Intrusive Thoughts: What They Are and How to Eliminate Negative Ones

Intrusive thoughts are those thoughts that involuntarily appear intermittently. There is a great diversity of repetitive and automatic thoughts, and some of them are very unpleasant.even wanting to harm others, such as your own children.

This type of thinking generates a lot of discomfort and, in turn, other thoughts such as “you shouldn’t feel this way.” In many cases we even blame ourselves for something that is normal, which are involuntary and unconscious thoughts.

Thought rumination is adaptive, it seeks to filter thoughts that are useful, but it usually does not succeed, since, in addition, we anticipate and believe that next time we are going to think the same thing again, which makes the problem worse.

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Why, even if we want to eliminate intrusive thoughts, do they remain?

There is usually a vicious circle; For example, consider the case of a mother who has the intrusive thought of wanting to harm her child, but, of course, she knows that she does not want to do this and is not going to do it. In these cases there is usually a circular pattern that occurs in this order and through these elements: internal stimulus (exhaustion that leads to the intrusive and involuntary thought of throwing it out the window), external stimulus (baby crying), sensations such as palpitations, emotion of anxiety and fear, thought avoidance reaction.

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After this circle comes anticipation and catastrophismwhich, as we have commented, increases the problem.

How do we approach them in therapy?

Automatic thoughts are a reflection of our beliefs, but we are not our thoughts. Therefore, once the evaluation has been carried out and any other pathology has been ruled out, we work on the defusion of thought, that is, distancing ourselves from these mental phenomena and connecting more and giving greater importance to actions, putting the focus on conscious action.

It is essential to carry out an adequate functional analysis, studying the external and internal stimuli involved and response (physiological/motor/cognitive) as well as the consequences. If there are avoidant behaviors (calling on the phone, not thinking about the problem…) we make the problem worse, since we do not expose ourselves, so something essential is exposure to emotions, reactions and thoughts.

1. Therapeutic resources for intrusive thoughts

Some of the dynamics used in our consultation to work on this problem are the following.

2. Psychoeducation

It is essential to explain to patients what is happening to them and why.

3. Behavioral experiments

With them, it is about verifying that when we want not to pay attention to thoughts, they appear more strongly.

4. Restructuring and cognitive discussion

This is one of the great techniques of psychology and on which a large part of our treatments are based. It consists of providing the person with the necessary tools to that you can come to the conclusion that the thoughts that are causing you discomfort are neither objective nor useful.

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5. Relaxation exercises

Sometimes it is necessary to provide the patient with relaxation strategies to reduce activation caused by stressful thoughts.

6. Analysis of patient beliefs

Behind intrusive thoughts are usually the person’s intrinsic beliefs. For example, if the intrusive thought is about killing your child, it is common for beliefs such as “a good mother never loses her temper” and excessive demands to be associated.

7. Work on associated symptoms, generally anxiety and guilt

As we have mentioned, unpleasant thoughts and mental images that appear involuntarily generate great discomfort, even being able to suffer anxiety attacks; This usually makes the problem persist longer. The same goes for guilt. Continuing with the same example, the mother who has the image of killing her son and this generates great fear and guilt, feeds back the vicious circle.

8. Defusion of thought

We are not what we think, we are what we do, therefore, we work to give more importance to actions and separate ourselves from thoughts that appear without our will.

9. Controlled exposure to situations and thoughts that are avoided

Due to the fear that these types of thoughts usually generate, we avoid those associated situations. For example, if a person recurrently has the idea that he may harm himself (but it does not correspond to autolytic ideation because he would not want to do it nor does he feel like doing it), he can try to avoid picking up knives.

10. Self-dialogue

It is closely related to the person’s beliefs; It is what we tell ourselves that can reduce or aggravate the problemwhich is why it is essential that we work on it in therapy.

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11. Concentration on values and actions of the person

If the person has thoughts, for example, of hurting someone, but this generates rejection, they would not want to do it and they do not conceive it as appropriate, the person must be redirected to these values that they have so that, in turn, guilt will decrease.