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How do you stop OCD intrusive thoughts?

Dr. Amy Funkenstein, MD answers the question, “Can you stop OCD intrusive thoughts?”

While we can’t completely stop OCD intrusive thoughts, we can better respond to them through a combination of acceptance, mindfulness, and learning to let go of the intrusive thoughts. Having strange or disturbing thoughts is normal; many people have them! What matters is not that we have these thoughts, but how we respond to them.

The best ways to respond to them involve a combination of mindfulness practices and a type of Cognitive Behavioral Therapy (CBT) called Acceptance and Commitment Therapy (ACT). The principle underlying both methods is acceptance of the intrusive thoughts, rather than fighting them. Trying to get rid of these thoughts is a reactive approach and counterproductive to improving your happiness and emotional well-being. Just because a string of words happen to pop into your mind, it doesn’t necessarily say anything about you, your values, or your morals.

What are intrusive thoughts?

Intrusive thoughts are unwanted, persistent thoughts or images that cause anxiety and distress. We all have these strange or even disturbing thoughts at times because we are humans with creative imaginations. Attempts to suppress the thoughts are usually not successful; what fuels OCD is not the experience of having intrusive thoughts themselves, but rather our responses to them.

Mindfulness

Mindfulness means paying attention to the present moment, stepping back, and witnessing the thoughts. It involves being aware of when you are triggered and accepting the subsequent discomfort without responding or resisting. Don Vardell, Executive Director of the Mountain Valley Treatment Center, stresses the importance of “shifting [our] focus to present values and experiences rather than worrying about future possibilities which may or may not occur.” It’s no small feat to simply be when you experience bizarre or uncomfortable thoughts, but mindfulness teaches us to view them from an objective perspective: intrusive thoughts are simply mental events and pose no inherent threat.

Acceptance and Commitment Therapy

Acceptance and Commitment Therapy is a grounding technique, meant to get you “out of your head.” It focuses on helping you reach a place where you can experience an intrusive thought, not feel overly affected, and move forward with your life. The key goal of using ACT, Don explains, is to “practice defusing negative thoughts or distortions so they are less powerful.” This approach can be simplified into a three-step process:

  1. Accept the thought. Pushing it away will make it louder, stronger, and more alarming.
  2. Do not try to stop the thought, whether mentally or through engaging in physical compulsions.
  3. Get busy with something meaningful that you value, and move on.

Facing intrusive thoughts head-on instead of running from them allows us to address anxiety in the run. Don sums up, “[The goal of treatment is] not to eliminate the obsession, [but] rather to tolerate it and thus have a better quality of life.” Mindfulness practices and ACT can teach us to notice thoughts and then let them go, focusing more on the response than the fact of having that thought.


Sources

  • A mindfulness-based approach has the potential to reduce drop-out from ERP and to improve ERP task engagement with an emphasis on accepting difficult thoughts, feelings, and bodily sessions and on becoming more aware of urges, rather than automatically acting on them.
    • Strauss C, et al. (2015). Mindfulness-based exposure and response prevention for obsessive compulsive disorder: study protocol for a pilot randomised controlled trial. BioMed Central, 16(167).
  • Our findings suggest that mindfulness training may not only alleviate OCD symptoms, but may lead to benefits beyond symptom reduction.
    • Hertenstein E, et al. (2012). Mindfulness-based cognitive therapy in obsessive-compulsive disorder – A qualitative study on patients’ experiences. BMC Psychiatry, 12(185).
  • In ACT, the goal is to help the individual experience an obsession for what it is, (i.e., a thought) and continue doing what is important to them.
    • Twohig MP, et al. (2006). Increasing Willingness to Experience Obsessions: Acceptance and Commitment Therapy as a Treatment for Obsessive-Compulsive Disorder. Behavior Therapy, 37(1), 3–13.
  • The focus of ACT for OCD is to help clients get to a place where they can openly experience thoughts, feelings, or bodily sensations, not be overly impacted by them, and continue to move in directions in life that are meaningful.
    • Twohig, M. International OCD Foundation. (2018). What is ACT?

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