Intrusive Thoughts Therapy
Unwanted intrusive thoughts are extremely common and very often these thoughts are so unacceptable or embarrassing for the person that they prefer not to tell anyone about them, not even a family member or a close friend.
In contrast, depression or anxiety have become better understood and more acceptable mental health struggles, thanks to decades of awareness campaigns by mental health advocates and psycho-educational reforms in educational settings.
However, people still feel that opening up about their scary thoughts (especially with violent or sexual content) will stigmatize them as dangerous or having a “sick mind,” At the very least they feel rightfully judged by others for lacking moral self control. This shame and fear often makes them bear their suffering in isolation.
The truth is millions of people have disturbing and frightening thoughts. Some more occasionally, while others feel constantly bombarded and rendered helpless by the condition. Unwanted intrusive thoughts haunt people who have strong moral values and who live their lives with integrity and empathy for others.
Scary thoughts or disturbing mental imagery is not a sign of a slow erosion of one’s values or an increased readiness to inflict pain on others.
How do intrusive thoughts start?
Typically, its starts with an external trigger, for example a news report on a stabbing attack or child abuse. This elicits strong emotional reactions and heightens our moral sensitivity. The next time we cut up vegetables or take care of a young child, our intensified emotional pathways retrieve the associations (a sharp knife, a sleeping child) and we immediately feel intruded by the unwanted intrusive thoughts or images that we could commit such repulsive acts ourselves.
Our rational mind tells us: “You would never do such a thing,” but it doesn’t seem to help anymore. The unwanted intrusive thought has entered your mind and got stuck there.
To make matters worse, the more we argue against it, the more it increases in intensity. In other words, the conundrum we are facing is that the more mental energy we expend to fight the unwanted intrusive thought or imagery, the more it increases its stickiness.
What does the research say?
There is a lot of research out there explaining the brain activities underlying unwanted intrusive thoughts. The simple take away of this research is that our thought process privileges heightened emotional content over rational explanations.
Originally, our brain was designed to keep us safe. Registering a strong emotional reaction signals danger. As human brains evolved we became more sophisticated in differentiating between actual dangerous stimuli and abstract thoughts about potential danger. A thought itself is never dangerous, it is just a thought.
However, if a thought is followed by an anxious feeling, your brain equates an abstract thought with actual danger. When fearful pathways are triggered repeatedly, they become automatic. This is the fertile ground for unwanted intrusive thoughts to flourish.
The paradox about unwanted intrusive thoughts is that the more you try to push them away, the more they get stuck. This is sometimes referred to as the ironic process of the mind. Trying not to think of something or pushing away an intrusive mental image has the effect of bringing it on even stronger.
Research has made abundantly clear that “appeasing” unwanted intrusive thoughts with reassuring words is not effective. Self-talk such as: “You would never do that,” “Don’t worry, you are such a kind person,” “This would never happen to you” aims to remove discomfort and dispel the fear. We are drawn to this coping mechanism of self reassurance because it feels rational and provides a brief moment of comfort.
Unfortunately, however, reassurance only fuels our worries and the short relief is an illusion. In fact, the unwanted intrusive thoughts are getting even more intense by attempts to self reassure. It’s like your worried self and your reassuring self are in a sparring contest, egging each other on and increasing your exhaustion, insecurity and helplessness.
What are the themes of intrusive thoughts?
Common unwanted intrusive thoughts revolve around themes that are often experienced as extremely scary or shameful and often morally repulsive.
The variety ranges from existential thoughts, like questioning reality, the fear of living in a shared illusion, blasphemous religious thoughts, forbidden sexual thoughts, thoughts of violence, like inadvertently harming others or oneself, morally repugnant thoughts and somatosensory intrusions.
Unwanted intrusive thoughts seem to wax and wane. Their frequency and intensity depends on a number of factors, both body and mind related. People report that they are much more vulnerable to unwanted intrusive thoughts when their sleep patterns are irregular, they experience stress or suffer from labile mood states (irritable, disappointed, lonely, feeling down).
Prescription and recreational drugs can also heighten the stickiness of unwanted intrusive thoughts. Some prescription psychoactive meds, caffeine, steroids, marijuana and alcohol can have an exacerbating effect on this stickiness of the mind.
How can therapy help?
Treatment and recovery has to focus on unlearning many of the unhelpful habits and coping mechanisms that have become so ingrained over time.
A preliminary but necessary step is to gain more psychoeducational expertise of the underlying brain functions that are activated by unwanted intrusive thoughts. Knowledge is power. The better you are informed the more you regain your agency in the process. The second and core part of recovery is to actively practice new ways of reacting to your unwanted intrusive thoughts.
This will consist of becoming aware of automatic emotional reactions, calling out secondary gains that keep you stuck and expanding the repertoire of your inner voice. In essence this consists of shifting unhelpful “reassurance talk” to a practice of non engagement with your unwanted intrusive thoughts.
Learning to not engage can seem hard at first. It requires a readiness to explore and a curiosity for our fascinating but stubborn human condition. It also requires expert help to guide you and help you push through in moments of doubt. The treatment certainly requires your commitment, but the good news is, it’s extremely effective. You will be able to free yourself of your scary and shameful unwanted intrusive thoughts and you will build a lifelong friendship with your own inner strength that allows you to do so.
If you feel that you’re struggling with unwanted intrusive thoughts, treatment at Vienna Praxis can help you regain your agency. Feel free to contact us for a free 15 minute consultation session with one of our therapists.