Intrusive thoughts in OCD can feel disturbingly real because your brain treats imagined threats as if they’re happening right now. The more you try to prove the thought wrong or make it go away, the more convincing it becomes. Learning to relate to these thoughts differently and to allow them to be there rather than fighting them is often what brings about real change.
Believe me, I should know, my name is Nova Sutton and before setting up Obsessless Therapy and becoming an online therapist for OCD; I personally overcame my own struggles with OCD & anxiety.
Table of Contents
– Why do intrusive thoughts feel so real?
– What’s actually happening in the brain?
– A personal story: from fear to understanding
– How intrusive thoughts take hold (and how to loosen their grip)
– What actually helps: evidence-based strategies that work
– Quick recap and next steps
– FAQ
Why do intrusive thoughts feel so real?
Because your brain can’t easily tell the difference between a real danger and a vividly imagined one.
When you experience an intrusive thought, say, a sudden image of harming someone, shouting something inappropriate, or losing control, it can trigger the brain’s threat system as if the danger is genuine. The body reacts with anxiety, guilt, or dread, reinforcing the belief that the thought must mean something.
It’s a bit like watching a horror film. You know you’re safe on the sofa, but your heart still races and your palms sweat. The brain’s emotional circuits don’t wait to check if the threat is real, they just react.
In OCD, this reaction can also get tangled up with doubt and moral responsibility.
The mind starts to ask: “What if this thought means I secretly want it?” or “If I can imagine it, maybe I could do it.” That moment of uncertainty pulls you into the OCD loop.
What’s actually happening in the brain?
OCD amplifies doubt by confusing possibility with probability.
Brain imaging studies suggest that people with OCD often have heightened activity in the error detection and moral reasoning areas of the brain (the anterior cingulate cortex and orbitofrontal cortex). This activity is thought to make the brain becomes over-alert to anything that could go wrong-even if it’s purely hypothetical.
When an intrusive thought appears, the OCD brain doesn’t just let it pass. It treats the thought as something significant that needs to be examined. The “what if?” feeling that follows can end up being used as evidence that the fear matters, even when the fear itself isn’t based on what’s actually happening.
You might think: If I keep checking or analysing, I’ll find certainty and finally calm down. But this is the trap. Each attempt to neutralise the thought through reassurance, research, or mental review can reinforce the pattern, as shown in cognitive behavioural studies of checking and reassurance seeking teaching the brain that the thought is important and needs to be checked again next time.
A personal story: from fear to understanding
Years ago, I was sitting on a packed flight when a thought flashed through my mind: What if my thoughts made this plane crash? My stomach dropped. I gripped the armrest, terrified that I’d somehow lose control and cause a disaster.
For months, I obsessed over what that thought meant. A stream of anxious questions ran through my head: “What if I actually want the plane to crash?” “What kind of person even thinks that?” I read forums, replayed moments, and tried to counteract every bad thought with a “safe” one. It felt like I was walking on mental eggshells.
Eventually, in therapy, I learnt that the thought itself wasn’t the problem; it was the meaning I kept giving it. My mind had turned it into something that needed analysing, proof, control. The more I tried to fix it, the more real it felt.
With gradual practice, I stopped trying to prove what the thought did or didn’t mean. Instead, I let it exist without reacting to it. Over time, the fear eased, not because the thoughts disappeared, but because they stopped controlling what I did.
That’s when recovery began to feel possible.
How intrusive thoughts take hold (and how to loosen their grip).
Intrusive thoughts can feel “sticky” because OCD links emotion, reasoning, and the need for safety. They might appear as sudden thoughts, images, urges, or memories, sometimes about random things, and sometimes about situations that feel grounded in, or linked to, real experiences.
Here’s how the cycle often takes hold:
- A random or distressing thought, image, urge, or memory appears. It might seem completely out of place, or it might relate to something that feels real or familiar.
- It sparks a strong emotional reaction. Fear, guilt, anger, disgust, shame, or confusion can be common.
- You start analysing. “Why did that happen? What does it say about me? Did I do something wrong? Do my feelings mean it’s true?”
- You look for certainty or relief. This might mean checking, asking for reassurance, replaying the event in your mind, avoiding reminders, or trying to push the thought away.
- Relief comes, briefly. Then the doubt or fear returns, and the cycle starts again.
Each time this happens, your brain learns: “These thoughts or memories must be important, better keep checking them.” Over time, this compulsive loop can start to make the thoughts feel even more convincing and urgent.
The aim of treatment isn’t to stop intrusive thoughts or memories, everyone has them. The work is about changing how you respond when they appear.
What actually helps: evidence-based strategies that work
When intrusive thoughts strike, it’s natural to want instant relief. But lasting change often comes from building a different relationship with those thoughts, rather than trying to fight or neutralise them.
Below are five practical, evidence-based strategies used in therapies such as Exposure and Response Prevention (ERP), and Acceptance and Commitment Therapy (ACT).
- Name what’s happening, without judging it
Instead of asking, “Why did I think that?” try noticing: “Ah, that’s an intrusive thought about harm/control/purity/etc.”
Giving it a label separates you from the mental event. It’s the difference between being in the storm and watching the storm. You’re not analysing or reassuring, just naming.
This helps the brain see the thought for what it is, an internal event that doesn’t need to be answered or fixed.
2. Drop the detective work
OCD pushes you to look for the “right” answer, promising that certainty will ease your anxiety. It might bring brief relief, but another doubt usually follows.
When the urge to review, test, or replay appears, pause and note, “This is my brain looking for certainty again.” Then redirect your attention to what you were doing, even if uncertainty remains.
The aim isn’t to feel sure, it’s to practise carrying on without resolution. Over time, the brain learns that it doesn’t need to keep sending alarms when you stop engaging with them.
3. Use curiosity, not control
Rather than trying to suppress or analyse a thought, turn your attention to what’s happening in the present moment. Notice the sensations that come with it: where do you feel it in your body? What emotion shows up first?
This approach shifts your focus from solving the thought to observing the experience. It trains the mind to stay with what’s happening now, instead of disappearing into mental “what ifs.” Over time, this reduces compulsive checking and builds tolerance for uncertainty, a key part of recovery.
4. Try “micro-exposures” in daily life
ERP (Exposure and Response Prevention) is often misunderstood as diving straight into worst-case scenarios. In practice, it can begin with very small steps.
If you usually avoid knives because of intrusive harm thoughts, a micro-exposure might simply mean standing near a knife and noticing the urge to move away, then practising not acting on that urge. Over time, this could build up to more direct contact, like touching the handle or chopping food for a short time.
The aim isn’t to feel calm or fearless. It’s to let the discomfort rise and fall naturally, teaching your brain that anxiety can be present without danger or action.
A therapist experienced in ERP can help you break this process into manageable stages, so you build tolerance and confidence at a steady, realistic pace.
5. Give OCD a character
A touch of humour can take some of the intensity out of fear. Try picturing your OCD as an overzealous security guard, loud, anxious, and convinced you’re always one step away from disaster.
When intrusive thoughts start, you might say to yourself, “Thanks for the warning, but I’ve got this.” That small bit of distance breaks the habit of responding with urgency or guilt.
Humour doesn’t dismiss the difficulty of OCD; but it can help you step outside it for a moment, see it more clearly, and take back a little control.
Quick recap and next steps
- Intrusive thoughts can feel real because the OCD brain often treats imagination as evidence.
- Trying to prove or disprove them only makes them stickier.
- Naming, noticing, and allowing uncertainty help loosen their grip.
- Small, consistent changes in how you respond can make a meaningful difference over time.
If this resonates, you might like to download my free Defuse from Intrusive Thoughts guided audio for OCD. It’s a free resource designed to help you pause the mental tug-of-war and reconnect with a steadier sense of awareness.
You can also book a free online OCD therapy consultation if you’d like structured support.
FAQ
Q: Are intrusive thoughts normal?
Yes. Everyone has strange or upsetting thoughts from time to time. In OCD, the difference is how much meaning and attention the mind gives them.
Q: Do intrusive thoughts mean I secretly want the thing I fear?
Intrusive thoughts usually focus on what matters most to you, your values, relationships, or sense of safety. The distress they bring tends to reflect fear, not desire.
If these thoughts are frequent or hard to manage, it can help to work with a therapist who has experience in OCD treatment, such as one trained in Exposure and Response Prevention (ERP). They can support you in learning new ways to relate to the thoughts and reduce their impact over time.
Q: Will these thoughts ever go away completely?
For many people, they fade as you change your relationship with them. Even if they return occasionally, they can lose their power when you no longer respond with fear or analysis.
Q: What kind of therapy helps most?
ERP (Exposure and Response Prevention) is the gold-standard, first-line treatment for OCD, supported by decades of research. Other therapies such as ACT (Acceptance and Commitment Therapy) and I-CBT (Inference-Based CBT) also have growing evidence and can complement ERP, or serve as alternatives where suitable. You can learn more about these treatments on the NHS website or through organisations like OCD-UK.
Author Bio:
Nova Sutton is an online therapist who runs Obsessless Therapy, an online portal to help people struggling with obsessive compulsive disorder. Like many of the people she now supports, she once found herself trapped in cycles of obsessive thoughts and compulsive behaviours that felt impossible to break.
