Intrusive vs. Obsessive Thoughts: What’s the Difference?
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At any given time, you are only partly in control of the thoughts that pop into your head.
Ideas, observations, judgments, memories, bits of music, and a thousand other types of mental jetsam are constantly flowing through your mind, according to research — and most of that is going on without your say-so.
A lot of these thoughts arise without you being aware of them. For example, a song might be stuck in your head for most of an afternoon before you take notice of it. But other times, an uninvited thought or image can pop into your head and immediately surprise you or catch your attention. Experts refer to these attention-grabbing thoughts as intrusive thoughts.
Nearly everyone experiences intrusive thoughts at some point in life. In general, they’re not a problem. However, for some people they can become very difficult to manage and can contribute to significant anxiety, distress, sadness, or self-doubt. These intrusive thoughts are known as obsessive thoughts, and they can be problematic for your mental health.
What Are Intrusive Thoughts?
“These are thoughts you didn’t try to generate, and that come in and affect your other thoughts,” says Richard Petty, PhD, a distinguished professor of psychology at The Ohio State University in Columbus. “These happen to everyone, and they can be positive, negative, or neutral.”
Intrusive thoughts happen to almost everyone from time to time, and they’re often harmless. “But sometimes they are negative in a way that catches our attention, often because they are against who we are or who we want to be,” says Jonathan Abramowitz, PhD, a distinguished professor of clinical psychology at the University of North Carolina in Chapel Hill.
According to Nebraska Medicine, intrusive thoughts are most often triggered by stress, and they may be frightening, disgusting, embarrassing, sexual or violent in nature, immoral, or blasphemous.
For example, someone who is very religious might notice themselves having thoughts they find blasphemous, or offensive to religion, Dr. Abramowitz explains. “Or you might have a thought about hurting yourself or harming someone else,” he says.
Although these thoughts may be uncomfortable or disturbing, for most people they simply pass through their head and don’t stick around, per Nebraska Medicine.
What Are Obsessive Thoughts?
For some people, the same unwanted and intrusive thoughts happen on a daily basis, and they feel anxious about them and that they can’t manage them. Experts sometimes call these types of intrusive thoughts obsessive thoughts.
According to research, obsessive thoughts are persistent and recurrent thoughts, images, or impulses that an individual feels are intrusive and inappropriate and that cause them significant anxiety or distress.
“These are intrusive thoughts that come up frequently, stick around, and upset people or interfere with their day-to-day functioning,” Abramowitz says.
An example of an obsessive thought, he says, is the persistent, intrusive idea that someone you love — a child or parent, for instance — may somehow be hurt or killed, despite no evidence that this idea is true. People who have obsessive thoughts may believe that even just thinking these thoughts will make them come true, which adds to their distress, he adds.
Obsessive thoughts are a hallmark symptom of obsessive-compulsive disorder (OCD), Abramowitz says. They can also happen among people with anxiety disorders, depression, post-traumatic stress disorder, or similar mental health conditions, he adds.
When Are Intrusive Thoughts Healthy, and When Are They Not?
The line between healthy and unhealthy can be difficult to draw, but it largely comes down to the effect that the thought is having on a person’s life, Abramowitz says.
Because it’s normal for people to have unwanted thoughts from time to time, the fact that such thoughts pop into your head is not by itself an indicator of a mental health problem, says Abramowitz.
If they’re not stuck in your head or causing you distress, you likely don’t need to worry, adds Dr. Petty. “Paying more attention to them can cause more problems,” he explains. “If they’re not bothering you, they’re not a problem.”
“[However], if you can’t sleep or function because of these thoughts, or if they’re interfering with your life, that’s when we would recommend some kind of professional intervention,” Abramowitz notes.
Abramowitz says that when assessing people with bothersome intrusive or obsessive thoughts, clinicians use questionnaires to measure the day-to-day impact on their everyday life, especially when diagnosing people with psychological conditions like OCD.
Questions may include: How often during the past week did you have this thought? How much distress did this thought cause you? Questionnaires may ask individuals to rate the severity of their intrusive thoughts and related distress on a scale from 0 to 4, according to research.
“A lot of this is subjective,” Abramowitz says. Two people might have the same intrusive thought, but one person might feel much more distress than the other. For instance, a religious person may find blasphemous thoughts to be very upsetting, while an atheist may not, he explains.
What to Do About Bothersome Intrusive or Obsessive Thoughts
If the thoughts you’re having are bothering you or preventing you from going about your daily activities, consider these expert-recommended tips.
1. Talk to a Mental Health Professional
Whether your unwanted thoughts are mildly bothersome or having a significant, negative impact on your life, Abramowitz recommends speaking with a mental health professional if you haven’t done so already. Depending on the nature and frequency of your thoughts and their impact on your life, you may have a mental health condition like OCD or an anxiety disorder.
In cases like these, a mental health professional could recommend a number of professional therapeutic strategies for you, such as psychotherapy (aka talk therapy) or medication. Many of these strategies have been used to help people who have obsessive or intrusive thoughts as the result of OCD, anxiety disorders, or similar conditions, Abramowitz adds.
Even if you don’t have a mental health condition like OCD, if you would like help managing certain unwanted thoughts, strategies like psychotherapy can still be beneficial for you. Therapy can be helpful for anyone, and you don’t have to have a mental health condition to try it.
2. Consider Trying Cognitive Behavioral Therapy
Research has found that cognitive behavioral therapy (CBT) in particular can be very helpful for anyone struggling with unwanted intrusive or obsessive thoughts, including those with generalized anxiety disorder or OCD. CBT is a common form of psychotherapy geared toward changing unhelpful thinking patterns to more constructive ones.
Abramowitz says that this therapy will likely involve some basic education about the mind and its relationship to intrusive thoughts. “Everybody has these thoughts, so you’re not terrible for thinking them — it’s just what the human mind does,” he says. When a person understands that these thoughts are normal and natural, this knowledge can help reduce the distress they feel when unwanted thoughts pop up, he explains.
For people with OCD in particular, one of the most effective treatments is a form of CBT called exposure and response prevention (ERP) therapy. During ERP sessions, which are guided by a mental health professional, people gradually face situations designed to trigger their obsessions (called exposures) in a safe and controlled setting, according to McLean Hospital.
Often, ERP sessions will begin with low to moderately anxiety-inducing exposures, and over time, therapists and patients will work up to more challenging exposures.
Importantly, ERP doesn’t completely remove thoughts or situations that cause distress; it equips individuals with helpful skills that they can use to cope when a distressing situation arises, rather than allowing their obsessions and compulsions to take over, per McLean Hospital.
3. Practice Acknowledging Unwanted Thoughts When They Happen
If an unwanted thought pops up in your head, try acknowledging the thought, rather than immediately trying to push it away. According to Nebraska Medicine, you can try saying to yourself, “There’s that thought again,” and redirecting your mind to the present moment as often as you need to, rather than dwell on the thought.
With time and practice, this technique can help your unwanted thoughts fade more quickly and lessen their power in your mind, per Nebraska Medicine.
4. Write Down Unwanted Thoughts and Physically Discard Them
For people with intrusive thoughts not caused by OCD or a related mental health condition, research shows that literally throwing away your bothersome intrusive thoughts may be another helpful strategy.
In a study that Petty co-authored, which was published in the journal Psychological Science, people wrote down something they didn’t like about their appearance on a piece of paper. When they then ripped up and threw away the piece of paper, this helped remove that negative thought from their mind.
“Physically discarding a thought allowed people to mentally discard the thought as well,” he says.
However, this approach is likely not ideal for people with OCD due to the nature of obsessions and compulsions.
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