A common and highly distressing experience for OCD patients is the belief that their unwanted thoughts suggest they themselves are bad, immoral, or have dangerous characteristics. When they first come for treatment many are convinced that if they’re having particular disturbing unwanted thoughts, they must secretly desire to do what those thoughts suggest.
Luckily, one of the most crucial aspects of OCD treatment is distinguishing an intrusive thought from an intention. Reducing people’s self-doubt, shame, and fear through understanding this distinction may help them move forward.
What Are Intrusive Thoughts?
Intrusive thoughts are spontaneous mental images, ideas, impulses, or mental images which cause you emotional distress. They usually feel “intrusive” because they are contrary to what you value, believe in, and feel that your identity really is. Some examples of intrusive thoughts include:
- Fear of harming a loved one.
- Violent or disgusting mental images.
- Sexual thoughts you find disturbing or unpleasant.
- Religious and moral issues.
- Doubts about relationships, your identity, or your own safety.
In research and practice, intrusive thoughts have been found to be very prevalent. The majority of people will experience some intrusive thoughts throughout their lives. However, those with OCD assign greater significance to these thoughts and are driven to endlessly try to understand why the thought is there.
What Are Intentions?
An intention is very different from a thought.
Intentions involve conscious decision-making, planning, desire, and purposeful action. When someone intends to do something, they actively choose a course of behavior and move toward carrying it out.
Intrusive thoughts, on the other hand, are automatic and unwanted. They appear without invitation and often create fear precisely because they contradict what the person truly values.
For example:
- An intrusive thought might say, “What if I hurt someone?”
- An intention would involve wanting to harm someone and taking steps toward doing so.
The emotional response is often one of the clearest differences. People with OCD are usually horrified by their intrusive thoughts. The distress itself is often evidence that the thought is inconsistent with their true values and intentions.
Why OCD Blurs the Line And What Can Be Done To Help
There’s something about OCD that fools you into believing your thoughts are actually important, or true.
Clinicians sometimes call this thought-action fusion: a cognitive bias whereby an individual believes that having a certain thought makes that thought and its associated behavior equivalent, or more likely to occur.
As a result, you may begin asking yourself: “Why would I even have this thought if I didn’t mean it?” “What if this thought is actually a latent wish of mine?” “What if I am secretly a monster?” “What if I’m not a good person?” This is how hours are wasted ruminating, getting reassurance, checking andavoidance, all of which solidify your OCD.
How Therapy Helps
In OCD treatment one of the main aims is not to prove the intrusive thought is harmless, but to find and maintain a more acceptable relationship with uncertainty and learn that thoughts don’t need testing. Through ERP-the ‘treatment of choice’ for OCD-clients learn to sit with intrusive thoughts without acting compulsively, and the brain learns that thoughts are not a message, a warning, or a hidden meaning, but only a passing event in the brain.
Most clients, with therapy, come to accept certain important truths; that:
- Thoughts aren’t actions
- Thoughts aren’t intentions
- Thoughts aren’t predictions
- Thoughts aren’t clues to who we are
- Uncertainty is normal
When we stop treating intrusive thoughts as having proof value then they quickly become non-problematic for the client. If we consider your mind a machine capable of producing tens of thousands of thoughts per day, many are helpful, many are silly and some are downright strange. The very fact that a thought is present is not what dictates its relevance. Rather, it’s what you do with it. When people begin to untangle intrusive thoughts from what they actually want, fear and shame decreases significantly and their confidence in handling OCD greatly increases.
In Conclusion and Finding Support
Remember that having a frightening thought does not mean you want to have the thought or that you will believe, want or do it. In fact, the reason you fear these thoughts is that they are contradicting your beliefs.
Through therapy, you can form a more functional way of relating to your thoughts, stopcompulsions and gain assurance that you can have the life you want to live, rather than a life dictated by OCD-induced fears. If you are interested in learning more about intrusive thoughts and OCD, I recommend looking up resources from the Cleveland Clinic, NHS Inform and the International OCD Foundation.
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