"The mind is not a vessel to be filled, but a fire to be kindled." — Plutarch
Intrusive thoughts are those unwelcome ideas or images that appear suddenly in your mind. They can manifest as offensive notions, often involving violence, explicit sexual content, or socially inappropriate scenarios. These thoughts might be directed towards loved ones, people around you, or even yourself.
Some common examples of intrusive thoughts include:
A sudden image of causing harm to your child or loved one, despite having no intention to do so.
Thoughts about engaging in inappropriate sexual acts with someone you're not attracted to.
A sudden urge to yell obscenities or expose yourself in public.
Fleeting and unexpected urges to jump when standing on a bridge.
Intermittent intrusive thoughts are a common and normal occurrence. Research indicates
that over 50% of people with no history of suicidal thoughts have experienced the urge to
jump from a tall building or bridge, a phenomenon referred to as the "high place phenomenon" (Hames et al., 2012). Intrusive thoughts have also been extensively studied in new mothers, revealing that nearly all women have had such thoughts of harming their baby at some point after birth (Brok, 2017).
Those more susceptible to anxiety are likelier to experience intrusive thoughts (Hames, 2012). While these thoughts can be normal, they are more prevalent in certain psychiatric disorders, including anxiety disorders, major depression, bipolar disorder, and schizophrenia.
Why do intrusive thoughts occur?
Why does a normal brain produce seemingly abnormal and unwanted thoughts? Some researchers hypothesize that these thoughts may be a form of misinterpreted warning signals (Hames, 2012).
For instance, when a mother experiences an undesired urge to drop her newborn baby, it could be her brain's way of warning her to hold on tighter to prevent an accident. Similarly, the unexpected urge in the "high place phenomenon" may prompt you to step back from the edge, potentially safeguarding you from the feared situation.
Importantly, these thoughts do not predict an increased risk of acting on the feared thought or urge. In fact, research has shown that there's no increased risk of violence in mothers with isolated intrusive thoughts of harming their children (Brok, 2017).
What to do if intrusive thoughts become an issue?
When intrusive thoughts become severe, recurrent, and anxiety-inducing, they are termed obsessions. Obsessions are often associated with obsessive-compulsive disorder (OCD). People with OCD frequently engage in compulsions—behaviors or mental rituals aimed at reducing anxiety linked to the obsessions.
For those experiencing normal, transient, non-distressing intrusive thoughts, no treatment is necessary. It's crucial to recognize these thoughts as normal and avoid over-pathologizing them, which could lead to unnecessary anxiety. Consider these thoughts as brain hiccups. As frightening as they may seem initially, intrusive thoughts will subside if you accept them and let them pass without fixating on them or trying to push them away.
If intrusive thoughts escalate to the level of obsessions, various treatments can be beneficial. Medications like selective serotonin reuptake inhibitors (SSRIs) and other antidepressants have shown effectiveness in treating obsessions. Cognitive-behavioural therapy (CBT), particularly exposure and response prevention (ERP) along with anxiety management strategies, can also be highly beneficial.
1. Hames, J. L., Riberiro, J. D., Smith, A. R., & Joiner, T. E. (2012). An urge to jump affirms the urge to live: An empirical examination of the high place phenomenon. *Journal of Affective Disorders*, 136, 1114-1120.
3. Brok, E. C., Lok, P., Oosterbaan, D. B., Schene, A. H., Tendolkar, I., & van Eijndhoven, P. F. (2017). Infant-related intrusive thoughts of harm in the postpartum period: A critical review. *J Clin Psychiatry*, 78, e913-e923.
Dr Rachel Graham
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