Anxiety: Intrusive thoughts and what to do

Anxiety is a natural human emotion that everyone experiences from time to time. It is characterised by feelings of worry, fear, apprehension, or nervousness about future events, situations, or uncertainties. Occasional anxiety can be a normal stress response. It can even serve as a helpful signal that something may require attention or caution. However, anxiety can develop into an anxiety disorder when it becomes excessive, persistent, and uncontrollable.


What is anxiety?

Anxiety disorders are a group of mental health conditions that can significantly impact a person's daily life and well-being. Some common anxiety disorders include generalised anxiety disorder (GAD), social anxiety disorder, panic disorder, and specific phobias.

Symptoms of anxiety can vary from person to person, but they often include:

  • restlessness or feeling on edge
  • rapid heartbeat or palpitations
  • sweating and trembling
  • difficulty concentrating or feeling easily distracted
  • muscle tension and aches
  • sleep disturbances, such as insomnia
  • avoiding certain situations or places that trigger anxiety
  • irrational fears or worries that are hard to control
  • feeling overwhelmed or a sense of impending doom

Anxiety can be triggered by various factors, including stress, trauma, genetics, brain chemistry imbalances, or environmental factors. Treatment for anxiety disorders may involve psychotherapy (such as cognitive behavioural therapy), medication, or a combination of both. Lifestyle changes like regular exercise, healthy eating, and stress management techniques can also be helpful in managing anxiety.

If you or someone you know is experiencing overwhelming anxiety that interferes with daily life, seeking help from a mental health professional can be recommended.

Intrusive thoughts - what are they and why do they happen?

Intrusive thoughts are involuntary, distressing, and unwanted thoughts, images, or urges that come to mind without conscious control. They can be disturbing, violent, or even taboo in nature and are often highly distressing to the individual experiencing them. Intrusive thoughts can occur in various mental health conditions. Still, they are commonly associated with anxiety disorders, particularly obsessive compulsive disorder (OCD).

The relationship between anxiety and intrusive thoughts can be understood through several mechanisms:

  • Hyperactivity in the brain: Anxiety is often associated with heightened brain activity, especially in regions responsible for threat detection and emotional processing. This hyperactivity can lead to an increased flow of thoughts, including intrusive ones.
  • Fear of the thoughts themselves: People who experience intrusive thoughts may become anxious about the thoughts being present in their minds. This fear can perpetuate the cycle by making the thoughts more prominent and persistent.
  • Selective attention: Anxious individuals may be more alert to potential threats or negative environmental stimuli. This heightened vigilance can make them more aware of intrusive thoughts when they occur.
  • Cognitive biases: Anxious individuals might have cognitive biases, such as the 'availability heuristic', where they overestimate the likelihood of negative events happening to them. This can lead to an increased focus on intrusive thoughts and an amplified sense of threat.
  • Anxiety as a coping mechanism: In some cases, anxiety and intrusive thoughts might serve as a way for individuals to mentally prepare themselves for potential dangers or worst-case scenarios, even if these scenarios are unlikely.

In the context of OCD, intrusive thoughts are particularly common. They can be associated with specific compulsions or rituals aimed at reducing the anxiety caused by the thoughts. For example, a person with intrusive thoughts about germs may use excessive handwashing to temporarily alleviate their anxiety.

It is essential to recognise that having intrusive thoughts is relatively common and does not necessarily mean someone will act on them or that they have a desire to do so. For individuals who find these thoughts distressing and disruptive to their daily life, seeking help from a mental health professional, particularly one experienced in treating anxiety disorders or OCD, can be beneficial.

Cognitive behavioural therapy (CBT) and exposure and response prevention (ERP) are effective treatments for managing intrusive thoughts and associated anxiety.

Strategies for dealing with intrusive thoughts

Dealing with intrusive thoughts can be challenging, but there are effective strategies you can use to manage them if they occur. Here are 10 techniques that may help:

1. Recognise and accept

The first step is to recognise that intrusive thoughts are normal for many people, especially those with anxiety. Understand that having these thoughts does not define your character or make you a bad person. Accept that they are just thoughts, and they do not have to dictate your actions.

2. Don't engage with the thoughts

Intrusive thoughts can be distressing, but trying to suppress or push them away often makes them more persistent. Instead of fighting the thoughts, practice allowing them to come and go without judgement or attachment. Remind yourself that thoughts are not the same as actions.

3. Mindfulness

Mindfulness techniques can help manage intrusive thoughts. Observe your thoughts without getting entangled in them. Ground yourself in the present moment by focusing on your breath or the sensations in your body.

4. Distract yourself

Engage in activities that require your full attention and concentration. This can help shift your focus away from intrusive thoughts and reduce their impact.

5. Challenge the thoughts

If the intrusive thoughts involve unrealistic fears or catastrophic scenarios, challenge them with rational and evidence-based thinking. Ask yourself if any evidence supports these thoughts and consider more balanced and realistic alternatives.

6. Exposure and response prevention

This technique is commonly used in treating OCD and involves gradually exposing yourself to situations that trigger intrusive thoughts without engaging in the associated compulsions or rituals. Over time, this can help reduce the anxiety associated with the thoughts.

7. Talk to someone

Sharing your thoughts with a trusted friend, family member, or therapist can help alleviate the distress they cause. Sometimes, simply talking about the thoughts can lessen their power over you.

8. Set aside "worry time"

Designate a specific time each day to allow yourself to worry and ruminate about your intrusive thoughts. When they arise outside of this designated time, remind yourself that you will address them during the scheduled worry time.

9. Practice self-compassion

Be kind to yourself and recognise that everyone has thoughts they don't want. Treat yourself with the same understanding and compassion you would offer a friend who experiences intrusive thoughts.

10. Seek professional help

If intrusive thoughts significantly affect your daily life or cause considerable distress, consider seeking help from a mental health professional. They can provide additional strategies tailored to your specific needs and situation.

Remember that managing intrusive thoughts is a process that may take time and practice. Be patient with yourself and celebrate your progress along the way.

Can counselling help?

Counselling can be highly beneficial for individuals who struggle with intrusive thoughts, especially when those thoughts are causing significant distress or interfering with their daily life. Here are several ways in which counselling can help:

Validation and normalisation

A counsellor can help normalise the experience of intrusive thoughts, reassuring the individual that these thoughts are common and do not define their character. This validation can reduce feelings of shame and guilt associated with the thoughts.


It is crucial to understand the nature of intrusive thoughts and their association with anxiety or other mental health conditions. Counsellors can provide psychoeducation to clients, explaining the mechanisms behind intrusive thoughts and teaching coping strategies to manage them effectively.

Cognitive behavioural therapy

CBT is a well-established therapeutic approach for treating anxiety disorders, including those related to intrusive thoughts. The counsellor works with the individual to identify negative thought patterns, challenge irrational beliefs, and replace them with more realistic and balanced thoughts.

Exposure and response prevention

As mentioned earlier, ERP is a specific CBT technique commonly used to treat OCD and other anxiety disorders. Counsellors can guide individuals through gradual exposure to triggering situations or thoughts while refraining from engaging in the associated compulsions or rituals.

Mindfulness-based interventions

Mindfulness practices can be useful in helping individuals detach from their intrusive thoughts and reduce their emotional impact. Counsellors may teach mindfulness techniques to promote present-moment awareness and acceptance of thoughts without judgment.

Emotional regulation

Counselling can assist individuals in developing skills to regulate their emotions when faced with distressing thoughts. Learning to tolerate discomfort and uncertainty can reduce the need to engage in avoidance or compulsive behaviours.

Building coping strategies

Counsellors can work with clients to develop personalised coping strategies for managing intrusive thoughts. These strategies might include relaxation techniques, problem-solving skills, or positive self-talk.

Addressing underlying issues

Sometimes, intrusive thoughts can be related to past traumas or unresolved psychological issues. In counselling, individuals can explore and address these underlying factors, which may contribute to intrusive thoughts.

Support and empathy

Counselling provides a safe and supportive environment for individuals to express their feelings and experiences without judgment. A compassionate counsellor can make a significant difference in helping someone navigate their challenges.

Long-term support

Counselling provides ongoing support as individuals work through their struggles with intrusive thoughts. Regular sessions can help monitor progress, reinforce coping skills, and address any setbacks.

Suppose you struggle with anxiety and intrusive thoughts. In that case, it's essential to find a counsellor experienced in working with anxiety disorders and intrusive thoughts, as they can tailor the therapeutic approach to meet the individual's specific needs. By working collaboratively with a skilled counsellor, individuals can gain insight into their thoughts, develop coping skills, and experience reduced distress related to intrusive thoughts.

Hope Therapy & Counselling Services has an experienced team of counsellors available to support you. We can offer various types of support depending on your unique needs.

Find out more about the services we offer or book a free 15-minute telephone consultation.

The views expressed in this article are those of the author. All articles published on Counselling Directory are reviewed by our editorial team.

Share this article with a friend
Wantage OX12 & Rickmansworth WD3
Written by Hope Therapy & Counselling Services, Offering Counselling, CBT, Hypnotherapy, EMDR & Mindfulness.
Wantage OX12 & Rickmansworth WD3

Driven by a vision to create a safe and nurturing space for individuals seeking support, Hope Therapy & Counselling Services was born. A handpicked team of skilled and highly compassionate counsellors with a shared commitment to helping others. Together, they work collaboratively to provide comprehensive, tailor-made counselling support.

Show comments

Find a therapist dealing with Anxiety

All therapists are verified professionals

All therapists are verified professionals