Living with Intrusive Thoughts

Dr. Steven Phillipson explains Pure OCD, its symptoms, and the many shapes and forms it comes in.

Written by Jana K. Hoffman

01 Dr. Steven Phillipson has specialized in OCD for over 30 years and coined the term Pure OCD or Pure O.

02 Approximately 2% of the population experiences unwanted recurring thoughts, called intrusive thoughts.

03 Intrusive thoughts are meaningless and do not speak to a person's character.

OCD3, Ep5: Making Healthy Diet & Exercise Choices for Mental Health, OCD

The human brain is highly creative and imaginative. We think thousands of thoughts every single day, including some that are considered violent or disturbing. For most people, unwanted thoughts vanish as quickly as they appear. But for others, the thoughts occur so frequently that they often become debilitating.

If this sounds like it might describe you, the first thing to know is you’re not alone. Naturally, you’re going to have questions so we’re here to provide you with a better understanding. There’s no better person to explain this phenomenon than expert clinical psychologist Dr. Steven Phillipson, who has dedicated many years to studying unwanted thoughts.

Approximately 2% of the population experiences unwanted recurring thoughts, called intrusive thoughts. Dr. Phillipson refers to intrusive thoughts as creative associations. For this 2%, intrusive thoughts leave behind unsettling feelings whereby a person may manifest them into a serious crisis. When someone has Obsessive Compulsive Disorder (OCD), intrusive thoughts are amplified. A person with OCD experiences “an avalanche of distress” associated with intrusive thoughts. In an effort to seek relief, the brain actually creates “a vicious cycle,” which reinforces the idea that something is seriously wrong.

According to Dr. Phillipson, there are three main themes: Violence, where it’s believed someone may partake in a harmful act against oneself or a loved one; Sexual, where someone may be attracted to children or a person of the same sex; and Religion, where someone may say something negative about God and feel guilt or endangerment. That said, intrusive thoughts aren’t limited to the aforementioned themes and come in many shapes and forms.

Dr. Phillipson explains that intrusive thoughts are completely meaningless, and it’s important that you and/or your therapist don’t assign a meaning to them. Intrusive thoughts don’t make you a bad person and they most certainly don’t reflect your character.

If you believe intrusive thoughts could be affecting your ability to lead a normal life, contact a local psychologist to start on your personal path toward healing.

Read full video transcript below:

Aaron Harvey (AH): Steve thanks for joining us. Today, we’d like to learn a little more about intrusive thoughts. So, it’d be great to start with your background, your speciality, and a little more about your inspiration for how you got involved.

Dr. Steven Phillipson (SP): I would listen to people talk about these very kind of upsetting intrusive thoughts that seemed so irrational to me. These were very intelligent people and yet they were acting in such a bizarre way and expressing fear over thoughts that I had myself, similar ones. And yet they were reacting to these thoughts as if there was something terribly wrong. I started looking into what must be going on here if these people are having such strong reactions to things that even they realized were kind of irrational and unnecessarily burdensome.

AH: So you said you yourself have intrusive thoughts.

SP: Sure.

AH: A lot of people have intrusive thoughts. Can you define intrusive thoughts for us and what that might mean in context of someone with OCD?

SP: Rather than using the phrase "intrusive thoughts," I prefer the phrase "creation associations." As I said, I give my brain a lot of license to generate these associations that are no different from the associations my patients come in with. The difference is that when my patients have these associations, their brain reacts to them as if there's a crisis going on. So when I have an intrusive thought or a creative association, I literally just sort of thank my brain for sharing the experience of the heebie-jeebies that lasts no more than 2 seconds, and I just kinda go on with my day. Persons with OCD, you know, have this kind of avalanche of distress that, in their efforts to seek relief from, it actually creates a vicious cycle that reinforces to the brain the idea that there is something actually wrong, there actually is a crisis going on. You know, it turns into a life-altering, very handicapping condition.

AH: And so with respect to the types of intrusive thoughts, you had mentioned a mother who might be afraid that she’s going to suffocate her newborn baby. What are some other examples of common type of intrusive thoughts?

SP: So the big three in OCD are about violence. The idea that we might act in a way harmful to others or ourselves in some loss of control. Some people think that they’ve committed some violent act and they spend a great deal of time researching or contemplating whether or not that moment might have happened. While other people think that they might be capable of committing a violent act so they might stay away from knives or sharp objectives. So the second most popular theme is related to sex. And so persons often will have thoughts that they might find underage children sexual. And the third subset is religion. Persons might have thoughts that they might say something negative about God or something negative about Jesus or Mary and then they feel an overwhelming sense of guilt or anxiety that they might be in danger.

AH: Due to the nature of intrusive thoughts, the types of thoughts, do they speak to someone’s character?

SP: Tragically this is probably one of the greatest misnomers about OCD is that people are so tempted to react as if they have some meaning about a person’s inner character and yet nothing could be further from the truth. If a patient came in with spiking about being attracted to children sexually, I often tell them that I'd be happy to leave them in a room with either of my two children for a week. And I say to them that at the end of that week, you’d be in a lot more danger than my children would be because it’s generally almost the exact opposite in terms of a person’s character. The targets of the spike theme are really just a fabrication of the malfunctioning brain. And there is no authentic belief system within the person related to those associations.

About the author

Jana Hoffman is a writer, editor and storyteller based in San Francisco. She is currently working as a copywriter at the Chan Zuckerberg Initiative. Outside of work, she is a trained volunteer for Crisis Text Line and has been open about her experiences with mental health.

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