This post is also available in Dutch.
If you’ve ever waited for a train and suddenly thought about jumping—or pushing someone—in front of it, or had a sexually perverted thought that had little to do with your actual desires, you’re not the only one. Unwanted intrusive thoughts are common yet differ greatly from one person to the next. Keep reading if you want to find out how you might deal with such thoughts.
If you’re like most people, you’re likely able to shrug intrusive thoughts off. Perhaps they barely even register. Some people aren’t so fortunate though. For them, it’s very difficult to let go of such thoughts. They may be recurrent and invoke anxiety, guilt, and disgust. Recurrent unwanted intrusive thoughts, if persistent, can become obsessions. Obsessions lie at the root of obsessive-compulsive disorder (OCD).
While it’s typically associated with compulsive hoarding and hand washing, OCD is actually characterized by obsessive intrusive thoughts. These thoughts may but do not necessarily result in compulsive behaviors.
Compulsions are repetitive behaviors which an individual feels driven to perform in response to an obsession. Compulsions can also be mental, such as self-reassurance or trying to push thoughts away. Whether physical or mental, compulsions can result in a feedback loop that increases the frequency of the thoughts, rather than reduces them. This means that it’s important to tolerate the uncomfortable thoughts; any behavioral or mental trick to reduce the anxiety associated with them may ultimately backfire. It’s much better to just keep cutting that onion, even when you want to leave the kitchen out of fear of stabbing your partner.
About 1% of the Dutch population suffers from OCD, but symptoms associated with it are more widespread. Obsessions and compulsions also occur in people who do not suffer from clinical OCD. Often they occur in people with a different mood or anxiety disorder, but, in fact, they also occur in many people without any diagnosable disorder.
Thoughts are strange. You alone perceive them, which can make you feel responsible for them. However, they often pop up at random, sometimes completely against your will. Anyone who sits still for longer than a minute will likely become acutely aware of this. There’s no reason to feel guilty about them though, especially when the thoughts are not wanted.
Thoughts also aren’t prophecies. Far from it. How many times have you cooked up some scenario that never actually happened in real life? Therefore, anxiety also isn’t a useful emotional response to intrusive thoughts, nor is disgust. You might as well interpret the thought as funny.
Believing that you’re responsible for your thoughts, thinking that they indicate danger, and giving them too much importance are all errors in thinking that psychologists call cognitive distortions. These are the main problem: not the intrusive thoughts, but what you believe about them.
A remedy against intrusive thoughts
It’s the strong emotional response that makes unwanted thoughts recurrent. It is therefore not surprising that intensive exposure therapy, where people face their fears for four entire days, can be profoundly effective in treating OCD. For example, someone who’s irrationally afraid of jumping in front of a train might spend an afternoon at the railway station with their therapist.
Another person, who’s afraid of contamination, might be asked to touch an object that frightens them and then refrain from hand washing. Exposure is a way of learning to tolerate intrusive thoughts and proving cognitive distortions wrong. This hints at an effective way of dealing with such thoughts in general.
The book Overcoming Unwanted Intrusive Thoughts suggests several self-treatment strategies. The main suggestion comes down to this: stop trying to not have these thoughts! There is no need; they do not mean anything. Let them be. Notice them pop up, gently refocus on what you were doing and repeat that process as often as necessary. Stop actively engaging with these thoughts.
It doesn’t matter whether you have clinical OCD or are dealing with some other anxiety or mood disorder. Perhaps you’re perfectly “healthy” but still have occasional strange or anxious thoughts. If they bother you in any way, practice disengagement (e.g., through mindfulness).
For some, the emotional response to intrusive thoughts may be too strong, making it very difficult to see them as just thoughts. In that case, help from a professional could be useful. Exposure therapy, cognitive-behavioral therapy, acceptance and commitment therapy, and antidepressants are all beneficial treatments. Just keep in mind that your thoughts do not define you and that there’s no need to struggle with them. We all have weird thoughts; just let them pass!