Intrusive Thoughts: “How can I be thinking these things?” (Part 2)

by | Apr 27, 2021

what are intrusive thoughts

Intrusive thoughts are treatable. Yes, they’re terrifying. And it’s awful to think about doing things you find reprehensible – even heinous. But the tortuous thoughts can become less frequent and intense, if not eliminated. Let’s chat about treatment for intrusive thoughts…

Our buddy’s expression has gone from stunned horror in part one to hopeful listening. He’s been having intrusive thoughts for about a month and just learned they’re treatable. He’s cautiously ready to talk about them and accept help.

We started this two-part series last week, as we discussed what intrusive thoughts are and their causes. If you haven’t read part one, be sure to get after it, because now we’re going to learn how to treat them.

Quick review: an intrusive thought (IT) is an invasive – often shockingly and graphically disturbing – involuntary thought, image, and/or unpleasant idea. In many cases, an IT may become an obsession: a continual thought, concept, picture, or urge which is experienced as invasive and not proper, and results in significant fear, distress, or discomfort.

I know ITs well. There was a time when some of mine chilled me to the bone. But, no more.

Come on, let’s see what we can see…

How are intrusive thoughts treated?

As with any malady we talk about here on Chipur, treatment for ITs is determined by the impact of the thoughts on one’s routine – life. For many, self-treatment, using selected strategies and techniques, works just fine. For others, therapy, even meds, is the way to go.

Let’s get right to it, as we take a look at some guiding facts and tips anyone can use to manage their ITs…

  • Learn all you can about ITs and come to understand the context within which yours occur. Perhaps it’s OCD, PTSD, generalized anxiety, or severe stress. Maybe something else. Just always remember that our brains can be smashingly good at creating “junk thoughts.”
  • When it comes to ITs, having a specific thought is not a predictor of future action. A thought is not an impulse, and impulse control isn’t the issue here.
  • Do everything you can not to engage with the IT or attempt to push it out of your mind. In fact, open your mind and let the IT in.
  • Forget about the supposed literal meaning of an IT. The more you mull it over, the more intense it’ll become. Trying to apply reason and exercising control will only make matters worse.
  • Don’t waste your time trying to convince yourself you won’t act on the thoughts. And don’t change any of your behaviors in an effort to avoid action. Think about the last time you had an IT. You didn’t act.
  • Identify the triggers of your ITs. And instead of avoiding them, spend time with them. Learn there’s no danger.
  • Monitor and manage your levels of anxiety, stress, and fatigue. They always make ITs worse.
  • Consider that an IT may be your mind’s way of getting your attention so you’ll slow down and emotionally tune-in.
  • Once you’ve slowed down, tuned-in, and come to believe you can handle your emotional experiences, the ITs may lighten-up. After all, they’ve accomplished their mission, so what reason do they have to exist?
  • Given an IT may, in fact, be sending you an important message, when the thought occurs, ask yourself questions like these: “What am I really trying to control, avoid, or fill?” “What is the thought trying to protect me from?”
  • Be it with a spouse, partner, friend, therapist, spiritual leader, or someone else you may trust, talk about your ITs. You need to divulge your secret.

There are many more facts and tips out and about; however, these will get you off to a great start with managing your ITs. But there isn’t going to be relief if you don’t start working them – now.

What therapies and meds are used for intrusive thoughts?

how are intrusive thoughts treated

“It isn’t easy talking about my intrusive thoughts, but it feels right – and good.”

Perhaps your ITs are causing routine – life – interruption. It happens, and when it does it’s time for professional assistance.

Often used to treat ITs is cognitive behavioral therapy (CBT). Simply, CBT helps with understanding the impact of thoughts, especially negative ones, on behavior. Yes, they’re interrelated.

And then there’s exposure and response prevention therapy (ERP), which is a form of CBT. Many consider ERP the treatment of choice for ITs. Simply, ERP is the practice of staying in an anxiety-provoking or feared situation (in this case, the IT – which may be an obsession) until the distress or anxiety diminishes. That’s what helps with side-stepping a compulsive reaction, such as avoidance.

For instance, someone may be having an IT about physically harming a child. Perhaps the IT has become an obsession. It makes sense that the individual would do all s/he can to avoid children.

But engaging in activities – compulsive reactions – to supposedly prevent the feared outcome of the IT only serves to strengthen it. See, it’s all about negative reinforcement: the mind learning that the only way to avoid a thought or feeling is to engage in a reactive (compulsive) thought and/or behavior. And that’s what we want to get around.

So relief ultimately comes by opening the door to the IT, having learned how to stay away from the compulsive reaction side of the fence.

Now, ERP will likely not totally eliminate ITs. But millions of people endure undesirable thoughts and consider them nothing more than an annoyance. And that’s where we want to go: to a point of management, eliminating routine – life – interference.

There are medications available to treat ITs. Commonly prescribed are the selective serotonin reuptake inhibitors (SSRIs): paroxetine (Paxil), fluoxetine (Prozac), sertraline (Zoloft), fluvoxamine (Luvox), escitalopram (Lexapro), and citalopram (Celexa). Also prescribed is the tricyclic antidepressant, clomipramine (Anafranil). An atypical antipsychotic, such as aripiprazole (Abilify) or quetiapine (Seroquel), may be used as an augmenting agent. A benzodiazepine, such as clonazepam (Klonopin), may also be prescribed to get one over the hump.

Keep in mind, the above medications are used for ITs caused by their most common generator, OCD or similar circumstances. We know ITs can present as a manifestation of other emotional/mental disorders. In such cases, other medications may be prescribed.

So goes the series

Well, that’s going to do it for our two-part intrusive thoughts series. If you found it relevant, I hope you found it helpful.

Believe me, I know how terrifying and shame-inducing intrusive thoughts can be. But I also know that through learning and the use of well-considered strategies and techniques, they can lessen in frequency and intensity, if not go away entirely.

Take heart, okay? The torture of intrusive thoughts can be no more.

Again, be sure to read part one.

Hundreds upon hundreds of Chipur articles stand ready to help you. All you have to do is peruse the titles.

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