Intrusive thoughts are unwanted, involuntary thoughts, ideas or images that have the tendency to become obsessions. In relation to obsessive-compulsive disorder or OCD, these repetitive and distressing thoughts can lead to anxiety and can be disruptive to the point of affecting an individual’s way of life and the people around him or her.
Despite the existence of these horrifying thoughts, OCD sufferers are mostly non-violent people. In fact, they do not really want to act on these thoughts and are often frightened of them, making it more painful and harder for them to deal with. These disturbing thoughts can be about any subject but there are several sub-categories associated with OCD; namely, relationships, religious, sexual thoughts, magical thinking, symmetrical and violent thoughts. Let us try to define the different intrusive thoughts in OCD and their examples.
Relationship Intrusive Thoughts
These are recurring, obsessive thoughts that affect what is supposedly a suitable relationship with a loved one or about one’s sexuality. These thoughts include, but are not limited to:
1. Unwelcome doubts on the faithfulness of a partner.
2. Always feeling the need to be reassured and getting approval from a partner.
3. Thoughts of fear about cheating on the sufferer’s partner.
4. Doubting the genuineness of one’s feelings for a loved one and constantly analyzing the relationship to the point of scrutinizing the relationship and finding flaws or faults on one’s partner.
5. Having identity-crisis or doubting one’s sexuality and having impulses and thoughts of attraction to members of the same sex.
Religious Intrusive Thoughts
Also referred to as scrupulosity, these are obsessive thoughts and images related to God and other religious figures. A person suffering from these thoughts can experience blasphemous thoughts, among others. St. Ignatius of Loyola and Martin Luther King, Jr. were said to have these distressing thoughts. The former was reported to have the fear of walking on straws that resembles a cross and the latter was said to have the urge to blaspheme against God. Other examples of religious intrusive thoughts are the following:
1. Having bad thoughts while praying.
2. Repetitive blasphemous thoughts.
3. Having thoughts on being possessed.
4. Making the sign of the cross several times and kissing or touching religious objects repeatedly.
5. Thoughts of not being forgiven from sins and that one will be going to hell.
6. Doubts prayers have been said incorrectly.
7. Doubting one’s relationship with God and feeling that one is drifting away from his faith and religion.
Sexual Intrusive Thoughts
Although having sexual thoughts can be experienced by normal people, intrusive thoughts of sexual act related to OCD can often lead to self-loathing and having unwanted thoughts on causing sexual harm to other people.
1. Sexual thoughts like inappropriately touching someone else or a child.
2. For homosexuals, fear of being attracted to members of the opposite sex while for straight people, having thoughts of being attracted to members of the same sex.
3. Fear of killing one’s partner while doing sexual acts.
4. Having fearful thoughts about incest or being sexually attracted to a family member.
5. Intrusive thoughts on committing pedophilia.
Magical Thinking Intrusive Thoughts
This illogical thought pattern is characterized with rules and way of life that are based on luck, numbers, color and the like. For people who suffer from distressing thoughts and are experiencing magical thinking thoughts, carrying out rituals can lessen anxiety.
1. Belief in having to count, recite names, words, phrases and images to reduce anxiety.
2. Making specific gestures.
3. Avoiding certain areas while walking like a line on the road.
4. Repetition of words.
5. Obsessions in arranging objects in a certain way.
6. Rituals done at a certain time of day.
7. Fear that not taking chain letters seriously can bring bad luck.
8. Certain numbers and color can bring good or bad luck.
Violent Intrusive Thoughts
These are recurring thoughts of the fear of hurting other people, including loved ones. Because of these images, ideas and thoughts, an individual may regard himself or herself as a bad person and believe that he or she is capable of acting out these intrusive thoughts. As a result, they may become depressed and at the same time put off seeking treatment for the fear of being judged or labeled. The client will also avoid going out or going to malls so as to avoid other people. Some of the examples of violent intrusive thoughts are the following:
1. Murdering other people, even strangers.
2. Being obsessed with knives and other sharp objects.
3. Harming loved ones and children.
4. Committing suicide by jumping in front of a fast moving vehicle or pushing someone to get hit by a train.
5. Killing members of the family by food poisoning.
Intrusive Thoughts on Orderliness and Symmetry
Intrusive thoughts can also be manifested with having the obsession to symmetry or having things properly arranged to avoid anxiety or the feeling of discomfort.
1. Obsession with cleanliness.
2. Having the need to align picture frames.
3. Arranging clothes and hanging them on one side.
4. Arranging canned goods with the labels straight and facing the same way.
5. Obsession with perfect arrangement of objects like books and distance of sofas from the wall.
The treatment for intrusive thoughts is also the same with managing OCD; namely, Exposure and Response Prevention Therapy, Cognitive Behavior Therapy and medications.
ERP is the treatment of choice since it is done by exposing the client to these intrusive thoughts, that is, he or she will be allowed to experience these thoughts for an hour or two and encouraged to challenge these thoughts. Conversely, CBT is motivating the client to acknowledge and accept the existence of these intrusive thoughts while anti-psychotic medications and anti-anxiety drugs are used for more severe cases of this condition.
In a study conducted in 2007, out of the clinical sample of OCD patients, 78% of them had experienced having intrusive thoughts while epidemiological studies reveal that this sub-type of OCD is the most common, globally. Also, about 2% of every culture is suffering from OCD.
