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OCD and Intrusive Thoughts: Signs, Symptoms, and Treatment

John has a Ph.D. in psychology and teaches college courses in human behavior. He writes about air and space, human behavior, and mysticism.

Do you suffer from intrusive thoughts?

Do you suffer from intrusive thoughts?

What Are Intrusive Thoughts?

Do you sometimes have embarrassing, frightful thoughts that just pop into your mind for no apparent reason?

Do these thoughts contain imagery of harming yourself or someone close to you?

Are you ashamed of these thoughts and afraid to talk about them because you fear being judged?

If you answered yes to these questions, you may suffer from a condition called intrusive thoughts.

In plain speak, intrusive thoughts are a series of words or images (or both) that enter your mind against your will. They sometimes come rapidly and often in flashes.

If you are experiencing a great deal of anxiety or are under unusual stress, intrusive thoughts can become exacerbated. These symptoms are commonly explored as part of anxiety counseling and therapy.

Intrusive thoughts can come in a variety of themes. Generally speaking, however, these themes fall into one of three distinct categories, according to the most recent research:

Note: You may have some or none of these thoughts. Each person experiences intrusive thoughts differently. Think of these in categories in broad terms.

Categories of Intrusive Thoughts

Category I: ViolenceCategory II: SexualCategory III: Spiritual

Violent Thoughts

Sexual Thoughts

Anti-Spiritual Thoughts

Violence against others

Inappropriate thoughts

Violence against God

Violence to Self

Violent sexual behavior


Animal violence

Inappropriate relationships

Violence/Intimacy with Saints

It is not uncommon to suffer from violent thoughts.

It is not uncommon to suffer from violent thoughts.

1. Thoughts Involving Violence

Under this category, violent thoughts can pop into your mind about harming someone close to you. This could mean striking the person or using an object to inflict pain.

Violent thoughts can also involve something bad happening to someone close to you in the form of an accident.

An example might be your child being hit by a car or your spouse slipping on ice.

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Here are some common themes researchers found when surveying college students:

- Harming elderly people

- Wishing harm to someone close

- Strong impulses to harm a child or animal

- Impulses to verbally and/or physically abuse someone.


2. Thoughts Involving Sexual Behavior

This category in particular brings a great deal of shame to the person suffering from intrusive thoughts.

Words and imagery connected to this category usually involve some type of sexual aggression or inappropriate behavior with others. An example might be touching a stranger.

Here is what researchers found as general themes for some people in this category:

- Kissing parents, strangers, or other inappropriate people

- Intercourse in different forms with the above mentioned

- Violence involved with intercourse


3. Anti-Spiritual Thoughts

Anti-spiritual thoughts are also called "blasphemous thoughts." These thoughts run counter-intuitive to a person’s spiritual beliefs. If you identify with or were raised in the Christian faith, your intrusive thoughts may center on violations against God.

If you identify or were raised in the Jewish or Muslim faith, your intrusive thoughts may involve compliance issues with laws or rituals.

The research is somewhat scarce here but generally speaking, anti-spiritual thoughts can contain the following imagery:

- Sexual thoughts about the identified creator, saints, or religious leaders

- Thoughts of being possessed by an evil force

- Repeated thoughts of blasphemous behavior during religious activities

Note: The important consideration here for all three of these categories is the thoughts come during odd or inappropriate times and simply “appear” in the mind. If you have a phobia, you may experience a momentary image of the object/situation you fear.


What Causes Intrusive Thoughts?

There are a number of different conditions that can cause you to have intrusive thoughts. Obsessive-compulsive disorder is considered to be the main cause of this problem in most people. Many famous people have OCD and have struggled with some of the “bad thoughts” described above.

It is important to state however that intrusive thoughts can also happen if you struggle with depression, suffer from different forms of body dysmorphic disorder or have another type of anxiety disorder.

Let’s walk through several of the more common mental health issues where we see intrusive thoughts.

Note of caution: A medical issue and/or prescription medication can act as the source behind intrusive thoughts and other behaviors.

Five Main Causes: Intrusive Thoughts

Common Features of Each Disorder as Outlined in Diagnostic and Statistical Manual of Mental Disorders (DSM)

OCDPTSDPanic DisorderGADSocial Phobia

Repetitive Behaviors

Reliving Event

Breathing Fears

Excessive Worry

Social Fears



Cardiac Fears

Parental Worries

Fear of embarassment


Traumatic Event

Fear of Dying

Child Worries



There can be other causes for intrusive thoughts not mentioned here. It is important that you get evaluated by your physician to rule out medical causes.

— Dr. John D. Moore

Mental Health Causes


If you have OCD, you are more likely to have intrusive thoughts. Here, we are talking about having obsessive thoughts that are repetitive in nature. As a coping mechanism, you may feel a compulsion to engage in a certain activity. An example might be tapping a spoon against your teeth five times to purge the thought. Many adults with OCD had lived with this disorder since childhood.

Post-Traumatic Stress Disorder (PTSD)

If you have PTSD, it is common to have “flashbacks” to the traumatic event. This causes you to relive that moment in a way that seems like the event is happening “in the here and now”. You may have nightmares or daydreams about the event which can be terrifying. The mental imagery of the event can be overwhelming and hard to shake. Intrusive thoughts associated with PTSD are often triggered by something or someone and can strike without notice.

Panic Disorder

If you suffer from a panic disorder, your intrusive thoughts can take on a variety of forms. Generally speaking, however, you may have worries about having an “attack” and be consumed with difficulties breathing. The mental imagery involved for those with panic disorders often contain visuals of not being able to breathe. Paradoxically, these thoughts can act as a trigger for an actual panic attack.

Generalized Anxiety Disorder

This disorder is also referred to as “GAD”. If you have GAD and suffer from intrusive thoughts, the essential characteristic is likely over-powering worry about the health and well-being of someone close to you. An example might be a parent having a stroke as a result of not taking prescribed medication. The only way to calm the worry of the person with GAD is to telephone the loved one or physically visit them to check on their well-being.

Social Phobia

This disorder is also known as a social anxiety disorder. If you are a person who has social phobia, your primary fear relates to being in a situation where you embarrass yourself and are unable to escape. Intrusive thoughts usually focus on these kinds of scenarios. An example might be walking through the mall and urinating on yourself in front of others.

Other Causes

Intrusive thoughts can also occur as a result of other mental health issues. These include but are not limited to:

- Major depressive disorder (not the same as suicidal ideation/thoughts)

- Schizophrenia (usually involve delusions of thoughts being “inserted” from elsewhere.

- Post-Partum Depression (usually thoughts about harming a newborn baby)


Treatment for Intrusive Thoughts

In order to be treated for intrusive thoughts, you must first visit your physician to rule out potential medical causes. Assuming there are none, treatment for intrusive thoughts can occur through a variety of therapies.

These therapies include:

Cognitive Behavioral Therapy (CBT)

CBT for intrusive thoughts involves challenging irrational thinking. CBT is one of the primary forms of treatment for people who suffer from various anxiety disorders, including OCD. It is important to find a therapist trained CBT in order to gain the maximum benefit.

Exposure Therapy

This particular treatment approach involves directly facing a given fear and remaining with the associated feelings (i.e. anxiety, shame, fear) until the intensity of the feelings subsides. Research shows this to be an effective treatment approach for intrusive thoughts however, many people do not opt for this approach because it means being “exposed” to the fear trigger.


People who have severe instances of intrusive thoughts benefit from medication therapy. Specifically, this means taking anti-anxiety or anti-depression pills (or both). There has been enough clinical research to suggest that certain types of anti-depressant medications work well at combatting OCD; the primary causal condition for intrusive thoughts.

Don't Suffer Alone

If you suffer from intrusive thoughts, you know just how difficult it can be to talk about some of the things you are thinking. This is particularly true if some of the mental imagery involves forms of violence. One of the best things you can do is to speak with your medical doctor about these issues. You can also talk to a mental health therapist. They will not judge you, and anything you say must be legally kept confidential.

The good news is that your intrusive thoughts can be treated so that they ultimately stop. Why not make a call today to your healthcare provider and create positive change?

This content is for informational purposes only and does not substitute for formal and individualized diagnosis, prognosis, treatment, prescription, and/or dietary advice from a licensed medical professional. Do not stop or alter your current course of treatment. If pregnant or nursing, consult with a qualified provider on an individual basis. Seek immediate help if you are experiencing a medical emergency.


Mary Hyatt from Florida on February 22, 2015:

The only time I've ever had bad intrusive thoughts that just sprung into my head was when I took a medication for stopping smoking. I also had terrible nightmares while taking the medication. I stopped taking it. Very interesting article.

John Lannoye (author) from Chicago on November 30, 2014:

Glad you liked!

John Lannoye (author) from Chicago on November 30, 2014:

Hi, Robert. Thanks and yep, I did for sure. Hehe. Glad you stopped by!

Hannemarie on November 30, 2014:

Great hub!!! very interesting.

Robert Levine from Brookline, Massachusetts on November 30, 2014:

He mentions that in the hub, schoolgirlforreal.

John Lannoye (author) from Chicago on November 30, 2014:

Thanks, Schoolgirlforreall! I am glad you stopped by :)

John Lannoye (author) from Chicago on November 30, 2014:

Thanks, CrisSp! Yes, I thought the emergency contact info might be helpful in case someone might be in crisis. I am glad you stopped by!

Rosemary Amrhein on November 30, 2014:

You have to be careful what psychiatric meds doctors give; some cause these. Great hub.

CrisSp from Sky Is The Limit Adventure on November 30, 2014:

Interesting and very informative hub. I like that you have thought of putting a note at the end of your hub on where to call for help when needed.

Voting up and sharing.

John Hollywood from Hollywood, CA on November 29, 2014:

I've never read anything like this. I must say this is one of the best hubs I've ever seen!

John Lannoye (author) from Chicago on November 29, 2014:

Thanks, Em for stopping by. A lot of people suffer from this for sure!

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