Imagine you are sitting in bed relaxing when out of no where you have an unsettling thought. The thought feels random and unprompted, which leads to fear and anxiety. This can feel uncomfortable and may lead to feeling guilty for having the thought. While these thoughts are, in reality, of no harm to you, they still can cause fear, anxiety, depression, etc.

What are Intrusive Thoughts?

Intrusive thoughts are unwanted thoughts that pop into the head with no warning. These intrusive thoughts can oftentimes be repetitive and can be distressing 1. While anyone can experience intrusive thoughts, those who deal with anxiety or depression are the most likely to experience chronic intrusive thoughts. These thoughts may occur in statements, images, sounds, etc. Intrusive thoughts seem to become stuck in your mind and can cause distress.

Types of Intrusive Thoughts

A common type of intrusive thought relates to safety and risk, which may involve thoughts or images involving being harmed, harming others, or loved ones being harmed. Mother’s may think of their baby being harmed, especially when a new mother. Another common thought involves inappropriate thoughts regarding sex.

For those who deal with Post-Traumatic Stress Disorder (PTSD), they may deal with intrusive thoughts related to the event that led to PTSD. Some examples of this could be experiencing war firsthand, being sexually assaulted, living through a natural disaster, etc. This may involve flashbacks, such as images, sounds, smells, and tastes experienced during the traumatic event.

Less disturbing thoughts may involve self-critical statements, such as ‘you look terrible today,’ or ‘they don’t like you’. These thoughts, while less distressing than those previously mentioned, can be extremely upsetting and may have a great impact on self-esteem2.

CBT Techniques for Intrusive Thoughts

Avoid Pushing Away Thoughts

Many people who experience these distressing thoughts will try to push it away, however, thoughts are oftentimes out of our control and therefore trying not to think of these things often leads to more of these thoughts. This can lead to avoiding situations in order to attempt to stop these thoughts. Some people even find themselves resorting to compulsive behavior to try to counteract the thoughts. This tends to be counterproductive, as it can lead to obsessive actions, as well as it continuing both the thoughts and the behaviors.

Acknowledging the Thought

The best way to deal with intrusive thoughts is to consciously recognize that these thoughts are intrusive and not anything you are prompting in any way. This is an important step in dealing with these thoughts, as it takes away the guilt one may feel for having these thoughts. Oftentimes, people feel as though having a thought is just as bad as an action. However, thinking and doing are extremely different things. It is imperative to acknowledge that regardless of the thought, it does not make you a bad person.

Therefore, the best way to deal with these thoughts is to acknowledge it, by telling yourself you had the thought but that is all it is, a thought. You also may challenge the thought. For instance, if you have a thought about harming someone, your challenge may be that you have never harmed anyone and you have no desire to harm anyone.

Thought Stopping

This strategy involves blocking and replacing intrusive thoughts. The process involves disrupting, dismissing, and replacing the negative thoughts. There are a few different ways to implement thought stopping. One option is to say ‘STOP’ in your head or to clap or snap your fingers whenever one of these thoughts pops up. Another is imagining a visualization whenever the thought appears or making a checkmark on a piece of paper each time it happens.

The idea behind these techniques is to utilize these actions to help you recognize how often these thoughts are occurring and to assist in distracting you from these thoughts. This also can help in identifying triggers that may be leading to unwanted thoughts. While this may seem contradictory to the idea of not pushing away thoughts, this technique specifies that suppressing these thoughts is absolutely not the aim.

Replacing the negative thought with a positive thought is important, as simply avoiding negative thoughts alone can lead to an increase in involuntary thoughts3.

Thought Records

This involves writing down the negative thoughts that pop up. Then, challenge these thoughts and work through the truth of the thought. For example: ‘you are going to get fired’. You may write down things such as ‘I have never been fired before’, ‘my boss constantly tells me what a good job I am doing’, etc. If there is any evidence to prove these thoughts to be true, it is okay to write those down as well, but ensure that these are valid points. For instance, ‘I was fired from my previous job’, may be a fair point. However, are you acknowledging all angles? Was the reason you were fired due to something you did, or was it outside of your control?

Hierarchy of Concerns

Intrusive thoughts tend to pop up when we have unresolved issues in the back of our mind. In order to help with this, start by making a list of problems or concerns. These could be any problems that have been popping up or have been ruminating. After making this list, make a hierarchy by listing them from problems you consider smallest and building up to the problems that feel the most overwhelming. After coming up with this hierarchy decide in which order to work on them and brainstorm possible solutions to each problem.


Many people who deal with intrusive thoughts deal with Obsessive Compulsive Disorder (OCD), anxiety, or depression. These individuals often benefit from taking prescribed medication, such as Selective Serotonin Reuptake Inhibitors (SSRI)’s, which can help regulate serotonin 4. The goal of the medication with intrusive thoughts is to alleviate the anxiety and be able to manage the way one reacts to intrusive thoughts.

Reaching Out for Support

If you are experiencing intrusive thoughts, our therapists through provide Cognitive Behavioral Therapy (CBT) and can assist in overcoming symptoms of concern.

Our platform offers a complete online therapy toolbox which includes time with a personal therapist who can support you throughout your journey. If this is something you have interest in, we would love to hear from you. References 5 6 7 8