If you have visited OCD forums on the internet or listened to podcasts about OCD, you have likely heard the term “intrusive thoughts” time and time again. But what exactly does that mean? By definition, something that is “intrusive” is unwelcome or uninvited, something that someone doesn’t want. It’s like an intruder in your home—someone you do not want to be there, who may even incite feelings of terror.
OCD can involve intrusive thoughts, images, feelings, or urges. Like that intruder, they are unwanted and cause a great deal of distress. They are not things you wish to think about or feel, and they likely run contrary to what you value, causing significant and often debilitating anxiety.
Intrusive thoughts may include the fear that something bad will happen to someone you love, or that you may have done something wrong that you can’t remember. Intrusive thoughts can also be more taboo; one common intrusive feeling is worrying that you might feel attracted to a family member, a child, or even an animal. Intrusive urges can also take many forms, like a sudden urge to veer your car into ongoing traffic.
A central aspect of OCD is that these thoughts, feelings, and urges are not something you actually believe or want to do. People with OCD are so tormented by intrusive thoughts that they seek to alleviate the distress and anxiety that they cause by engaging in repetitive behaviors, called compulsions.
Compulsions can involve any repetitive physical or mental action done in order to relieve feelings of distress that arise from intrusive thoughts, feelings, and urges. Common compulsions may include saying certain phrases or prayers in one’s head, touching items until “it feels just right,” checking locks dozens of times “just to be sure,” or avoiding certain objects or locations.
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Getting “stuck” on intrusive thoughts, feelings, images, or urges
Due to the distress they cause, people with OCD will often say “I just need to get rid of the thoughts.” I have met with many members who say this when they first enter treatment. What I say to them is that the purpose of therapy is not to “get rid” of the thoughts. I teach my members that people without OCD have these same types of thoughts, feelings, and urges from time to time—even taboo ones.
The difference between someone without OCD and someone with OCD is that those without OCD can more easily filter these thoughts out and move on from them. They may understand with confidence that they don’t need to find any significance in these thoughts. That means they are better able to discard intrusive thoughts quickly—sometimes so quickly that they forget the thought has occurred.
On the other hand, people who suffer from OCD get “stuck” when these thoughts, feelings, or urges come to mind. Instead of properly filtering the stimuli out, they become hyper-focused on them. They feel that the thought must mean something, and they can spend hours upon hours trying to solve the perceived problem or eliminate their anxiety. Unfortunately, the more they focus on these thoughts, the more real they seem.
In many ways, we need anxiety: All humans should have a part of our brains that responds when situations require it—an alarm system of sorts. If I am in real danger, I’d hope that this “alarm system” kicks in and causes me to do something like flee the scene, fight, or freeze. This allows me to prevent or limit the danger I am in.
The problem is that for people with OCD, it’s as if this part of the brain is not working properly. The alarm goes off even when you are not in real danger, and you do compulsions to feel better. This gives you temporary relief from anxiety, inadvertently teaching your brain that there really was a danger in the first place, even though there wasn’t. This makes the alarm go off again and again when intrusive thoughts, feelings, and urges arise.
Retraining your brain
The good news is that while the thoughts may never go away, they can affect you less. In order to overcome the vicious cycle of OCD, your brain needs to relearn these signals, which can occur through habituation. Habituation occurs by carefully exposing someone to the anxiety caused by intrusive thoughts, and continuing to resist responding to it with compulsions. Essentially, this means “getting used to” the thoughts that cause discomfort.
Let me give an example of habituation: growing up, my family moved to a place where a train track ran right behind my backyard. The train would always go over the tracks around 1 am each day and would shake the entire house—that’s how close it was. Though I was acutely aware of it at first, after living there for a few weeks, I no longer paid attention to it. It didn’t wake me up in the middle of the night or cause me to get scared. I habituated and adjusted to it. The more I experienced it and saw that it was not dangerous and that nothing bad happened, the less I even noticed it.
The same is true for feared stimuli: the more someone is exposed to them without responding to them, the more comfortable they become with them. They began to build a tolerance for the thing that was once very distressing.
That’s why once you stop engaging with intrusive thoughts, the “false alarm” goes off less and less. The more you do this, the more it becomes habitual. Initially, you may catch yourself responding to a thought, but if you give yourself compassion and try again, you can make progress. Guidance from a specialty-trained professional can allow you to make great strides, with discipline and practice.
Learning to deal with intrusive thoughts, feelings, and urges effectively
If you are getting stuck on intrusive thoughts, exposure and response prevention (ERP) therapy can teach you how to stop engaging with the thoughts causing your distress. You will learn how to sit with uncomfortable feelings and resist the urge to do compulsions. You will see that anxiety, like any other feeling, eventually passes, and you don’t have to do anything to make this happen.
The best way to practice ERP and manage intrusive thoughts is to work with a therapist trained in ERP. At NOCD, our therapists specialize in OCD and ERP, and they will provide you with a personalized treatment plan designed to meet your unique needs. Your therapist will teach you the skills needed to begin your OCD recovery journey and will support you every step of the way. They will guide you in taking small steps to reach your goals.
Our team of therapists at NOCD are passionate about the treatment of this debilitating disorder and are trained by world-renowned experts. To learn more about working with a NOCD therapist, schedule a free call with our care team.