How Do I Stop My Intrusive Thoughts?
As a therapist specializing in the treatment of Obsessive-Compulsive Disorder (OCD), this is by far one of the most common questions I hear.
Most, if not all, individuals experience intrusive thoughts - those unwanted, disturbing thoughts that catch you off guard, Ever look over a balcony and think "woah...that's a long way down," and imagine yourself falling? Or think, "What if I jumped in front of that moving train?"
While most individuals are able to dismiss these thoughts as annoying, those individuals with OCD have a difficult time doing so. They will appraise these thoughts and images as meaningful, question the kind of person they are for even having them in the first place, and put up their metaphorical gloves to try and fight them via the use of rituals (both mental and physical). Unfortunately, the more they fight a specific thought, the more it shows up, the more intense it becomes, and their ability to find enjoyment in the simplest of pleasures becomes compromised. It therefore makes sense that one of their main questions, and goals, in therapy is "How can I get rid of my intrusive thoughts?!"
The short answer: "We can't." (I know - not the answer you were looking for).
The long answer: "We can't, but we can certainly learn skills to turn down their volume, reduce their frequency, and have them take a back seat so they are no longer serving as a barrier to creating a meaningful and productive life." Yes, this is possible!
Here's how we achieve this goal together:
Step 1 is reminding yourself that the bizarre, unwanted, and intrusive thoughts you experience are no different than the bizarre and unwanted thoughts of someone without OCD. Whether someone will admit it or not, we all have strange thoughts from time to time. Therefore, intrusive thoughts themselves are not the problem - its your response to them that will determinate whether these thoughts become stuck, or are able to pass through your mind more freely.
Step 2 is remembering that no one has full control over their thoughts. There is no way to communicate with our minds that we only want to have thoughts from column X, and to leave out thoughts from column Y. While we are able to consciously think about specific topics on the spot, for example thinking about how we want to plan our day, or running through a list of potential restaurants to meet a friend, there are many, many thoughts that spontaneously appear that are out of our control. Sometimes these thoughts actually work to our benefit - ever feel stumped on a problem when all of a sudden the answer comes to you when you least expect it? Other times, however, these spontaneous thoughts can be upsetting, intrusive, and completely unwanted. Think of them as junk mail thoughts, similar to the annoying spam E-mails that crowd our inbox, even though we don't want them.
Step 3 is learning, and practicing, ways to become more open to the presence of uncomfortable thoughts and feelings. This does not mean working towards developing a liking to the content of intrusive thoughts, or trying to prove them right or wrong. It's about making room for them to show up, to recognize them as annoying and uncomfortable, while allowing them to take a back seat as you pursue something more meaningful than analyzing their content. Back to the junk mail analogy - responding to intrusive thoughts with rituals is like answering a spam E-mail that says, "you just won a free cruise!" Instead of opening this E-mail and responding to it, it's probably best to leave it alone, and let it sit in your spam folder. The same applies to unwanted, intrusive thoughts; the best approach is to allow these thoughts to be present without entertaining them, analyzing them, or spending valuable time answering them.
Step 4 is to practice intentionally thinking your intrusive thoughts, or intentionally calling up intrusive images - Woah(!), that can't seem right, can it? By intentionally bringing to the surface your obsessional content, and resisting any attempts to ritualize, you are engaging in the gold-standard OCD treatment called ERP, in which you are allowing your mind to practice step 3 -learning that it is okay to be in the presence of these thoughts, that thoughts/images themselves are not harmful, and that you can continue to lead a productive life despite them coming along for the ride. Holding intrusive thoughts in your mind is not the same as dialoging with them. It's like reading the subject line of a spam E-mail over and over, without opening it, responding to it, and questioning its validity - you're simply noticing it. Mindfully noticing thoughts, without fusing with their content, is a skill taken from Acceptance and Commitment Therapy (ACT), which is a great supplement to ERP.
Step 5 is to engage in meaningful experiences, even with your intrusive thoughts present. The OCD bully unfortunately likes to take you out of the moment, and have you miss out on pleasurable experiences. However, this does not mean you need to fall for OCD's mission. It takes practice, but remind yourself that engaging in an activity and only finding 50% enjoyment (due to the discomfort of intrusive thoughts), is better than continuously giving in to OCD symptoms and missing out on these moments completely.
Treatment for OCD takes time, hard work, and determination, but know that if you invest the time, energy, and discomfort now, you will set yourself up for a much more meaningful and enjoyable future.
Need support and guidance in your treatment? Check out the International OCD Foundation and look for a provider in your area.
DISCLAIMER: The blog posts shared on www.StacySmithCounseling.com contain the opinions of Stacy Smith, MS, LPC, and do not reflect the opinions of any organizations or affiliates. While Stacy is a licensed mental health professional, all blog posts on her site are for informational purposes only, and are never a substitute for professional advice catered to your individual needs. Stacy Smith is not liable for any diagnosis, treatment plans, or decisions made based on the information presented on this website.