Intrusive Thoughts and Anxiety: Why They Happen and What Helps

“What if I actually did it? What kind of person thinks that?”

If a thought has ever shocked you so much that you couldn’t stop going back to it, you’re far from alone. Intrusive thoughts are one of the most common things people bring to me, and one of the things they feel most ashamed of. The good news is that they are very treatable, and they say far less about you than you fear.

I’m Andy Griffiths, a psychotherapist and clinical hypnotherapist in Glasgow. This guide explains what intrusive thoughts are, why anxiety makes them worse, and what actually helps.

What are intrusive thoughts?

Intrusive thoughts are unwanted thoughts, images or urges that pop into your head and feel completely out of character. Common examples include:

Research suggests almost everyone has thoughts like these from time to time. Most people notice them, think “that was odd”, and move on. With anxiety, they don’t move on.

Why anxiety makes them worse

• Your brain is on high alert. Anxiety keeps your nervous system in fight or flight, scanning for danger. Instead of letting an odd thought pass, it treats it as a threat.
• Fighting the thought feeds it. Try not to think of a pink elephant. The harder you push a thought away, the more often it tends to come back.
• Thoughts start to feel like facts. Anxiety can make you believe that having a thought means it might happen, or says something about you. This is sometimes called thought action fusion.
• Checking and reassurance keep it going. Checking, googling or asking someone to reassure you brings a little relief, but it teaches your mind the thought was dangerous. So it comes back.

If your intrusive thoughts are mostly about illness, you might also find my guide to health anxiety helpful.

Things you can try today

• Name it. Say to yourself, “That’s an intrusive thought.” Labelling it puts a little distance between you and it.
• Let it be there. Instead of pushing it away, let it sit in the background while you carry on with what you were doing. It usually fades faster that way.
• Notice your reaction, not the thought. The thought isn’t the problem. The panic about the thought is. Ask, “Why am I judging this thought?” rather than “Why am I having it?”
• Cut back on checking. Try delaying the urge to check or seek reassurance, even by a few minutes at first.
• Look after the anxiety underneath. Sleep, movement, less caffeine and slow breathing all lower the background anxiety that gives these thoughts their power.

How I work with intrusive thoughts

Self help is a good start, but when intrusive thoughts have been around for a while, it can be hard to break the pattern on your own. In sessions I combine:

• Psychotherapy. Understanding what the thoughts attach to, and why they have become so sticky for you.
• Hypnotherapy. Calming the nervous system so your brain stops treating every odd thought as an emergency.
• NLP and reframing. Changing your relationship with the thoughts, so they lose their emotional charge and simply pass.
• Practical steps. Gently reducing the checking, avoiding and reassurance seeking that keep the cycle going.

If you’ve already tried CBT and it didn’t help, my article on what to do when CBT hasn’t worked may be useful. And if low mood is part of the picture too, there’s more in my guide to therapy for depression.

When to get support

It’s worth speaking to someone if:

Common questions

From clients

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