Understanding One of the Most Misunderstood Symptoms of OCD
Have you ever had a thought suddenly enter your mind that made you wonder, “Why did I just think that?” Maybe you imagined something terrible happening to someone you love. Perhaps you had an inappropriate thought during a serious moment. You might have suddenly wondered whether you could hurt someone, do something completely out of character, or lose control of yourself.
These experiences can be alarming, especially when the thought seems completely inconsistent with who you are. They are often referred to as intrusive thoughts.
Intrusive thoughts can happen to almost anyone. Having one does not automatically mean that you have Obsessive-Compulsive Disorder (OCD), nor does the content of an intrusive thought necessarily reveal something about your character, desires, or intentions. For some people, however, intrusive thoughts become frequent, distressing, and difficult to dismiss. Instead of appearing and disappearing, the thought becomes something they feel compelled to understand, disprove, prevent, or neutralize. That pattern can sometimes be associated with OCD.
What Are Intrusive Thoughts?
Intrusive thoughts are unwanted thoughts, mental images, ideas, or urges that seem to enter your mind involuntarily. They may be strange, upsetting, violent, sexual, embarrassing, offensive, frightening, or simply inconsistent with what you actually believe. One of the most important characteristics of an intrusive thought is that it is unwanted.
The person experiencing the thought may be disturbed precisely because the thought conflicts with their values. For example, someone who deeply loves their family might suddenly imagine harming a family member. A religious person might experience an offensive religious thought. Someone who takes their responsibilities very seriously might suddenly wonder whether they accidentally caused a terrible event.
The immediate reaction is often: “Why would I think something like that?” That question can become more distressing than the original thought.
Are Intrusive Thoughts Normal?
Intrusive thoughts themselves are not unusual. Human brains constantly generate thoughts, memories, images, possibilities, and associations. Not every thought that enters your mind is deliberate or meaningful. For many people, an unusual thought appears briefly and disappears just as quickly.
Imagine standing near the edge of a train platform and suddenly thinking about what would happen if you jumped. You have absolutely no desire to jump, and the thought may disappear almost immediately. The presence of this kind of thought alone does not necessarily indicate a mental health disorder. The more important question is often what happens after the thought appears.
When Do Intrusive Thoughts Become a Problem?
For someone without OCD, an intrusive thought may be uncomfortable but relatively easy to dismiss. The person might think: “That was weird.” And then continue with their day.
Someone struggling with obsessive thinking may instead become intensely focused on the significance of the thought. They might ask themselves:
- Why did I have that thought?
- What if I secretly wanted it?
- What if having the thought makes me a bad person?
- How can I be absolutely sure I would never do it?
- What if the thought is actually a memory?
- What if this says something about who I really am?
The person can then spend considerable time trying to find certainty. Ironically, attempts to prove that the thought is meaningless can make the thought feel increasingly important.
What Are Some Examples of Intrusive Thoughts?
Intrusive thoughts can involve almost any subject. They often seem especially disturbing because they involve subjects that matter deeply to the person experiencing them.
Common examples of intrusive thoughts may include:
- Thoughts About Harming Someone – suddenly imagining hurting their spouse, child, friend, or even a stranger.
- Thoughts About Losing Control – Someone might suddenly wonder: “What if I lose control and do something terrible?”
- Sexual Intrusive Thoughts – Thoughts that involve unwanted sexual images, ideas, questions, or urges.
- Religious or Blasphemous Thoughts – Experiencing unwanted thoughts that contradict their religious beliefs, such as offensive thoughts during prayer or worship.
- Relationship Intrusive Thoughts – Suddenly questioning their feelings toward their spouse or partner.
- Intrusive Thoughts About Mistakes – Thoughts that involve the possibility that a person has made a serious mistake, like what if I accidentally hit someone while driving,
- “What If?” Thoughts – OCD-related intrusive thoughts frequently begin with two deceptively simple words:
What if?
- What if I hurt someone?
- What if I’m actually a terrible person?
- What if I forgot something?
- What if I secretly wanted that thought?
- What if something happened and I don’t remember it?
The search for an absolutely certain answer can keep the person stuck in the thought.
Do Intrusive Thoughts Mean You Secretly Want to Do Something?
One of the biggest misconceptions surrounding intrusive thoughts is that thinking about something means you secretly want it to happen. A thought is not the same thing as an intention. Our minds can generate ideas and images without our choosing them. An unwanted thought can even be completely inconsistent with someone’s actual beliefs, desires, or values.
Someone may become terrified that having a violent, sexual, offensive, or inappropriate thought reveals something hidden about their personality. The fear can lead to intense self-examination and instead of providing certainty, repeatedly examining the thought can create even more doubt.
Can You Have Intrusive Thoughts Without Having OCD?
Yes. Having intrusive thoughts does not automatically mean someone has OCD. Intrusive thoughts can occur in people who do not have a mental health condition, and unwanted thoughts can also occur alongside a variety of mental health concerns.
What can distinguish OCD is the larger pattern surrounding the thoughts, including recurring obsessions, significant distress, compulsive responses, avoidance, and interference with everyday life. A mental health professional can evaluate the complete pattern rather than diagnosing someone based on the content of a particular thought.
When Should You Talk to Someone About Intrusive Thoughts?
It may be helpful to speak with a mental health professional when intrusive thoughts:
- Occur frequently or feel difficult to disengage from
- Cause significant anxiety, guilt, shame, or distress
- Lead you to avoid people, places, objects, or activities
- Cause you to repeatedly seek reassurance
- Lead to extensive checking or mental reviewing
- Interfere with relationships, school, work, sleep, or everyday activities
- Take up a significant amount of your day
People sometimes hesitate to discuss intrusive thoughts because they are embarrassed or frightened by their content. However, clinicians familiar with OCD understand that intrusive thoughts can involve disturbing and highly sensitive subjects. Being able to describe what you are experiencing can be an important first step toward understanding the pattern behind the thoughts.
Contact New Frontiers & Gain Control of Your Life
Perhaps the most important thing to understand about intrusive thoughts is that having a thought and wanting something are not the same thing. A strange or disturbing thought can feel important simply because it frightened you.
When intrusive thoughts become persistent enough that you spend significant amounts of time analyzing them, avoiding triggers, seeking reassurance, or performing rituals to feel safe, there may be a larger pattern worth discussing with a mental health professional.
At New Frontiers Psychiatric & TMS, our mental health professionals work with individuals experiencing OCD, anxiety, intrusive thoughts, and related concerns. If intrusive thoughts are causing significant distress or interfering with your daily life, contact our Milwaukee-area team of compassionate psychologists to learn more about evaluation and treatment options.
Author: Dr. Hong Yin
Hong Yin, MD, has been a practicing medical professional in the Milwaukee community since 2012. She understands that your health and wellness concerns extend beyond routine medical care. She’s a highly trained, board-certified psychiatrist who provides an array of comprehensive services and procedures to help people overcome mental health problems.