Psychosomatics of intrusive thoughts
Intrusive thoughts are unwanted, unpleasant thoughts, images or urges that keep coming into your mind and cause anxiety. According to the NHS, in obsessive compulsive disorder (OCD) they come with repeated actions that bring temporary relief from the anxiety. It does not mean you are "going mad" and it is not your fault. Treatment exists: cognitive behavioural therapy and, if needed, medicine. The Ladder method does not replace a doctor.
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When to see a doctor
A general doctor first, then a psychiatrist or a therapist who works with cognitive behavioural therapy. The doctor will ask about your thoughts and actions, see how they affect your life and choose a treatment. There is nothing to be ashamed of: it is a health condition like any other. If a child or teenager close to you has such thoughts, they need a doctor too.
In the Ladder method
In the Ladder method, intrusive thoughts are not explained as "you are a bad person" or "you think too much". It is not your fault and you are not "going mad": a doctor and a therapist deal with this. Questions to yourself belong next to treatment and do not replace it.
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In the method, thoughts that go round in circles suit the image of fear of making a mistake and a wish to keep everything under control: what are you afraid of if you do not check once more? It is an image, not the cause of the disorder.
On the ladder this shows up as the steps "I have no right to a mistake" and "if I do not control it, something bad will happen". You can work through them while treatment goes on.
These are questions for reflection, not an explanation of what causes the condition and not a treatment.
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How it shows up
Book a doctor’s appointment if you notice:
- Thoughts come again and again and frighten you
- You need to check the door, the stove or the iron several times
- Rituals (counting, order, hand washing) to feel calmer
- Shame about your thoughts and secrecy
- Anxiety, tension and poor sleep
- The thoughts take a lot of time and get in the way of life
What medicine knows
According to the NHS, an obsession is an unwanted and unpleasant thought, image or urge that repeatedly enters your mind and causes anxiety, disgust or unease. A compulsion is a repetitive behaviour or mental act that you feel you need to do to temporarily relieve those feelings. For example, checking all the windows and doors are locked several times before you leave the house.
If intrusive thoughts and actions keep coming back and get in the way of your life, it may be obsessive compulsive disorder (OCD). It can affect men, women and children and often begins around puberty and early adulthood. Many people put off seeing a doctor out of shame, but OCD is a health condition like any other: it does not mean you are "mad" and it is not your fault.
Women can also get OCD during pregnancy and after giving birth. The thoughts may be about harming the baby or not sterilising feeding bottles properly, and the compulsions may be checking again and again that the baby is breathing. If such thoughts keep coming back and affect your daily life, tell a doctor: they can support you and refer you to a specialist (NHS).
Treatment helps. It is cognitive behavioural therapy (CBT), which teaches you to face your fears and obsessive thoughts without "putting them right" through compulsions, and, if needed, a type of antidepressant medicine. The NHS writes that OCD is unlikely to get better without proper treatment.
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Frequently asked questions
What are intrusive thoughts?
According to the NHS, they are unwanted, unpleasant thoughts, images or urges that repeatedly enter your mind and cause anxiety. When they come with repeated actions that bring temporary relief from the anxiety, a doctor may speak of OCD.
Are intrusive thoughts an illness?
Unwanted thoughts on their own happen to many people. A doctor speaks of a disorder when thoughts and rituals keep coming back and get in the way of life. OCD is a health condition like any other, not a weakness and not a fault (NHS). A doctor can assess it.
How do I get rid of intrusive thoughts?
The NHS writes that OCD is unlikely to get better without proper treatment. Cognitive behavioural therapy and, if needed, medicine help, so start with a doctor or a therapist. In the Ladder method you can, next to treatment, ask yourself what you fear a mistake would mean, and this does not replace a doctor.
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Answers to common questions
Psychosomatics does not replace tests and treatment. Only a doctor can make a diagnosis.