Intrusive thoughts include everything from flashback memories, urges, images, or thoughts that occur spontaneously or that can be triggered by various stimuli. Intrusive thoughts often cause an individual great distress and the thoughts tend to reoccur or have an underlying theme. The tricky part about these types of thoughts is that the more individuals try to avoid the thought, the more apparent or intense they become. However, there are some intrusive thoughts that do not create distress and they aren't necessarily thoughts that pose any concern or need to be evaluated. In this post, I’ll be explaining the nature of intrusive thoughts, their degree of severity, ways to reduce symptoms, and how to cope when they are present.
Intrusive thoughts can occur for a variety of reasons including mental health diagnoses, symptoms of anxiety, depression, and trauma or they can occur for no reason at all. Humans have a stream of consciousness which means that our mind never stops thinking. Sometimes the thoughts that seep into our awareness may leave as soon as they enter or we may fixate or get stuck on a particular thought. The thoughts that we get stuck on may continually pop up to the point where they become intrusive. They can range from an unusual in nature thought to a harmful thought (about oneself or others).
For example, it may be a morbid thought for a very positive person or it could be a provocative thought for a modest or conservative individual. Then there is the classification of intrusive thoughts that involves harmless obsessions and compulsions. These obsessions and compulsions don't cause physical harm to the individual or others, yet they may cause a profound impact on an individual's functioning either because they cannot focus on anything else and therefore become less effective managing daily tasks or they can be time-consuming if there is a behavior that is carried out in a response to the obsessive thought (for example, an Obsessive Compulsive Disorder can present with a behavior that is carried out in response to the thought). When these types of intrusive thoughts become severe, an individual may not be able to hold onto jobs or care for others.
Out-of-character thoughts: These include thoughts that are atypical for one typical thought pattern or vies. For example, it may be a morbid thought for a very positive person or it could be a provocative thought for a modest or conservative individual.
Obsessive thoughts: This classification includes thoughts that are generally harmless and the nature of the thought is obsessive and persistent until a compulsive behavior follows (i.e. excessive washing hands).
Fearful thoughts: Intrusive thoughts that exacerbate a fear. They can be related to fear of dying, fear of heights, fear of job loss, any type of performance failure, etc.
Flashback thoughts: These types of thoughts directly relate to past memories or traumas. They may be easily triggered by environmental cues that cause the memory to surface. When the memory is pushed to the forefront of the mind, the brain and body respond as if the memory is occurring at the moment (for more clarity on flashbacks related to trauma, please read my blog post titled "trauma and the brain")
Harmful thoughts: Noted as the most severe form of intrusive thoughts, harmful compulsions relate to urges to harm oneself or others. These pose a great risk due to the amount of energy it takes to suppress these thoughts and the distress it causes individuals is also typically high.
I will say that I have had clients in the past who had severe childhood trauma have intrusive thoughts to harm themselves and others. Some of these clients denied distress related to the thought and the lack of remorse was one aspect that had to be addressed as part of trauma treatment. I've had other clients in the past who have experienced great distress related to their thoughts. Neither type of client acted on any of these thoughts. I want to emphasize that having an intrusive thought does not mean an individual will act on the thought. However, when intrusive thoughts are rated as severe and pose a threat to the safety of the individual or others, working with a professional is crucial for supporting and mitigating the risk until risk management can be calculated and coped with independently.
The breakdown of these thoughts is not meant for self-diagnosis or to scare anyone of these types of distressing thoughts. These types of thoughts are a NORMAL response to natural cognitive processes, psychological chemical imbalance, trauma, or life stressor and these thoughts can be treated.
Remember the questions to ask with any mental health-related issue are:
How often is this symptom impacting the way I think, feel, or function?
What is the level of distress it is causing me?
Here are some self-help tools for mild instances of intrusive thoughts:
Identify and categorize the intrusive thought (i.e. obsessive- related to ______, and _______).
Identify any patterns that would illustrate environmental triggers for the thoughts. Either internal distress or external stimuli. (i.e. Whenever I have a headache, the flashback follows, or "whenever I'm not distracted, I obsess about _____).
Tell yourself that the thought is a normal response to your brain's defense mechanisms. Although the thought is not helpful, the brain is responding to something that triggered the thought and behavior. It could be an emotion, an overcompensation of the need for control, or other reasons.
Having intrusive thoughts does not mean something is "wrong" with you. It means your brain and body are working through something and it's part of the natural human response. Recognizing that it's there and understanding why (i.e. natural stream of thought or a response to a trauma or psychological condition) can help ease the distress related to the thoughts.
Accept the thought and develop a coping plan (preferably with a professional if causing impairment or harm) on what to do anytime the thought arises. Typically grounding techniques, keeping a thought log, or having a support person to call can be helpful.
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