Obsessive thoughts are a formal symptom of obsessive-compulsive disorder (OCD). They’re often unwanted, intrusive, and upsetting. But managing OCD intrusive thoughts may be possible.

When living with obsessive-compulsive disorder (OCD), you may spend most of your time and energy dealing with obsessions and compulsions.

Obsessions are intrusive thoughts that are difficult to stop and control. Compulsions are repetitive acts or rituals that you engage in to relieve some of the distress obsessions cause you.

Everyone experiences intrusive thoughts from time to time. But as a formal symptom of OCD, these obsessions may be constant and can impact all areas of your life.

Intrusive thoughts are images, ideas, or memories that may pop into your head repeatedly and at any time. You may find it hard to put these thoughts away at will.

When you live with OCD, these obsessive thoughts can last more than an hour every day and negatively impact your mood and ability to function.

Intrusive thoughts can have different themes. Some may not be unpleasant but the fact that they keep coming up may upset you and make you exhausted. Other times, these themes can be upsetting and frightful.

For example, you may experience intrusive thoughts about hurting yourself. This doesn’t mean you want to, but the images about you doing it keep popping into your head.

Other examples of obsessive thoughts include:

OCD intrusive and obsessive thoughts typically don’t go away unless you receive formal OCD treatment.

Although compulsions may help you reduce the anxiety caused by obsessive thoughts, these typically come back. This may also result in a lot of time and energy spent on rituals, which can be exhausting and upsetting.

How long do intrusive thoughts last?

When you live with OCD, intrusive thoughts may last for a lifetime. If you’re receiving treatment, it’s likely that you may experience them less often or that you may learn to cope with them so they don’t upset you as much.

Currently, there isn’t a cure for OCD, and without treatment, you may experience obsessive thoughts often.

If you live with OCD, it’s natural to want to know how to stop intrusive thoughts forever. This may not be as simple as taking medication, though.

It’s highly advisable that you receive formal OCD treatment, which may help you deal with intrusive thoughts and the need to engage in compulsions.

1. Consider speaking with a mental health professional

Working hand in hand with a health professional, like a psychiatrist or psychologist, may help you make progress in dealing with intrusive thoughts and other symptoms.

Some people with OCD develop symptoms of other conditions like anxiety and body dysmorphic disorder. Your therapist can help in identifying these or other symptoms and developing an all-inclusive management plan.

They might also suggest specific types of psychotherapy that may work for your case, discuss possible OCD medications that could help, and support you in developing coping skills you can use at any moment.

2. Try exposure response prevention (ERP)

Exposure response prevention therapy is considered the first-line treatment for OCD symptoms. This type of therapy helps you manage obsessive thoughts and compulsions by exposing you to the first ones and preventing you from engaging in the latter.

For example, say you repeatedly wash your hands (compulsion) because you experience intrusive thoughts that tell you, “If you don’t wash your hands, you’ll contract an illness and die.”

ERP therapy helps you experience these thoughts without having to engage in hand washing. In time, your distress may gradually disappear when you realize that not washing your hands constantly doesn’t result in illness and death.

How does exposure response prevention (ERP) work?

ERP involves the following steps and aspects:

  1. Assessment and plan. Your therapist will assess your symptoms and health history.
  2. Identify your triggers. You work with your therapist to identify what worsens or activates your symptom, like objects or people, and your most distressing thoughts.
  3. Analyze and find patterns. By analyzing your triggers, your therapist finds connections between your obsessions and compulsions, discusses the relationship, and identifies what you fear will happen.
  4. Rank the different situations. You both rank different situations from least to most distressing to create a fear pyramid.
  5. Confront and report. Over time, you confront obsessive thoughts identified while avoiding engaging in your rituals or compulsions.
  6. Coaching. Your therapist offers coaching on how to handle the situations.
  7. Consequences reviewed. In time, you may realize there are no frightful consequences when you don’t engage in your rituals as your intrusive thoughts had you believe.
  8. Recurrence prevention planning. As you tackle each scenario, you gradually work your way up the fear pyramid over time and then work with your therapist to prevent recurrences.
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3. Try to develop effective distractions

Intrusive thoughts are, by definition, intrusive. This means they pop up without warning and you may have a hard time preventing or stopping them.

But learning to quickly shift your attention away from intrusive thoughts may offer you some relief. However, try to keep in mind that OCD obsessions are typically difficult to control at will without the support of a professional.

Evidence shows that your brain activity slows when you distract yourself, leading to fewer racing thoughts. And, even though this may work for you, it may only be temporary.

Distractions may be more effective at helping you not engage in compulsions.

Some ideas include:

4. Consider exercising regularly

Exercise may help you reduce compulsions and elevate your mood. It’s possible that they also help you deal with intrusive thoughts.

In general, exercising can help you reduce anxiety. For that, you may want to do some type of physical activity every day as a preventive habit. Exercising when experiencing distressing thoughts may offer some people relief in the moment.

Intrusive thoughts are ideas and images that pop into your mind without notice and they tend to cause great distress. Intrusive obsessive thoughts are a formal symptom of OCD.

Intrusive thoughts don’t typically go away on their own and you may experience them often and persistently, particularly if you don’t receive OCD treatment.

Exposure response prevention therapy, grounding distractions, and exercising may help you deal with intrusive thoughts and corresponding compulsions.