What are intrusive thoughts and why do we have them?

Intrusive thoughts are unwanted thoughts, images, or urges that arise suddenly and unexpectedly and can cause a lot of anxiety. Intrusive thoughts are often violent, sexually explicit, or otherwise socially inappropriate. Intrusive thoughts may be directed towards loved ones, people who are close by, or oneself.

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Common intrusive thoughts include things like:

1. The sudden image of harming your child or other loved one.

2. The idea of performing a sexual act with someone or something inappropriate.

3. The sudden urge to yell, curse, or expose oneself in public.

4. A strange urge to jump when standing close to a ledge.

The unwanted and unexpected nature of intrusive thoughts separates them from other thoughts, like worries, ruminations, or desires. Intrusive thoughts are often so contrary to one's character that the person is ashamed and repulsed by them.

Why do we have intrusive thoughts?

Intermittent intrusive thoughts are common and normal. One study by Hames and colleagues (2012) suggested that over 50 percent of people with no history of suicidal thoughts have had the sudden urge to jump when standing on a tall building or bridge. This particular intrusive thought is so common that it has a name: the "high place phenomenon." or the "call of the void."

Intrusive thoughts have also been well-studied in new mothers. A 2008 study by Fairbrother and colleagues showed that half of the healthy mothers had intrusive thoughts of harming their infants by four weeks after birth. A recent meta-analysis of 50 studies showed that nearly all women had had intrusive thoughts of harming their baby at some point after delivery (Brok, 2017).

People who are more sensitive to anxiety are more likely to experience intrusive thoughts (Hames, 2012). And while these thoughts can be normal, they are more common in psychiatric disorders such as anxiety disorders, mood disorders like major depression and bipolar disorder, and psychotic disorders like schizophrenia.

What causes intrusive thoughts?

So why does a normal brain produce seemingly abnormal and unwanted thoughts? Some researchers hypothesize that these thoughts are a sort of misinterpreted warning signal (Hames, 2012).

For example, when a mother experiences a sudden, undesired urge to drop her newborn baby, perhaps it is her brain's way of warning her to hold on tighter to the child. Or, in the context of the high place phenomenon, the strange and unexpected urge to jump causes you to step back from the edge of the bridge or building. So in some ways, these intrusive thoughts may protect you from the thing you fear.

Importantly, intrusive thoughts do not seem to predict an increased risk of carrying out the feared thought or urge. In the meta-analysis by Brok and colleagues (2017) cited above, none of the 50 studies found an increased risk of violence in mothers with isolated intrusive thoughts of harming their children.

How can you stop intrusive thoughts?

When intrusive thoughts become severe, recurrent, and anxiety-provoking, we call them obsessions. Obsessions are perhaps best known in the context of obsessive-compulsive disorder (OCD). People with OCD often suffer from compulsions as well. Compulsions are behaviors or mental rituals used to decrease the anxiety associated with the obsessions.

People with transient, non-distressing intrusive thoughts do not need treatment. These kinds of intrusive thoughts are normal, common, and harmless. Trying to stop them can backfire and make them more frequent and anxiety-provoking. Instead, it can help to think of these thoughts as brain hiccups. As frightening as they may initially seem, intrusive thoughts will dissipate if you accept them and allow them to pass without giving them too much attention or trying to push them away.

If intrusive thoughts reach the level of obsessions, we can use medications and therapy to help. Selective serotonin reuptake inhibitors (SSRIs) and other antidepressant medications are effective in treating obsessions. Cognitive-behavioral therapy (CBT) can also be beneficial, especially when it includes exposure and response prevention (ERP) and anxiety management strategies. We will talk more about specific therapeutic techniques that you can use to combat intrusive thoughts in future blog posts. For now, you can learn more about stopping intrusive thoughts on my Youtube channel: How to get rid of intrusive thoughts once and for all.

And here is a helpful book on dealing with these thoughts:

Amazon Affiliate Disclosure: Links below include Amazon links. As an Amazon Associate, I earn from qualifying purchases. This means that I get commissions for purchases made through links in this post. This helps me run the site, including this blog.

Overcoming Unwanted Intrusive Thoughts: A CBT-Based Guide to Getting Over Frightening, Obsessive, or Disturbing Thoughts by Sally Winston

References

Hames, J. L., Riberiro, J.D., Smith, A.R., & Joiner, T. E. (2012). An urge to jump affirms the urge to live: An empirical examination of the high place phenomenon. Journal of Affective Disorders, 136, 1114-1120.

Fairbrother, N., & Woody, S. R. (2008). New mothers’ thoughts of harm related to the newborn. Arch Women Mental Health, 11, 221-229.

Brok, E. C., Lok, P., Oosterbaan, D. B., Schene, A. H., Tendolkar, I., & van Eijndhoven, P. F. (2017). Infant-related intrusive thoughts of harm in the postpartum period: A critical review. J Clin Psychiatry, 78, e913-e923.