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).
Obsessive-Compulsive Disorder
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.
Cognitive distortions
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!
Written by Jeroen, edited by Mónica and Marisha, translated by Jill and Felix
Hallo Jeroen
Nu pas lees ik je uitermate boeiende artikel over ongewenste gedachten. Dank voor je omschrijving en voor je zinvolle aanbevelingen (hoe ermee om te gaan).
Intrusive gedachten zijn voor mij – van kindsaf al – een aanvankelijk zeer fascinerend en spannend fenomeen. Heel laat in mijn leven groeiden ze uit compulsieve ‘opdrachten’ die ik weliswaar wist te weerstaan, maar waar mijn dagelijks bestaan na een crises een paar jaar grondig door werd verpest omdat ik door dwang- en angstgedachten nauwelijks nog normaal kon funktionieren.
Als jochie van 8 had ik ‘s winters tijdens vorstperioden regelmatig de neiging mijn tong niet alleen uit te steken naar bevroren ijzeren brugleuningen maar hem (mijn tong dus) er ook op te leggen. Zodat ie ter plekke bevroor. Ik ontwikkelde fantasiën hoe het zou zijn om hulpeloos vastgeplakt aan de brugleuning te zijn en hoe ijzingwe?kend en spannend het zou zijn als omstanders, politie, brandweer en GG en GD mij uit mijn benarde positie kwamen redden. Mijn ‘what-if’ gedachtescenario’s heb ik heel lang verklaard uit het lezen van Donald Duckverhalen. Maar ook de opluchting die kwam als ik het toch maar niet deed hield me op de been. Het leven was ineens een stuk interessanter als je normaal je weg kon vervolgen.
Later toen ik door destructieve dwanggedachten me vreemd begon te voelen en angsten ontwikkelde, volgde in een (mislukte) Psychotherapie en kon ik mijn problemen alleen met medicatie oplossen. En dat betekende: alle ongewenste gedachten en gevoelens verdringen. Heel lang leed ik een tamelijk gelukkig leven, tot mijn onverwerkte verleden me inhaalde en een 2e levenskrisis begon. Alle ongewenste gedachten uit het verleden kwamen als een Tsunami over me heen en ondanks de enorme lijdensdruk besloot ik mijn obsessies ‘normaal’ – zonder medicatie – te verwerken. Dat lukte met hangen en wurgen, dagelijkse meditaties en veel therapievormen brachten in 3 jaar langzaam maar zeker de mindset: het omarmen van al mijn ‘ongewenste’ gedachten en ervaringen en het ‘ontmachten’ van de angst en negativiteit. Inmiddels ben ik een redelijk vrij mens, ìnclusief intrusieve en fantasievolle gedachten, die me helpen mijn leven te verrijken.
Dat wou ik je even laten weten.
Beste Ruud,
Bedankt voor deze prachtige reactie.
Bijzonder om te lezen hoe jij met zulke gedachten om hebt leren gaan. Ik denk dat een hoop mensen zich in dit verhaal zullen herkennen. Ik wens je het allerbeste en alle vrijheid toe. Ik kan je dat boek, Overcoming Unwanted Intrusive Thoughts, trouwens echt aanraden mocht je zin en behoefte hebben om verder te lezen. Volgens mij past het goed bij de mindset die je beschrijft.
Gr
Jeroen
Hi, do you know any psychologist in The Netherlands that is specialized in OCD? I tried regular therapy and doesn’t work.
If you know someone who speaks English and could help me, I will appreciate it. I’m very desperate.