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What are intrusive thoughts?

Intrusive thoughts are thoughts that appear suddenly, out of nowhere and are not connected to what the individual is currently thinking about. They are often dark and involve harm occurring to the individual or their loved ones, sometimes at the hands of the individual. Despite them not being very rational they can feel extremely real and likely to occur.

There are two types of intrusive thought. The first is related to feeling anxious due to an outside trigger. For example, an anxious person waiting for a loved one who is a few minutes late coming home from work. They may start to have intrusive thoughts about their loved one being involved in a horrific car crash. The more they have these thoughts, the more anxious they become and the more vivid the intrusive thoughts. This is essentially an anxiety disorder and is very treatable.

Another type of intrusive thought is not directly linked to anxiety. These thoughts are compulsive in nature, adding to the anguish they cause. They might involve thinking about stabbing a loved one, pushing a stranger in front of a moving train, molesting a child, killing your pet, stripping in public, throwing one’s baby down the stairs, amongst others. They are very distressing and one might feel scared, anxious, embarrassed, guilty and ashamed. The individual may question whether they would ever act on their thoughts. They may want to keep them a secret for fear of judgement. They can lead to obsessive or compulsive behaviour (OCD) as the individual attempts to prevent the thoughts occurring. An example might be washing one’s hands 100 times in a row to prevent certain thoughts. Alternatively they may behave in a more and more restricted way for example avoiding seeing a friend that they have had intrusive thoughts about. These types of thoughts are also treatable and can lessen over time.

With both types of intrusive thought, it is vital to stress that they are just thoughts and not impulses to act. In fact people that have these thoughts are precisely those who would not act on them. It is important to point out that there is a huge difference between a thought and an impulse to act. They are just thoughts and are more common than imagined. Nevertheless the distress, anguish and anxiety they can induce is very real and it is for this reason that one may benefit from speaking to someone who will not judge, however dark and unacceptable they may seem.

How to lessen the impact of intrusive thoughts

It is important to bear in mind that these are just thoughts and that they will pass. Therefore try not to ‘buy into’ them by thinking about them. If you start to think about whether you would really commit the act or start to worry about your thought then it will become more powerful. On the other hand, do not try and stop the thoughts, as it is well known that what we resist persists. Instead, attempt to cultivate the approach of observing your thoughts and labelling them as intrusive yet not getting caught up in them. At the same time take some deep breaths, breathing from your belly, until your anxiety decreases and you feel more grounded.

Treatment approaches

Cognitive Behavioural Therapy (CBT) and the ‘Third Wave’ approaches such as Acceptance and Commitment Therapy (ACT) and Dialogical Behavioural Therapy (DBT) are all clinically proven to be effective for intrusive thoughts.

Psychiatric consultation – This is appropriate when the intrusive thoughts are causing a great deal of distress and are linked to high anxiety levels. It is also useful when they have been occurring over a long period and previous psychiatric consultations have not helped to alleviate them. Our consultant psychiatrist will take a thorough history and will formulate an effective treatment plan, perhaps with medication to reduce some of the symptoms.

Psychotherapy can also be effective. The practitioner might explore with the origins of your intrusive thoughts and help you gain greater understanding about your anxiety. They will seek to build up your inner psychological robustness so that you feel more empowered and in control and experience less intrusive thoughts.

Psymplicity Healthcare approach

When you speak to one of our qualified care co-ordinators, they will listen to your issue with empathy in a non-judgemental manner. They will help you to decide which course of treatment is most suited to your needs and very soon you will find your way on the way to feeling more in control of your thoughts and feelings and towards enhanced psychological wellbeing.


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