Over the last 10 years, I have met many kind people who come to my office feeling extremely distressed, confused, and ashamed about their intrusive thoughts. I am writing this blogpost in case it can support someone who is impacted by intrusive thoughts but is afraid of or hopeless about counselling. Additionally, I hope to provide insight for loved ones; helping them better understand what their friends or family members may be going through.
If you have never experienced intrusive thoughts, it might be a difficult to wrap your head around them. Think of the most embarrassing or bizarre thought you’ve ever had—one you wouldn’t likely share with anyone. Now recall a frightening image of a violent movie scene you wish would go away from your mind. For many, these thoughts or images come and go quickly, but for some, they become stuck, leading to overthinking and replaying the same thoughts in their minds.
How can you know if the thoughts you are experiencing might be intrusive? Here are some common indicators:
They have fast onset
They are disturbing to the person experiencing them
They take too much of your energy and time
They cause self doubt (i.e.: do I love my partner? Did I turn off the stove?)
They are unwanted
They are inconsistent with the values of the person experiencing them
They create stress/ anxiety
They get stuck in one’s mind
Intrusive thoughts can manifest differently for each person. Below are some of the most common types I have encountered:
Sexual Orientation
Individuals could be confident in their sexual orientation for years until an intrusive thought emerge. Some, who have never been attracted to the opposite sex, may suddenly find themselves fixating on a random thought about someone of the opposite sex being attractive. They often express uncertainty, saying, “I don’t think I’m attracted to the opposite sex, but what if I am and I just don’t realize it?”. Same can happen to folks who identify as heterosexual, they may only have been attracted to the opposite sex but something could trigger a self-doubt around their sexuality making them wonder if they may be attracted to same sex individuals.
Death
I’ve met people who, while driving, experience sudden thoughts about what might happen if they drove their cars toward a barrier. When asked, they clarify that they would never do such a thing and have no intention of harming themselves or others. They often share fears about death and dying, seeking reassurance that they are not suicidal wondering how such an odd thought could pop in their minds. Additionally, I’ve met young people who struggle with intrusive thoughts about losing family members or having existential fears related to death.
Violence
This type of intrusive thought is particularly distressing. I’ve witnessed people who, in tears and visibly shaken, hesitate to share their troubling thoughts, fearing the implications of having such thoughts. These intrusive thoughts can involve loved ones, strangers, pets, or children. It is often the individual’s biggest fear, some even say they would rather die than to hurt a child or a loved one. The people I met, have never acted on these thoughts and almost always the thought had a fast onset meaning they had never had such a thought for their entire life but as soon as the thought entered their mind, it consumed them.
Relationships
Common intrusive thoughts around relationships include, “What if I don’t truly love my partner?” or “What if my partner is cheating on me?” These doubts can arise at various times, even within the same client.
Everyday Tasks
Many people are familiar with this type of intrusive thought. Questions like, “Did I turn on the oven? Did I lock the door? Was I polite?” often cause significant anxiety.
Germs
This is another well known one so I will not go into details with this. People could be feeling anxious after touching someone or something, worrying they may have come into contact with germs.
Past Events
Ruminating on past mistakes or embarrassing moments can lead to feelings of regret or shame. Clients may find themselves fixating on a movie scene or an image that becomes stuck in their minds.
Religion
Although I’ve encountered this issue with only a few clients, it remains common. Some individuals may experience intrusive thoughts that feel blasphemous and become anxious about offending God.
Imagined Scenarios
I’ve met individuals who vividly imagine the death of a loved one, including their funeral and life afterward, often crying themselves to sleep as if the loss were real.
People impacted by intrusive thoughts often may
Feel anxiety around these thoughts
Mentally scan for evidence in support of or against their thought
Feel ashamed and/or scared about these thoughts and not share them with others, experiencing them in isolation
Alternately, they may overshare/confess and ask for reassurance from others.
If you have been impacted by intrusive thoughts, it’s important to remember that you’re not alone; many people experience similar thoughts and feelings. You are not your thoughts and your thoughts do not always represent who you are. Recognizing that is the first step to healing. You can also talk to your family doctor for a mental health assessment around your intrusive thoughts and work with a counsellor on managing these thoughts. While working with intrusive thoughts, I incorporate Cognitive Behavioral Therapy and Exposure Response Prevention Therapy as well as teaching stress management and self-compassion strategies to my counselling practice. Here are some tips that have helped my clients in the past:
Provide psychoeducation for clients and their families.
Gradually reduce assurance-seeking behaviors.
Limit time spent on compulsive behaviours including assurance seeking.
Manage stress, as it can trigger intrusive thoughts.
With the right supports and strategies, it can get easier. Wishing you hope and courage to make changes and to seek for help. If you would like to hear more about how counselling may help you, I invite you to book a 15 minute free consultation appointment.