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  • Writer's pictureNicole Ambrose, LCSW

Intrusive Thoughts: Why We Have Them and What To Do About It

Have you ever experienced this?? You’re driving into work as you normally do and suddenly you’re hit with a frightening thought… “What if I were to crash my car on purpose?” Or maybe you’re holding your newborn and for a split second you think… “What if I drop my baby right now?”

Pretty scary that we are capable of thinking about harming ourselves or others. You don’t have actual intent to carry out any harm, but it’s absolutely terrifying that you even had a thought about it. Of course, if you do have a plan or intent to harm, we’re no longer talking about intrusive thoughts and it’s best that you seek out immediate help by calling 988 or 911.

Those are not the only types of intrusive thoughts though. Have you been hit with this kind of thought… “What if I’m gay and have been lying to myself for my whole life?” Or you’ve caught yourself wondering if you’re a bad person because you’ve broken some kind of rule strictly enforced by your religion.

If you can’t relate to those examples, have you ever had the thought “What if I have cancer or some other life-threatening illness that is going undetected by my doctor?” Again, thoughts that pop up out of thin air about serious topics like sexuality, religion, or health can be tormenting to have for certain folks.

The most common type of intrusive thoughts are those surrounding self doubt and potential mistakes. Thoughts like “What if I’m not actually good at my job and I’m just fooling everyone?” Or “What if I left the coffee pot on?” Or “What if I forget how to breathe?” Or “What if I do or say something inappropriate that embarrasses me?” We could go on and on with these.

What Are Intrusive Thoughts and Why Do We Have Them?

As humans, our mind is what sets us apart from other species, but sometimes our ability to think and overthink is more of a detriment than a gift. Researchers have estimated that we think between 60,000-70,000 thoughts a day!! That’s a lot to manage. Any one of those could be an intrusive torpedo that sends you spiraling in fear, so you have to learn to identify them.

Intrusive thoughts are unwanted, repetitive thoughts, images, or urges that can cause anxiety or distress. These thoughts are a common experience and most people have had at least a few throughout their lives. Although, the most reported types surround violence, harm, health, religion, sexuality or sexual acts, and self doubt that does not mean there aren’t other categories of intrusive thoughts.

There is not always a clear cause for intrusive thoughts. Some just happen at random and others may be triggered by the circumstances a person finds themselves in. For many people, intrusive thoughts are nothing to be concerned about. They are infrequent and exit the mind just as quickly as they entered. But this is NOT how it goes for everyone!

If you are a person that experiences intrusive thoughts very regularly, it may be a sign of an anxiety disorder, like Obsessive-Compulsive Disorder (OCD), Post-Traumatic Stress Disorder (PTSD), substance use disorders, or eating disorders. Those with other issues like dementia, Parkinson’s Disease, and traumatic brain injuries may also experience recurring intrusive thoughts.

When intrusive thoughts become more excessive and persistent, they can be extremely worrisome and debilitating. Given the nature of the thought, some people are flooded with fear, guilt and shame; so much so that they enter an impossible war within themselves to try to control and stop the thoughts only to find that this just makes them worse. So what can you do to free yourself from the mental madness?

Strategies For Coping With Intrusive Thoughts

Firstly, remember that thoughts are not facts. We are all capable of having thoughts that DO NOT have any deeper meaning at all. Having a thought does not mean we’ll act on it. A thought doesn’t necessarily reflect or mean anything about who we are as people either. In fact, many intrusive thoughts depict the exact opposite of our true beliefs and values and that is what makes them so scary.

You do not want to go down a rabbit hole with an intrusive thought, so here’s what you do instead:

Step 1: Acknowledge The Thought

It’s natural to want to push the thought away - to suppress it or ignore it - but this is almost guaranteed to make it louder in your mind. Your resistance acts like fuel on a fire. You have to acknowledge it if you want to move past the thought.

A good indicator to help you identify and acknowledge an intrusive thought is the preface “What if…” This is often how an intrusive thought begins. When you notice one, simply say to yourself “That was an intrusive thought” and move on to step 2.

Step 2: Practice Mindfulness

This is the practice of being present in the moment without judgment. Intrusive thoughts can easily send you into the abyss of your mind if you engage and try to find the deeper meaning of the thought. This will most definitely make your anxiety 1000% more intense.

Instead, focus on grounding yourself in the present moment. You can do this by bringing your attention to your breath with a breathing exercise, or by gently patting yourself down to bring your focus to the body and away from the mind. You can also bring awareness to your surroundings by listing what you can see, hear, smell, taste, and feel as a way to ground yourself. If the intrusive thought persists despite your mindfulness efforts, move on to step 3.

Step 3: Practice Cognitive Defusion

This is similar to mindfulness, but is essentially a fancy term for distancing yourself from your thought process. It allows you to become more objectively aware of your thinking without getting caught up or clinging to any particular thought. There are many different strategies that you can use to create distance from your intrusive thoughts, but here are a couple fan favorites that you can use just about anywhere that an intrusive thought may come up.

  • Imagine your thought is a pop-up on your computer screen. While it may be alarming and catch you off guard, you can simply acknowledge it as a pop-up and close it out much like you would on your laptop or phone.

  • Imagine a river running through your mind. Place each intrusive thought on a leaf and send it down the river. Observe it as it gets further away until it disappears completely.

  • If you struggle with visualizations, then try this one. After you identify and acknowledge the intrusive thought, simply thank your brain for bringing it up and give yourself permission to move on. Sometimes the brain pulls up our fears as a way to help us avoid potential hurt or harm. Even though this approach causes more distress, we can express gratitude for the brain’s efforts and let it go.


Intrusive thoughts are no walk in the park! They happen to us all as a part of our human experience, but we can learn to live with them differently. We are capable of dispelling and overcoming certain fears. If you are someone that experiences intrusive thoughts often and have a hard time coping on your own, seek out professional support and guidance with an expert therapist. You don’t have to take them on by yourself in fear of how you might be viewed if others knew the contents of your thoughts.

Nicole Ambrose, LCSW specializes in anxiety treatment and can provide you with a nonjudgmental space to unload and weed through your thoughts.

There are several methods of therapy that can benefit you - things like Exposure Therapy, Dialectical Behavioral Therapy (DBT), and Cognitive Behavioral Therapy (CBT).

Nicole can help you develop strategies to address your symptoms as well as improve your quality of life.

Call us on 954-391-5305 for a complimentary consultation today!


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