently went to church and Christian summer camps. Then, they just went away someday and got replaced with other subjects. I'm still learning how to cope and it has been eye-opening to stumble upon this website, knowing that I'm not alone, as I have been considering doing something drastic if they continued as I thought I would be a threat to others and even to people closest to me. I now know that these thoughts simply are thoughts and I should let them go.

Another reassuring comment on this thread. Have you or anyone else reading this ever had an intrusive thought / distorted memory last so long (10 years plus now sporadically) that you started to believe / think it has a deeper meaning? luckily I know it’s irrational but on bad days I find these type of intrusive thoughts / memories can make you question your psyche

Yes I've had the same or similar thoughts for 11 years, it drives me insane, i noticed it after I had my daughter ,and it hasn't gone away, I've been on a lot of different meds, some have helped some haven't,

Doesn’t matter

January 18, 2021

In reply to by Anonymous

I’ve struggled with this strange feeling inside for years since I was a young boy,
I just didn’t know what it was until I hit my teenage years. I started to realize I was fighting off negative depressing evil wicked thoughts about my self on a daily basis and still do to this day, I’ve just learned to cope with them and try my very best not to take out my bad days on anyone I love. anyone out there struggling with this ugly scary sad lonely fight your not actually alone so don’t be scared of saddened by this ugly disease instead fight!!! Fight every damn day cause your worth it...

Lindacrowe63@g…

November 16, 2018

Intrusive thoughts take over my existence until I let them go.it imprisoned me for a while. I am going to try your advice and see if it improves my life. Thank you

Ela, ohmygoodness, you hit the nail on the head!! Last night I was so so overwhelmed with my kids especially my daughter. They just won’t pick up after themselves and don’t listen the first 20 times I say something. My daughter just won’t clean her room even though I ask a million times a day. She’s 13. And I lost it yelling. After that I had a thought of hurting her! I absolutely love my kids and would never ever hurt them, that tonight really shook me to the core. I could barley sleep, my anxiety is though the roof. This really messed me up.

i had this thought that i was going to hurt my mom idk why but that night she made me so mad and i think that triggered it. i was never so mad in my life but i love her so much, she does everything for me but at the same time i think i went so crazy that my brain unconsiously did this to me. i fight these thoughts away but they just come back and it hurts me inside so much because my anxiety with my what ifs and all that. my mom kept calling me stuff and saying stuff and blocking me over and over again and it hurts when you cant even defend yourself and it built up my anger so much and im only 14 years old so idk how to cope with it good enough but thats how were both like and i was destroying myself over these thoughts but now im going to think of them as if they were hotdog buns with out the hotdogs. but like i think these thoughts came because i was literally going crazy i was so mad that night but these thoughts hurt me so much that i have to fight the urge not to hurt myself because i imprinted the thought to hurt myself instead because im 14 and dont know how to cope with this and i get so scared that im going to jump infront of a semi or something now from these urges it was so hard and still is for me to cope but i KNOW I WILL NEVER HURT MY MOM I LOVE HER but these thoughts

That happened to me when I was 10 and 15. I was so ashamed of myself and wondered what ppl would think of me if they knew what was going on in my mind. My therapist told me to let the thoughts go through my mind and eventually I wouldn’t get them. That’s what happened. Just do what the doctors said in their article. Also make sure to get a therapist. They want to help you!

Thank you for that advice mat. That's what my therapist has been saying and it's incredibly hard to do, but I'm so so happy to know that my life won't be like this forever.

How to get rid of both . I have been having both for several years and it is devastating me. Another problem here is that many of those thoughts are flashback images of early adolescence sexual experimentation that I had engaged into when I was that age. Many many years later I am still not free of these.

I can’t comment on the masterbation but sexual intrusive thoughts - I am going through somthing similar. it just started with a thought, I was going through a very stressful time at work and home and had a thought - what if I was a diffrent sexuality? I couldn’t get it out of my head and was driving me bananas. I know my Preference and can feel it, but the intrusive thought was making me question everything about myself, causing distress and severe anxiety.

The book the Drs have written REALLY helped me, even this artical helped so much. In my experience with this questioning sexuality, it is so hard to do it logically because how can you prove a negative? It compounds the difficulties in talking about it because there is nothing wrong with diffrent sexualities, so when I talked about it people are like, “maybe you are repressing somthing” which is not the case, so that makes you feel worse.

I would defo get the book. It is so helpful in making you feel better and that you are not alone. I am also getting therapy soon to help with my anxiety and are on medication which also helps. meditation really helps as it focuses the mind and helps you let go of thoughts.

I wish you well, mate. I hope you are and find a solution.

I needed to see this today. I've been having similar problems (and the thoughts started the exact same way - what if? during a really stressful time w/work). Thank you for sharing your thoughts on this.

He has crazy bizarre thoughts that just pop into his head, he can think he is a tree, wanting to hurt me, or our grandson, or he now has a thought that cars can talk, the thoughts can change ever day, it consumes him, some very unwanted thoughts that I cant comprehend. Do you think that this medication is making matters worse? whenever talks to his Doctor, he seems to increase or decrease the same meds. He has been in and out of institutions for his thoughts, and he's not getting better, there are times that the thoughts don't bother him, but then they can come on strong. What would your import be on this, I am at my ends. I keep my bedroom locked at night, for I don't know from one min to the next if I will be ok, for he says there is times he wants to act on the thoughts, but he feels he can control them. Please any advice would be helpful

Thank you for this article can you recommend a therapist in the Springfield MA area trained
In treatment of this.?

OMG! FINALLY!!! I only talk to my husband about this.. I’ve been thinking that I’m just crazy and somethings wrong with me... awful thoughts that I will just obsess over and torment myself with.. it’s like two sides of my brain arguing all day debating weather or not I’m a terrible human... I’m not, I’m a loving mother and wife that wouldn’t hurt a bug... yet one terrible thought gets stuck in my brain and then spindles out of control.... thank you so much for writing this article... I just bought the book.. so glad I’m not alone!!!

I've been struggling with unwanted intrusive thoughts lately and it's been driving me crazy because I know I'm not that person. After searching the internet on ways to stop thinking intrusive thoughts, I found this to be the best article. I'm confident this will work, thank you, guys!!!!

Thank you for this article! So comforting and refreshing to know that I am not alone in having what I call "Mickey Mouse" thoughts. My question is I say affirmations or an affirmation to quieten my mind. Does doing that reinforce the thoughts.
Thanks
Roy

This article really helped me. It helped me to know I’m not alone. It’s going to get better, and that the intrusive thoughts are not things that I want to do! Thank you

This article explains perfectly what I am going through. Started therapy last week. Hopefully these thoughts will dissipate soon with the help of therapy and fluoxetine as I am depressed and very anxious all the time.

I'm thankful for the article however my mind works in strange ways I feel like the thoughts will stick and won't go I'll just keep reading articles it keeps me distracted hold on that's it! To keep me from my intrusive thoughts I'll read articles to keep me busy and educated!!

Thank you for that helpful article I never had these thoughts before i am learning about anxiety I am recovering I am so pleased that this can be cured without meds using self-help books vitamins and therapy counselling and talking to others support groups have been most helpful I take a medication three times a week only when needed to help me relax and sleep and I am recovering well nice that this can be cured thanks for giving me hope with this article This works for me i hope it does for others and I wish everyone a speedy recovery

Thank you so much for your helpful article that I found casual it, this was my problem but everybody just had told me: "do not pay attention to them"... Of that see I'm not alone, I'm very happy, I wish this article be helpful for any other people like me... god bless and goodluck my dear friends!

I have bipolar 1 disorder, which has lead to many diagnosis including OCD, general anxiety disorder, dpdr disorder, cptsd and some others, but between the cycles of the bipolar moods and the bear constant suicidal ideation my intrusive thoughts have begun to get more disturbing. I was having a good new years with my sister and brother and out of the blue I just think "enjoy it, you dont have much longer." I've had borderline suicidal intrusive thoughts before but this one has been the most unnerving and I'm not looking for validation or reassurance, I just want to know if it's time to seek help from my psychiatrist so I dont have to be hospitalized for suicidal tendencies again. Warm regards, Lilith.

Lilith, I can really relate to what you’re going through. Mental health problems run in my family but I am experiencing constant suicidal thoughts after a traumatic experience with my gf. These thoughts have screwed with my feelings, and have taken over. If you want to talk about them I’m all for it

I suffer with suicidal thoughts a friend of mine killed him self 20 years . Since then my mind tells me to do it or I want to do it . The thoughts come and go I suffer bad anxiety and ocd. I'm getting alot of help and medication. But it's really bad at moment .

DistressedDisaster

January 5, 2019

This actually helped alot. My brain tends to do things such as think about 'Wish this person was dead' or a manner of other horrid and disturbing ideas that leave me afraid and triggers my anxiety against myself. this article really puts things in perspective and I plan to save this page to re read whenever I need a reminder that I'm not insane, nor am I desiring such events to occur or happen.

I am so glad I googled this tonight. Thought I was alone in this. Sometimes I can't believe my own thoughts and I thought I was going crazy!! I've been suffering for so long now. Nice to talk to people who actually understand what I am going through.

The person I love the most has every symptom you describe. He is crying out for help. We have had a genetics test. He goes to a therapist weekly; and he doesn’t feel as if is getting the help he needs. He suffers severe fear driven anxiety. He has too much dopamine. He cannot continue to have these thoughts. He says he is losing his mind; and I don’t know what to do next. Is there a specialist in Colorado?

Thank you for a great article! I have struggled with OCD for as long as I can remember, and over the years it has morphed into different thoughts/patterns. Once I would conquer one "stage" of it, and finally realized that when those thoughts came i knew that they were not true, then it would move on to something a little more complex. I'm still dealing with it daily, but by the grace of God I have gotten married, had 4 children, and am still continuing to battle (and WIN) against this disease. We can do it, y'all!!! Get help. Talk to someone. I have a friend that I call or text, and she reminds me that it is my OCD. When we hold it all in (as I did for years) it truly makes it worse. We need a rational mind to reassure us that we are not alone. Prayers for all with this disease ❤

I have never understood my sudden panic and anxieties that pops out of no where. This really helped me understand it more and giving me hope to control or at least lessen it. Thank you.

I want to profoundly thank the authors for this article. This was a life saver for me. I felt I was on the verge of breaking down mentally. I cannot thank you enough for the insights and tools this article provides. You've done a tremendous service for people who suffer.

Sudha Priya Sh…

January 12, 2019

I have this kind of thought which makes me sick always.Reached to the suicidal point in life .I know what i think is not real .Reached hospital because of that.

Thank you for this information. It really answered the questions that's been going on in my head. I will be saving this information. Thank you agian

I suffer from this all the time. Reading this was like a jaw drop. I can't believe how succinctly it covered and expressed what I go through and how my brain works. Really feels liberating to understand and nice to know I'm not alone. I am also an alcoholic who goes to AA meetings and has been sober for over 3 years. I figured I just wasn't working the program hard enough. I never really felt like my friends went through this specific type of problem. It is freeing to realize that this specific issue has nothing to do with my alcoholism, and I am hopeful to see recovery and growth in this area of my life the same way I did with my alcoholism. Thank you very much.

From the bottom of my heart, thank you for this article! I've been struggling with this for the last 5 years and I never even dared to look into it until now. That's because I feel so ashamed about it and I was scared that I would only find that there's something really wrong with me. I'm starting therapy for the first time soon and I'm terrified that the therapist is going to judge me and tell me that this isn't normal, that I'm a monster.. That's the anxiety speaking and on some level I know that, but that doesn't make it any easier. I'm on the verge of suicide but this article gave me some hope back and I haven't felt that in a long time, I can't thank you enough.

Why would you ever accept and let a bad though manifest its self??? Thats the craziest thing ever! Step #1 Your supposed to rebuke it with all your mental strength. Step #2 You strip it from any authority it thinks it has, then you push it out far, far away from you. Step #3 Once its out of your mind you imagine mentally sealing your mind from it so that it cannot enter again. Then you change your thoughts and try focusing your attention on something else completely different to take your attention and focus on that bad thought. You do that until it leaves you alone and if it tries to come back you repeat the steps again until it eventually leaves you alone because some bad thought can linger around trying to find a way back in.

That's way easier said than done. Thoughts are hard to control and regulate, anxiety and insecurities can easily get the best of someone. You're the exact type of person to think your opinion is 100% correct and applies to all, just because it works for you. Not everyone is you. Many people struggle a ton with this kind of stuff, and it's uncontrollable. You say "just block it out" like its easy, I swear everyone on this page has tried their very hardest to block out the thoughts, but it just doesn't work. Stop trying to decide how people work. Everyone here has tried what you said, and that's just not enough, hence why we're here.

Man, reading the comments made me tear up, because I was just so happy to see that we are all fine, we are getting through it. Yes guys! We got this

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