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What are intrusive thoughts?
Intrusive thoughts are unwanted thoughts, images, urges, or even sensations that come repeatedly against your will and out of nowhere. They can be quite distressing and cause intense emotions like disgust, guilt, fear, and shame. If you have obsessive-compulsive disorder (OCD), these are called obsessions. They often target the things you value most, which may partially explain why onset, a shift, or an increase occurs for women (and men) during the perinatal period. Intrusive thoughts can also present in those with post-traumatic stress disorder (PTSD) (flashbacks, frightening thoughts) and postpartum depression (thoughts of death/worthlessness).
To better understand OCD, it is helpful to know the term ego-dystonic, a concept developed by Sigmund Freud. Ego-dystonic refers to a state of disharmony. Individuals with OCD are ego-dystonic because their obsessions are not aligned with their values, beliefs, and self-image. This is why they experience negative and distressing emotions. OCD obsessions are not consistent with one’s current or past behaviors; they do not act on them. Individuals with OCD realize their obsessions are not rational unlike someone with postpartum psychosis who may believe them and they present as delusions and hallucinations.
The remainder of this article will take a closer look at OCD and intrusive thoughts.
The most common obsessions are of a sexual nature, fears of doing something illegal or violent, fears of hurting a baby, child, or other loved one, worries you may catch an illness/serious disease or pass one on to someone else, or cause doubt. OCD is called the ‘doubt disorder’ after all!
Here are some obsessions my clients or others have reported having:
“I fear I may hurt my baby by putting his diaper on too tight or getting him sick because of food or medicine I give him.”
“When I changed my daughter’s clothes, I felt a sensation in my genital area, what if I molest her?”
“I had a horrible image of picking up a knife and stabbing my child. I no longer feel safe being alone with my baby.”
“Did I turn off my curling iron, what if I burn down our beloved house? If it’s not the curling iron, it’s that I forgot to unplug my computer or I left the stove on. It’s always something.”
“What if I have an aneurysm and drive my car off the road or into another car killing everyone? I don’t know what’s worse the image or the fear.”
Unusual, strange, or scary thoughts are not uncommon. In reality, most will have a sexual or harm thought at some point in their lives and the majority will acknowledge the thought as unusual and move on. OCD brains grab onto these thoughts and have a harder time moving past them.
Obsessive-Compulsive Disorder (OCD) Cycle
As a result of obsessions and the immense distress they cause, most people engage in avoidance behaviors or rituals (compulsions) to relieve their distress. In some circumstances, parents have avoided being alone with their children or even touching them for fear they may do something. Avoidance and rituals may work temporarily, but over time they stop working and instead feed OCD, making it stronger.
Perinatal OCD Treatment
OCD is treatable. If you are experiencing intrusive thoughts that cause you significant distress, please see a mental health therapist that specializes in perinatal OCD and/or a doctor who also understands OCD/perinatal OCD. Be sure to explain any distress and fears that these obsessions are causing you. If you are unsure if a therapist or doctor specializes in OCD, there are perinatal organizations that can help you find one. You don’t have to continue suffering alone or without proper help. Exposure and response prevention (ERP) is the gold-standard therapy and is quite effective for OCD. There are also safe medications that treat perinatal OCD. Keep in mind when medication is terminated, OCD symptoms generally return unlike with therapy; when you graduate from ERP therapy the gains are not lost.
The sooner you seek help, the sooner you’ll start to feel like your old self again.
