If you have arrived at this post, it might be that you are experiencing intrusive thoughts. You might know that intrusive thoughts are related to obsessive-compulsive disorder (OCD), and you want to know how normal it is to experience intrusive thoughts or when an intrusive thought is normal and when it becomes pathologic.
It might surprise you to discover that intrusive, unwanted thoughts, images, or impulses are extremely frequent in the general population. Numerous studies have verified that the majority of nonclinical people (80-90%) experience, at least occasionally, these types of thoughts that are comparable in content to the obsessions people with OCD have (Purdon & Clark, 1993; Freeston, et al., 1991; Clark, & Rhyno, 2005; Rachman & de Silva, 1978).
Hence, this body of research suggests that intrusive thoughts are universal and that the content of these thoughts is not what makes a thought problematic. If someone asks if it is normal to have thoughts of, for example, killing someone, or jumping into a train platform before the train is arriving, the answer is yes, anyone can have these thoughts. However, while this same thought is harmless by itself, it can become pathological in some people.
Difference between normal and abnormal obsessions
You might ask then, what is the difference between OCD thoughts and non-pathological intrusive thoughts? Having unwanted intrusive thoughts are distressing for most individuals, whether they have OCD or not. However, the main distinction between people with OCD and nonclinical individuals is that the person with the disorder evaluates these intrusive thoughts more negatively, responds to them more strongly, and perceives less control over them.
In his book “Cognitive-behavioural Therapy for OCD”, Clark (2004) explains using this table the criteria for distinguishing between normal and abnormal obsessions:
|Normal mental intrusions||Obsessions in OCD|
|Less frequent||More frequent|
|Less unacceptable/distressing||More unacceptable/distressing|
|Little associated guilt||Significant feelings of guilt|
|Less resistance to the intrusion||Strong resistance to the intrusion|
|Some perceived control||Diminished perceived control over the obsession|
|Considered meaningless, irrelevant to the self||Considered highly meaningful, threatening important core values of the self|
|Brief intrusions that fail to dominate conscious awareness||Time-consuming intrusions that dominate conscious awareness|
|Less concern with thought control||Heightened concern with thought control|
|Less emphasis on neutralizing distress||Strong focus on neutralizing distress associated with the obsession|
|Less interference in daily living||Significant interference in daily living|
OCD obsessions are more frequent and perceived as unacceptable and upsetting, with a less perceived sense of control than nonclinical intrusions. People with an obsessive disorder believe that these thoughts have a meaning and that they are a threat to the self and its values, while the nonclinical population assigns no meaning to them, as they don’t believe those thoughts say anything about themselves, and as a result, they can let them go. Clinical obsessions are more strongly avoided and resisted, increasing the likelihood of the use of maladaptive thought control techniques.
When an intrusive thought becomes an obsession?
Two things can happen when someone has intrusive thoughts. Either the person doesn’t give the thought any relevance and can let it go, or the person will assign a negative meaning to the thought and will perform actions to try to control it, which can develop into an obsessive disorder.
Certainly, different cognitive-behavioural theories explain the development of OCD, but all of them agree that for developing an obsession, it is necessary two things: 1) evaluate a mental intrusion erroneously and 2) attempt to control the intrusion or neutralise the distress or predicted negative consequences related with the thought. Together, faulty evaluations and the use of compulsions, neutralisation or other control techniques are the cause of the escalation of intrusive thoughts into obsessions.
Faulty evaluations of the intrusive thought
The different cognitive-behavioural theories differ on which faulty evaluations are more characteristic of OCD. Nevertheless, these six belief domains have been proposed to explain the disorder (Clark, 2004):
|Inflated responsibility||The belief that one has power which is pivotal to bring about or prevent subjectively crucial negative consequences.|
|Over importance of thoughts||Beliefs that the mere presence of a thought indicates that it is important.|
|Overestimation of threat||An exaggeration of the probability or severity of harm.|
|Importance of controlling thoughts||The overvaluation of the importance of exerting complete control over intrusive thoughts, images, and impulses, and the belief that this is possible and desirable.|
|Intolerance of uncertainty||Beliefs about the necessity of being certain, the personal inability to cope with unpredictable change and difficulty in functioning in ambiguous situations.|
|Perfectionism||The tendency to believe there is a perfect solution to every problem, that doing something perfectly is possible and necessary, and that minor mistakes will have serious consequences.|
In conclusion, yes, it is normal to have intrusive and unwanted thoughts. Evaluating an intrusive thought from the lenses of these six domains, together with maladaptive efforts to control the intrusion is the difference between a normal intrusive thought, and an intrusive thought that becomes an obsession.
If you struggle with intrusive thoughts and think you might have OCD and want therapy for OCD, contact us, we can help!
Clark, D. A. (2004). Cognitive-behavioral therapy for OCD. Guilford Press.
Clark, D. A., & Rhyno, S. (2005). Unwanted Intrusive Thoughts in Nonclinical Individuals: Implications for Clinical Disorders. In D. A. Clark (Ed.), Intrusive thoughts in clinical disorders: Theory, research, and treatment (pp. 1–29). The Guilford Press.
Freeston, M. H., Ladouceur, R., Thibodeau, N., & Gagnon, F. (1991). Cognitive intrusions in a non-clinical population. I. Response style, subjective experience, and appraisal. Behaviour research and therapy, 29(6), 585–597. https://doi.org/10.1016/0005-7967(91)90008-q
Purdon, C., & Clark, D. A. (1993). Obsessive intrusive thoughts in nonclinical subjects. Part I. Content and relation with depressive, anxious and obsessional symptoms. Behaviour research and therapy, 31(8), 713–720. https://doi.org/10.1016/0005-7967(93)90001-b
Rachman, S., & de Silva, P. (1978). Abnormal and normal obsessions. Behaviour research and therapy, 16(4), 233–248. https://doi.org/10.1016/0005-7967(78)90022-0
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